Rosenhan 1973 Classical Flashcards
Rosenhan 1973
aim
Can psychiatric testing accurately tell normal from abnormal psychiatric States
To highlight the negative effects of diagnosis as abnormal and institutionalized
Normal behaviour is defined as being distinct from abnormality that competent practitioners can readily recognize it
Rosenhan 1973
Sample
8 participants 5m 3f aged 20-70 (was 9 but 1 breached protocall and was excluded) including Rosenhan (who was the only one that an hospital knew was coming (the otger 7 didnt know abt the study))
Five of these people had previously worked or engaged with either psychology or psychiatry
Four of the remaining eight participants the first round of hospitals went on to go to the other four hospitals
12 hospitals on the east and west coast of the United States of America one of which was privately funded and some were Shabby quality
Rosenhan 1973
Iv und DV
IV = the hospitals that they are at
DV = the diagnosis and the observations of the nurses psychiatrists and staffs interactions
Rosenhan 1973
1 Procedure 1/2
Participants set up an appointment under a false name and occupation
at this appointment they claim they could hear unfamiliar voices from the same sex that were saying “empty” and “hollow” and “thud”
Upon admittance to the hospital participants stopped acting these symptoms
in the psych Ward participants engaged with patients and staff as they would do in everyday life
when asked how they were feeling they said they were fine and no longer experienced any symptoms
they received but flush down the toilet prescribed medication
they recorded observations such as describing the experience regarding the ward the staff and the patients
participants were discharged when staff saw it fit
four participants repeated this process at four other hospitals
Rosenhan 1973
1 procedure 2/2
There were two further breaches of protocol
however this did not result in their exclusion
two people reveal that they work in psychology to staff
and one attempted to romance with nurses
and gave psychotherapy to the other patients however nobody gave a s***
4/12 hospitals staff responded to questions reparticipant such as
asking them asking when will the staff meeting is
or when they were like to be discharged
participants only asked any one member of staff one thing per day never twice and the responses were recorded
Participants contacting staff were overwhelmingly ignored at the 4 hospitals
in 6/12 hospitals staff contact time was measured
times ranged between 3.9-25.1 minuites
mean= 6.8 min
Rosenhan 1973
2nd study procedure
At a secret research test hospital in a secret location
Staff were aware of the first to these results and there were informed that one or more participants Who will act similar to the previous studies may attempt to gain access in the following three months
staff would rate each patient on a 10-point scale from most likely to be a pseudo patient at 1 to least likely at 10
0 participants were sent to the hospital at all scores were obtained from 193 patients
41 patients were judged highly likely to be pseudo patients
Rosenhan 1973
Results 1/3
Exp 1
There were 11 diagnosis of schizophrenia and discharged with this diagnosis
and 1 diagnosis of manic depressive psychosis
Even after the participants stopped acting symptoms diagnosis were not reversed as it was not identified that in any of these 12 hospitals but this was a type 1 error
Due to this it was concluded that there is an overlap between sane and insane behavior
this is evident by the fact that without the psychotic diagnosis the behaviors shown by ppts would be attributed to regular activities such as being bord or being a writer
however within the context of the diagnosis they would be considered insane and abnormal behavior
Showing how much they overlap
Meaning that the first aim of the study to determine if psychiatric testing can accurately tell normal from abnormal psychiatric States was found to be untrue because of this overlap
Rosenhan 1973
Results 2/3
Participants state of the hospital between 7 to 52 days
the mean amount of days of 19
the nurses reported participants were friendly cooperated and had no abnormal indications
2.94% of the 1468 recorded participants psychiatric staff interactions included verball engagement
In the 6/12 hospitals where staff contact time was recorded
it was 3.9-25.1 min
mean: 6.8 min
in the 4/12 hospitals questions asked to staff were recorded there was a overwhelmingly majority of the participants were ignored by the staff
the interactions in 4/10
move head, eye contact, pause and chat, stop talking
Psychiatrist 71 23 2 4
nurse 88 10 4 15
Rosenhan 1973
results 3/3 and Rosenhans conclusion
in the second study out of the 193 patients that were scorred to be pseudo patience
zero were actually pseudo patients and
41 were highly suspected to be
Rosenhan concluded:
it is clear we cannot distinguish the sane from the insane in psychiatric hospitals
the hospital itself imposes a special environment in which the meanings of behavior can easily Be Misunderstood
Rosenhan 1973
Generalisability +
• The used a Large variety of Hospitals and Sex of ppts so its Generalisable
• it took place in 12 hospitals over 5 states on 2 coastsbof the USA, of varying quality, one of which was privatly funded
this means that it is Generalisable to many types of Hospitals
• psudeo pattients consisted of 8 overal, 5 male and 3 female
this makes the results that hospitals were unable to distinguish Sane and insane behaviour in both male and female patients in hospitals of varining quality and funding in the United States, Generalisable to those groups and places within the General population
Rosenhan 1973
Generalisability -
• Ethnocentric
• Took place in 12 hospitals in 5 states of 2 coasts Of THE USA
• therefore meaning the results that Hospitals cant distinguish between Insane and Sane behaviours cannot be Generalised to Hospitals in Other countrys and cultures, making Rosenhan 1973 Ethnocentric and Low in Generalisability
Rosenhan 1973
Reliability +, Standardised Procedure
Rosenhan’s 1973 study is Reliable due to having a standardised procedure:
• Pseduo Patients claimed they had abnormal psychotic symptoms (hearing Unfamiler same sex voices say: Thud, Hollow and Empty)
• upon administration the acted Symptoms were stopped and they acted as they would everyday, making observations of Staff and Other patients and in 4/10 hospitals recording Daily interactions with staff (psychiatrists and nurses)
and in 6/10 hospitals recording their contact time with staff
• the staff then diagnosed them ususaly after on average 19 days.
Due to this standardised procedure Rosenhan’s Study can be Replicated by other researchers with ease!
making it Reliable
Rosenhan 1973
Reliable +, consistant diagnosis
• Rosenhan’s study had good reliability as the Diagnosis given by the 12 hospitals for the same psychiatric symptoms
• in 11/12 hospitals the pseudo patients were diagnosed with SZ
• this shows the studies results were reliable as they were consistant
Rosenhan 1973
Reliability -, Standardised procedure was broken
• the standardized procedure was only loosely followed
• two psedo patients had revealed themselves to be psychologists and one even trying to have relations with nurse and give psychotherapy to fellow patients
• meaning that if the study was replicated it’s result a less likely to be found is these two patients still had their results counted in the final results
• procedure was broken it wasn’t what got the original results of the 11 false schizophrenia diagnosis so if a study follows the procedure it’s less likely to show the studies results
• and if they do find the results it will not be due to the standardized procedure but another factor
• therefore due to the standardized procedure being broken it cannot be 100% validly used in support of the studies reliability in terms of replicability
Rosenhan 1973
Reliability -, research follows procedure dosnt get sane results
(Lauren Slaters 2004)
and a weakness of this
• the study was repeated by Lauren Slater’s in 2004
• she went to 9 psychiatric hospitals and stated she had auditory hallucinations
• and was diagnosed with psychotic depression and given antidepressants
• so they failed to get the same results of schizophrenia diagnosis
• meaning the study was replicated however it found different results which is evidence against its reliability
• HOWEVER
• Lauren Slater’s could not prove that she had actually completed this experiment as she have no evidence that suggested that she had she had only mentioned it in a book
Rosenhan 1973
application
Rosenhaan study highlights the issues with the accuracy of procedures of diagnosis of mental illnesses
• it’s raised concerns on the extensive use of medication
• and furthermore hospitals of force to address contact time between the staff and the patients
• this study therefore bought light to the floors and issues of diagnosis procedure allowing for it to develop and change into a more effective and efficient system
Rosenhan 1973
Context affects Diagnosis and behaviour perception
Int val -
• clinicians wouldn’t expect those presenting there’s apparently mentally ill not to be so due to the context of being admitted to a psychiatric hospital so the idea that they were mentally ill was taken as the truth and challenging this behaviour/ diagnosis perception was not thought of
• therefore due to the context of being in 12 Mental psychosis hospitals the null hypothesis of the patients not actually being mentally ill would be less likely to be considered
• this is a confounding variable that reduces the link between the cause (which is the behaviour) and effect (which is a schizophrenia diagnosis)
• that leads to the study having low internal validity
Rosenhan 1973
Qualitive data used was Objective In Val +
The qualitative data collected for Rosenhan’s study including:
the interaction times between staff and patients
and the number of patients that received a schizophrenia diagnosis
and the number of certain interactions recorded between the patients and the staff
and in experiment 2 the number of patience deemed to be highly likely to be a pseudo patient
ect.
these sets of quantitative data can only be objectively analyzed
as it is very difficult to challenge the meaning of high or low values of quantitative data as usually they can only have one meaning
Therefore meaning that due to the use of this quantitative data the analysis of this data is not prone to experimenter bias
therefore allowing for the link between the cause (which is the behavior) and the effect (which is the diagnosis) to be accurately established
therefore meanings overall this study has high internal validity
Rosenhan 1973
High eco
The city is high ecological validity as it took place in real Psychiatric hospitals
that were unaware they were appart of the study (exept the one Rosenhan went to)
therefore the behaviour and interactions observed would be natural
making the findings Valid
as the Natural observed behaviour would be likley to occur again in real life, as it dud
giving the study high ecological Validity
Rosenhan 1973
high mundane realism
The study had High mundane realism
due to participants being administered to real psychiatric hospitals and going through the real life psychiatric hospital process
of being assessed by Hospital Staff over a few days before being diagnosed
therefore meaning that the studies tasks reflect those of real life giving it high mundane realism
Rosenhan 1973
Objectivity of Pseudo patinets may be affected -iV
During time at the hospital a rapport may have been formed between them and the staff
meaning it is likely that observations of the staff may have been more subjective
in their reports of their behaviors they may describe them as being helpful to all of a patients there, with long and clear explanations from their questions they asked
when reality the staff may have simply given short yes or no answers
this affects the validity of the data collected in the study as the observations may be untrue and therefore making the study overall invalid
Rosenhan 1973
Lack of temporal validity - gen, IV and Reliability
Due to the study taking place in 1973 and the Hospital Staff using the dsm
it is likely that the results of the studies not representative today
as now hospitals use the dsm 5 and therefore may not be able to reach the same diagnosis or treatments as showed in the original study
Therefore lowering the internal validity as the results of the study that hospitals cannot differentiate between sailing in the same behavior cannot be applied today due to the difference system of diagnosis being used
It also shows how the study is low in reliability as due to the system of diagnosis changing
means the study cannot be replicated
as the procedure of diagnosis in the hospitals is different to what it was in 1973 due to the dsm-5 being used now and not dsm2
It also shows how the study has low generalizability
as the study’s results cannot be generalised to modern hospitals and staffs and patience
as again the procedures of diagnosis and the hospitals and staffs training themselves have changed since 1973
Rosenhan 1973
Ethics -
Rosenhall 1973 has low ethics
as the pseudo patients were held forcibly even though they gave consent but they could not withdraw at any time
doctors and nurses involved were deceived as they did not know they were partaking in the experiment and couldnt give consent
Time was taken away from the people who were actually mentally ill
and pseudo patients suffered distressed and mistreatment in the hospitals and were not protected from mental harm
This shows how rosin Hahn study was highly unethical as it broke many ethical guidelines
Rosenhan 1973
Ethics +
Despite the ethical issues many of them were necessary
While is true sometime may be taken away from the mentally ill this may not be the case as on average pseudo patients only had staff interactions for about 6.8 minutes per day
Pseudo patients may not have been able to withdraw at any time due to them being in a hospital however they did give their consent and knew that this may be the case
Doctors and nurses may have been deceived and not being able to give consent to the study
however they had to be deceived otherwise the study would not have been able to be conducted validly and the results may have been affected by demand characteristics and social desirability bias (e.g re diagnose when realise normal behaviour)
Finally the massive impact of the study helping to encourage the improvement of psychological treatments standards means that the ethical issues are outweighed by the positives
Meaning of overall rosenhan study could be considered ethical
