Rosenhan (1973)

Question 1

Background?

Answer 1

Research has shown that the reliability of early classification systems were very poor. Beck et al found that agreement on diagnosis for 153 patients was only 54%. This was said to be due to vague criteria for diagnosis and inconsistencies in the techniques used to gather data.

Question 2

Research Method?

Answer 2

Field Experiment, participant observation, and self report.

Question 3

Sample

Answer 3

-Psuedo patients were 8 sane people (five men, three women) who ranged in ages and occupation.

Question 4

Part One - Procedure?

Answer 4

• Sought admission to 12 hospitals across 5 different states in the USA
• Psuedo patients called the hospital and arranged an appointment at the hospital. On arrival they reported they had been hearing voices which were unclear, unfamiliar, of the same sex as themselves, and said “empty”, “hollow”, “thud”.
• Once admitted, psuedo patient behaved normally and recorded all interactions and observations in a notebook
• Psuedo patients had the responsibility of persuading hospital staff that they were sane and could therefore be discharged

Question 5

Part One - Results?

Answer 5

• All of the pseudo patients were admitted to hospital where they remained for between 8 and 52 days.
• Seven were diagnosed for schizophrenia (other diagnosed as bipolar), and when they were finally discharged, they left with the diagnosis of “schizophrenia in remission”
• Nome of the staff asked what the notes were, they assumed in was part of their illness (writing behaviour)
• Real patients detected the pseudo patients’ sanity
• The staff tended to keep themselves away from the patients except for administrative or practical duties

Question 6

Part Two - Procedure?

Answer 6

• Hospitals were informed about their diagnosis errors in the first part of the study.
• They were then warned that one or more pseudo patients would present themselves over the next three months attempting to be admitted to the psychiatric hospital. None actually did
• Each member of staff was asked to rate each patient who arrived at admissions. according to the likelihood they were a psuedo patient. S 10 point rating scale was used, with one and two reflecting high confidence that the patient was not genuine.

Question 7

Part Two - Results?

Answer 7

-Although no psuedo patients actually presented themselves, out of 193 genuine patient who attended for psychiatric treatment, 41 were judged, with high confidence, to be pseudo patients by at least one member of staff.

Question 8

Conclusions?

Answer 8

• Psychiatric diagnosis is extremely inaccurate.
• Hospitals seem to be special environments where behaviour gets easily distorted and patients treated in such a way to perpetuate any problems they may have rather than providing the kind of environment which would help and support them.
• Once a patient is labelled “insane”, all subsequent behaviour is seen int he light of the label.
• Institutionalisation in psychiatric hospitals has negative effects on interred patients.
• Mental health works are insensitive to the feelings and emotions of psychiatric patients.
• The DSM-5 has poor reliability
• The diagnosis of mental illness can be influence by the situation an individual finds themselves in.