5.3.1 classic study rosenhan 1973 Flashcards Preview

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rosenhan 1973 classic study clinical : what was the title

on being sane in insane places


rosenhan 1973 classic study clinical : what was the aim

To investigate whether psychiatrists can reliably tell the difference between people who are sign and those are insane.

And to highlight the negative effects of being diagnosed as abnormal and institutionalised


rosenhan 1973 classic study clinical : what was the procedure

Design: covert participant observation. Participants: a pseudo patients including rows in hand and other professionals. Dispatched to 12 different psychiatric hospitals across the USA with varying funds, and staff and patient ratios. None had any recorded mental health issues
method: the hospital managers were aware of the study taking place. Each patient on arriving at admissions complained about hearing voices of the same sex saying thud, empty and hollow. psychiatrists use the DSM 2 to diagnose. All background info sude patients gave the truth and all participants were taught how to avoid swelling medication.

Pseudo patients ceased stimulating Symptoms of abnormality upon entering the ward and participants had to get themselves discharged, feeling powerless.

Once there, participants recording notes for example how many times the nurses interacted with patience and lawyers were briefed if anything were to go wrong, ensuring patients were never on the ward

Independent variable: symptoms display to the psychiatrists, dependent variable: admission to hospital


rosenhan 1973 classic study clinical : results

qualitative : all pseudo patients were admitted (7 w diagnosis of sz), discharged as schizophrenia in remission, average time spent in hospitals was 19 days and normal behaviours were often seen as aspects of the illness for example writing notes seen as abnormal. Real patients on the ward noticed the pseudo patients were normal and 35 reported them. Hospital conditions were terrible for example lack of privacy and real patients would flush medication down the toilet. 35 out of 118 patients were suspicious about the pseudo patients

quantitative : only 4% of psychiatrists stopped and talked to patients and only 10% of nurses made eye contact when asked questions by patients.

71% of psychiatrists and 88% of nurses walked with their head averted when asked questions by patients


rosenhan 1973 classic study clinical : follow up study

after the initial study some hospitals wanted to show this could not happen in the workplace.

Rosen had agreed to send some more sude patients towards to see whether they would be identified as healthy imposters but no pseudo patients were actually sent. Staff had to rate every patient on a scale of one to 10, one being fake.

They found that at least one member of staff wrongly reported, with high confidence that 41 out of 193 patients were fake.

23 out of 193 reported by at least one psychiatrists and further 19 by one psychiatrist and one other staff member


rosenhan 1973 classic study clinical : conclusion

Rosen had concluded that the sign cannot be distinguished from the insane in psychiatrist hospitals.

In the hospital environment special meanings are given to behaviour and patience in such an environment experience powerlessness and depersonalisation and segregation.

And concluded that the DSM was not a valid measurement. Type one error: when the professional diagnose is a sick person is healthy. Type two error: when a professional diagnose is a healthy person as sick


rosenhan 1973 classic study clinical : EVAL generalisability

Generalisability: 12 hospitals used which increases generalisability.

And use a range of hospitals including old, new and different funds.

Moreover several different hospitals were used in several different states as there is some evidence of generalisability but all institutions were in the USA so whether findings would be the same elsewhere due to cultural differences is unclear.


rosenhan 1973 classic study clinical EVAL reliability

eight people in 12 hospitals using the same procedure e.g. hearing thud increases the replicability of the study but pseudo patients taking notes is subjective


rosenhan 1973 classic study clinical EVAL application

Shows the effects of labelling and diagnosis and application for the DSM as the study led to changes and made the DSM three, so the study has arguably paved the way for critical reforms to the diagnostic process but this was not Rosenhans intention


rosenhan 1973 classic study clinical EVAL validity

patients were being themselves with the exception of hearing voices which stopped once admitted; genuine patience 35 at 118 notice they were normal which increases validity. But as staff were told they were hearing voices, a common sign of schizophrenia, it could be expected that they would be admitted.

Also with the follow-up study, as hospitals believed the sude patients would be arriving, this may have left them looking for signs - demand characteristics based on this lie. It also has high ecological validity as it was conducted within real psychiatric hospitals but it could be argued that the validity was poor due to the fact that pseudo patients may have only recorded instances of negative interactions between staff and patients as they were supporters of rosenhan.

Also there were seven pseudo- patients per hospital and therefore the was no way of establishing whether the data each person collected was reliable


rosenhan 1973 classic study clinical EVAL ethics

staff would’ve been left feeling embarrassed that they were wrong in their diagnosis and that they probably would not have consented to the study.

Also the staff in hospitals were not names and it would not have been just one individual making the incorrect diagnosis.

Also the sude patients did say they heard a voice so there was some deception albeit briefly.


rosenhan 1973 classic study clinical EVAL well designed study

Use of covert participant observation and collection of both qualitative and quantitive data.

Makes it a whirl design study.

As the staff were initially unaware that the sude patients were researchers their behaviour would’ve been more natural