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(Aim-, To investigate if the sane can be distinguished from the insane…
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- To investigate if the sane can be distinguished from the insane in clinical settings.
- Investigate the effect of labelling on medical diagnoses.
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Patients and Staff which spanned across 12 Hospitals, although there were 8 pseudo patients, these were observers (3 Women and 5 Men) with no history of mental health problems
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Pseudopatients phoned 1/12 hospitals representing a range of good and bad, old, and new institutions across 5 USA states and make an appointment that they were hearing voices such as ‘empty’, ‘thud’ and ‘Hollow’, they had fake names.
Everything except occupation was disclosed to staff (Family relationships and Life events). All were admitted to institutions with schizophrenia diagnosis except 1 who was admitted with manic depression and psychosis.
Once admitted, the pseudopatients behaved normally and was honest to all questions except about being part of a study. They recorded experience using notes and tried to convince staff of their sanity to escape. They had daily visitors who
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- All were diagnosed as having serious mental health disorder and minimal symptoms.
- Sanity was never detected by staff and was discharged with schizophrenia diagnosis in remission. Average hospital stay was 19 days with shortest being 7 days and longest being 52.
- Patients did suspect pseuopatient sanity. One asked whether rsearcher was journalist. 1/3 of patients challenged pseudopatients in 3 hospitals.
Staff treated researchers in manner that was consistent with their diagnosis and frequently pathologized normal behaviour. For instance, note taking was referred to as ‘writing behaviour’, pacing corridors (Boredom) was interpreted as
nervousness and waiting outside lunch hall early was labelled by one clinician as “Oral-Inquisitive Syndrome”.
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When contact was initiated to staff by pseudopatients, 71% of times they were ignored, eye contact was only made 23% of the time with 2% of staff showing verbal responses. Of 185 reasonable questions asked to senior staff, none were
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- There is unreliability in diagnostic process.
Diagnostic labels change the perception of the person so that all behaviour was interpreted within context of label, could lead to self-fulfilling prophecy as person is treated in manner consistent with label and this is interpreted as being
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- Academic staff responded better to questions from apparent students than hospital staff did when being asked by pseudopatients