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Rosenhan (1973) On being sane in insane places (CLINICAL CLASSIC STUDY -…
Rosenhan (1973) On being sane in insane places (CLINICAL CLASSIC STUDY - SCHIZOPHRENIA)
Aim
FIRST EXPERIMENT: To investigate whether psychiatrists can reliably tell the difference between people who are sane and those who are insane. To highlight the negative effects of being diagnosed as abnormal and institutionalised
SECOND EXPERIMENT: To investigate if the tendency towards diagnosing the sane from insane could be reversed.
Method
FIST EXPERIMENT: A covert participant observation was used.
SECOND EXPERIMENT: A field experiment.
Results
Rosenhan found that 11/12 hospitals
admitted the pseudo patients with a diagnosis of schizophrenia and one with bipolar depression.
The average time a pseudo patient stayed in the hospital was 19 days, it ranged from 7 to 52 days.
In three cases the pseudo patients writing behaviour was seen as part of their pathological behaviour by nurses.
In his second experiment, he found that 41 patients were said to be pseudo patients by at least one member of staff, even though no pseudo patients were sent.
Sample
FIRST EXPERIMENT: the staff and patients of 12 psychiatric hospitals across the USA from 5 states with varying funds and staff-to-patient ratios
SECOND EXPERIMENT: The staff in a research and teaching hospital with the ground of Stamford University.
Conclusion
SECOND EXPERIMENT: The results demonstrate issues with the reliability and validity of diagnosis, strongly suggesting it wasn't possible to detect the sane from insane as staff were unable to identify that none of the patients were actually pseudopatinets.
FIRST EXPERIMENT: There was a failure to detect sanity as doctors were more likely to favour Type 2 errors (diagnosing a healthy person as sick) than Type 1 errors (diagnosing a sick person as healthy), due to taking caution. Once diagnosed, it's hard to get rid of the label associated with the mental illness and so people become depersonalised. Once tagged as abnormal, all behaviours are interpreted according to people's institutional label.
Evaluation
Rosenhan used quantitative, objective data in the
form of number of days spent in the hospital (1), this means that other researchers could conduct a similar study and compare the results to see if they are similar to test the reliability of Rosenhan’s results on newer versions of DSM
As they did not know they were part of a study the staff did not give consent to take part in the study.
The validity of the results is higher as a variety of real hospitals were selected for the observations.
As the pseudo patients were admitted, the staff had no reason to think they were faking it, as healthy people do not say they hear voices that are not there.
Staff could be distressed, and may question their work which would negatively impact on real patients.
Procedure
FIRST EXPERIMENT: 8 pseudo patients (5 men and 3 women) who were confederates asked for appointments at the hospitals. The hospital administrators and chief psychologists were aware of the study taking place. Each pseudo patient on arriving at admissions complained about hearing voices saying 'empty', 'hollow' or 'thud'. Psychiatrists used the DSM-II to diagnose the pseudopatients with either schizophrenia or bipolar depression. Once admitted, the pseudo patients acted normal (for instance, having conversations with fellow patients), disposed of any medication and didn't claim to hear voices anymore. They noted what they heard and saw (unstructured observation) and tried to do this covertly, but if the staff detected them they carried on recording things overtly.
SECOND EXPERIMENT: The hospitals were made aware that 193 new pseudopatients would be seeking admission over the next 3 months. Staff were issued with a questionnaire to rate each new pseudo patient on a 10-point scale of whether they were real or fake.