Rosenhan (1973) Flashcards
What are the aims of Rosenhan (1973)?
To see if the sane can be distinguished from the insane using the DSM classifications system and if they can be differentiated, how sanity can be identified
How many pseudo-patients were there in Rosenhan?
8 pseudopatients
They went to 12 different hospitals
Describe the pseudopatients in Rosenhan
Range of ages and occupations
(3 psychologists, a paediatrician, a psychiatrist, a painter, a housewife and a psychology graduate)
They gave false names and occupations (if their true occupation involved mental health)
Describe the hospitals used in Rosenhan
12 hospitals
They were located in 5 states on the East and West Coast of America and were different.
Some were old/shabby with others being newer, some were research-based, some had good staff-patient ratios and some were underfunded.
What did the pseudopatients do at their first appointment in Rosenhan?
They said they heard voices.
They said most of the time they were unclear but that they could make out the words: “hollow” “empty” and “thud”.
The rest of the information they gave about themselves during the appointment was accurate and true
What did the pseudopatients do once they had been admitted? (Rosenhan)
They stopped showing abnormal behaviour and symptoms
They did as they were asked and took notes
(at first, this was covert but once they realised no one cared, they did it in public areas)
What are the results of Rosenhan?
All but 1 pseudopatient was admitted with schizophrenia
(the other was diagnosed with manic depression, now known as bipolar disorder)
The average stay in the hospital was 19 days
(range 7 to 52 days)
All pseudopatients were discharged with schizophrenia in remission
Normal behaviour was reported in a pathological way
(Pacing up and down due to bordem was recorded as nervous behaviour. Note taking was recorded as ‘obsessive writing behaviour’)
Explain the follow up study for Rosenhan
A hospital that had heard about the results believed they would not make these same mistakes.
They were informed that at some point in the next 3 months, 1 or more pseudopatients would attempt to be admitted.
The staff were asked to rate each patient according to the likelihood that they were a pseudopatient.
41 patients out of 193 were suspected by at least 1 member of staff
No pseudopatients attempted to be be admitted
What is the conclusion of Rosenhan?
Rosenhan conducted that staff were unable to distinguish between the sane and the insane.
The ‘stickiness of diagnostic labels’ had important implications for society as once someone has been diagnosed, everything they do is seen as abnormal behaviour.
Evaluate the generalisability of Rosenhan
Strength:
It had a large sample size as it took place at 12 hospitals and so a large number of staff would have been involved
Not androcentric
Weakness:
It was ethnocentric to USA and some counties may have experienced different situations or may use the ICD instead
Some cultures may not have seen ‘hearing voices’ as mental illness
Evaluate reliability in Rosenhan
There was a standardised procedure as all pseudopatients said the same thing at the initial appointment
(but this did stop once they were admitted)
They collected both quantitative data (days admitted for etc) and qualitative data (notes/observations from pseudopatients)
Evaluate the validity of Rosenhan
Ecological and Task Validity
All the staff worked at these hospitals and were just acting as normal doing their everyday jobs
The staff believed they were real patients and so treated them as such
Evaluate the ethics of Rosenhan
Hospital staff were deceived about the pseudopatients and wouldn’t expect people to lie
This could have asked time, effort and money away from patients that truly needed the help
The follow up study may have caused people to be turned away that needed help
The pseudopatient may have been distressed as it was difficult to be discharged.
Even though they were told not to swallow medication, they had no control over whether they’d be forced to as they were believed to be real schizophrenics.
However, real identities weren’t used and so the pseudopatients wouldn’t face any problems due to a mental health record
Describe the application of Rosenhan
It led to pressure to revise and improve the accuracy of diagnosing and classifying mental health disorders
However, the DSM was used and so the application may be restricted to countries that use the DSM
The study highlighted the ‘Stickiness of diagnostic labels’ and led to improvements in how people with mental health disorders are treated
