rosenhann 1973 classic study

Question 1

what is the background of rosehans study

Answer 1

relates to issues surrounding the use of DSM and its reliability (does every doctor come to the same conclusion) and validity (are the doctors consistently choosing the right illness) as well as issues surrounding defining “abnormality”

Question 2

what is the aim of the rosehan study

Answer 2

• to investigate whether 8 sane people would be diagnosed with a mental disorder and admitted in 12 different hospitals and whether they would be recognised as sane
• a further aim was to experience what it is like to be in such an institution and what is felt like being labelled as ‘insane’

Question 3

what is the method of the rosehan study

Answer 3

• 8 pseudo-patients with no schizophrenia symptoms, 3 women and 5 men
• 1 was a 20 year-old graduate, a house wife, a painter, paediatrician, a psychiatrist and 3 psychologists
• 12 hospitals were in 5 different states in the US and varied in character
• the pseduo patients went to clinical interviews and reported their symptoms of hearing voices that were unclear but seemed to be saying empty or hollow
• other than changing their identity, they recalled details of their own life so behaviour was not pathalogical
• 7 were diagnosed with schizophrenia and 1 was diagnosed with manic depression
• when they were admitted to hosptial they started behaving normally and stopped hearing voices, they took a notepad and pen along with them and recorded what they heard and saw
• they secretly disposed of any medication they were given but otherwise were friendly and polite and did everything that was asked of them - “paragons of cooperation”

Question 4

what is the results of the rosehan study

Answer 4

• the pseduo patients were never detected, evidence was strong that once labelled schizophrenic the pseudo patients were stuck with that label
• the patients spent 19 days in the hospital, after which they were discharged with schizophrenia in remission

Question 5

what was found about the hospital environment in rosehans study

Answer 5

• the staff spend only 11.3% of their time outside the cage ( secure area with glass windows) and much of this was doing chores rather interacting with patients
• doctors only came onto the ward on average 6.7 times per day, those with the most power had the least to do with the patients

Question 6

what was found about the powerlessness and depersonalisation in rosehans study

Answer 6

• staff would not make eye contact with patients, the patients weren’t treated as persons, they felt invisible
• there were no doors on toilet cubicles and staff would inspect their medical records and personal belongings without asking permission - no privacy
• they observed that other patients would not take their medication - this was unnoticed by staff

Question 7

describe procedure 2 in rosehans study

Answer 7

staff at a teaching hospital doubted the findings of the first study, so rosehan told them that sometime in the next 3 months one or more pesudo patients would attempt to be admitted

Question 8

what are the results for procedure 2 in rosehans study

Answer 8

• 193 patients arrived at the hospital where 83 of these patients were rated as pseudo patients by at least 1 member of staff, psychiatrist or both
• rosehan sent no pseduo-patients fin the follow on study, so all the patients seeking admission within the 3 month period were genuine

Question 9

what is the conclusion of the rosehan study

Answer 9

• the sane can not be distinguished from the insane in the psychiatric hospital
• in such an environment, patients feel powerlessness, depersonalisation and segregation
• once labelled patients find to escape such labels and be judged as normal

Question 10

what are the advantages of the rosehan study

Answer 10

• the study is reliable
• by using 8 people in 12 hospitals the study was able to be replicated and the same results were found so therefore results can be regarded as reliable
• Slater attempted to replicate Rosenhans study by presenting herself at 9 psychiatric emergency rooms
• her symptoms was an isolated auditory hallucination (hearing the word thud)
• slater was given a diagnosis of psychotic depression and prescribed antipsychotics or antidepressants
• shows that the study can be replicated and will still produce the same results so its not time-bound

Question 11

what are the applications of the rosehan study

Answer 11

• the study had a huge impact on mental health care, not just in america but worldwide
• caused psychiatric hospitals to review their admission procedures and how they trained their staff to interact with patients
• today the study is a compulsory part of training in psychiatric medicine and nursing
• along with Spitzers criticism, the study was a major influence of reforming the DSM

Question 12

what are the disadvantages of the rosehan study

Answer 12

• the study is ethnocentric so is not generalisable to the wider-population
• 12 is a small sample for a country as big as the USA
• the study was based in america which makes it hard to generalise to hospitals around the globe
• which may have better or worse hospital conditions