Rosenhan Flashcards
what was Rosenhan’s study called (1973)
On being sane in insane places
what was the purpose of Rosenhan’s study?
to test the hypothesis that psychiatrists cannot reliably tell the difference between those who are sane and those who are insane
Study 1: Aims
to see if 8 sane people who gained admission to 12 different hospitals would be found out as sane.
Study 1: hospitals involved
12 different hospitals in 5 different states in the USA
all hospitals varied in character (old/ new, well-staffed/ poorly staffed, private or not)
settings varied so that findings could be generalised
Study 1: facts about the pseudopatients
8 - 5 men and 3 women
. a psychology graduate in his 20s
- a painter
- 3 psychologists
all used fake names
one wanted to be discharged immediately - hospitalisation was extremely stressful (ethics)
Study 1: what voices did the pseudopatients claim to hear
voices unfamilliar but the same sex as themselves
said words ‘empty’ ‘hollow’ and ‘thud’
these words chosen because they are similar to existential symptoms
study 1: what did the pseudopatients do once they were admitted to hospital?
stopped displaying any symptoms
each pseudo-patient was told they would have to get out by convincing staff they were sane
study 1: range and average length of hospitalisation
7-52 days
average - 19 days
study 1: what did the nurses report about the pseudopatients
pseudopatients never detected
evidence that patients were stuck with the label ‘schizophrenic’ once given it
study 1: did the psychiatric patients detect the pseudo patients
that the pseudo patients did not have schizophrenia
study 1: what diagnosis were all but one of the pseudo patients given?
schizophrenia in remission
study 1: how long did the hospital staff spend outside ‘the cage’?
11%
study 1: how many pills were given during the admission of the pseudo patients?
2, 100 pills - not swallowed
study 1: what did rosenhan note about the hospitals
they were not to blame for their failure to recognise sanity
type 1 error
diagnosing a sick person as healthy
type 2 error
diagnosing a healthy person as sick
study 1: evaluate - participant covert unstructured observation
covert - increased validity - no demand characteristics
unstructured - rich qualitative data (e.g. nurse undressed in front of patients, depersonalisation) -
participant - could experience the ward from a patient perspective
study 1: evaluate the field experiement
has ecological validity whilst still manage to control variables (such as the pseudo patients behaviour)
study 1: evaluate deception of hospital staff
unethical as no consent or right to withdraw
however, confidentiality was protected - no hospitals or staff named
study 1: pseudo’s right to withdraw
rosenhan prepared lawyers to intervene to get the pseudo’s out of the hospital if they requested it
study 1: standardised procedure
pseudo’s trained to behave in the same way - reliable
however, not all pseudo’s stuck to the standardised procedure
- one struck up a romantic relationship with a nurse
- graduate asked his wife to bring in college homework - which revealed he was a psychologist
study 1: validity - Seymour Ketty (1974)
pseudo’s were faking a mental condition - doesn’t tell us how people with genuine mental conditions are diagnosed
lacks ecological validity as it is not expected that someone would carry out deception in order to b admitted to a psychiatric hospital
Study 1 - impact on society
psychiatric hospitals reviewed their admission procedures and how they trained their staff to interact with patients
impacted the reformed versions of the DSM (DSM II was in use during this study)
what error are doctors and psychiatrists more likely to make
a type 2 error rather than a type 1 error
Study 2: aim
to see if the tendency toward diagnosing the sane could be reversed
study 2: procedure
rosenhan told the hospitals that sometime in the next 3 months more pseudo’s would attempt to be admitted
each staff member asked to rate patients presenting themselves on a scale of 1-10 to reflect the likelihood of them being a Pseudo
study 2: findings
judgements given on the 193 patients admitted for psychiatric treatment
- 19 thought to be pseudo by one psychiatrist and one other staff member
- 41 judged with high confidence by at least one staff member to be pseudo
conclusions of the studies
normal behaviour interpreted in a pathological way by staff - extensive note taking didn’t cause questions by hospital staff - 3 patients had their writing diagnosed as an aspect of their pathological behaviour - ‘ patient engages in writing behaviour’
staff unable to distinguish between the sane and insane
once labelled insane then all of their behaviour is understood through this label
what did rosenhan think staff should do to understand patients
read history and similar materials to help them understand how patients experience these hospitals
what did the pseudo patients observe from the hospital staff
the staff avoided and depersonalised the patients
no privacy
what is the patients deprived of once they are admitted to the psychiatric hospital
power and legal rights