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Rosenhan (1973) - Coggle Diagram
Rosenhan (1973)
Ethics
S: The pseudopatients, who were the researchers themselves or people instructed by Rosenhan, gave informed consent for their participation, ensuring they were aware of the nature of the study and the potential risks involved.
W: The hospital staff were deceived about the pseudopatients' symptoms being real. The doctors and nurses in the hospitals could not consent to take part or exercise their right to withdraw from the study. The other patients in the study had no possibility of consenting or withdrawing and didn't enter psychiatric hospitals in order to be in psychology research
S: Rosenhan did protect confidentiality - no staff or hospitals were named. This protected criticism towards them due to the lack of confidence already rife in Americas mental health system at the time
W: Rosenhan may be criticised for failing in a duty of care towards his own researchers - the pseudopatients. He put them in a harmful environment where they experienced tension and stress. None of them were physically abused but they witnessed physical abuse going on. They were instructed in how to avoid taking medication, but if they had been forced to take medication, it could have produced side-effects on them.
Science
S: This study was falsifiable as the hypothesis involved testing medical institutions to test their reliability and validity of diagnosis that could've been proved wrong had the pseudo patients been discovered.
W: It was a real-life experiment where each pseudopatient had to take notes on the behaviour of the staff which may have been subjective as different people may have viewed behaviours differently so results are not internally valid.
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W: The study's use of pseudopatients may introduce sample bias, as these individuals may not accurately represent the broader population of psychiatric patients. This could limit the generalizability of the findings and raise questions about their external validity.
AO1
Aim
To test the poor reliability and validity of the diagnostic classification system for mental disorders at the time by seeing whether normal (sane) people could be admitted to a psychiatric hospital based on a symptom.
To test is there are negative consequences of being diagnosed as abnormal and to raise awareness about what life inside and the conditions within a psychiatric hospital at the time
Procedure:
First, they phoned the admissions office of one of the 12 psychiatric hospitals.
- The hospitals were in a range of conditions; good/ bad, old/new, research/ private. They also varied in staff to patient ratio. Hospitals were spread across 5 states within the US
- Each researcher told the hospital they were hearing voices and asked to make an appointment.
- At the admission appointment, researcher claimed they were hearing a singular voice- They claimed it was unclear, unfamiliar, same sex as researcher and said a singular word e.g., empty, thud, hollow.
- 7 of them were admitted with a diagnosis of schizophrenia. One was admitted with manic depression with psychosis.
- When admitted each pseudo patient immediately stopped showing any symptoms and responded as normal to every instruction apart from taking medication. They all claimed they were fine and experiencing no symptoms
- Within the hospital, the researchers had to record and observe their own and other patients' experiences and seek release by convincing staff they were sane.
Results:
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All but one pseudo patient was discharged from hospital with a diagnosis of schizophrenia in remission. This suggests they had never been detected as sane.
- Their sanity was not detected by staff, but 35/118 patients voiced suspicions about their sanity.
- The average stay of the researchers was 19 days, and the lengths ranged from 7-52 days.
- There was little contact with doctors or nurses. Pseudo patients were ignored 71% of the time when contacting the nurses; eye contact only made 23% of the time and verbal responses were only given 2 % of the time
- Their normal behavior was pathologized and interpreted in ways consistent with their diagnosis. Note taking, pacing the corridors out of boredom was seen as nervousness, waiting outside cafeteria for lunch was seen as 'oral- inquisitive syndrome,' all these behaviors were taken as symptoms of their diagnosis.