Classic Study: Rosenhan (1973) Flashcards Preview

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Flashcards in Classic Study: Rosenhan (1973) Deck (21)
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1
Q

What were the aims of Rosenhan’s first study?

A
  • To investigate whether psychiatrists can reliably tell the difference between people who are sane and those that are insane
  • To highlight the negative effects of being diagnosed as abnormal and institutionalised
2
Q

Who were used in the sample of the first study?

A
  • 8 pseudo patients including Rosenhan
  • Dispatched to 12 different psychiatric hospitals across the USA with varying funds and staff/patient ratios
  • None had any recorded mental health issues
3
Q

What type of method was used in the first study?

A

Covert participant observation.

4
Q

Briefly describe the procedure of the first part of this classic study.

A
  • 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”
  • Psychiatrists used the DSM-II to diagnose
  • All background information pseudo patients gave were the truth
  • All ppts were taught how to avoid swallowing medication
  • Pseudo patients ceased simulating symptoms of abnormality upon entering ward
  • Ppts had to get themselves discharged, feeling powerless
  • Once there, ppts recorded notes of things such as: how many times nurses interacted with patients
  • Lawyers were briefed if anything were to go wrong, ensuring patients were never on the ward
5
Q

What was the IV and DV of the first study?

A
IV = Symptoms displayed to the psychiatrist
DV = Admission to the hospital
6
Q

What were the qualitative results of Rosenhan’s first study?

A
  • All pseudo patients were admitted (7 with the diagnosis of schizophrenia)
  • Discharged as schizophrenia in remission
  • Average time spent in the hospitals was 19 days
  • Normal behaviours were often seen as aspects of their illness (e.g. writing notes was seen as abnormal)
  • Real patients on the ward noticed the pseudo patients were normal and 35 reported them
  • Hospital conditions were terrible, e.g. lack of privacy
  • Real patients would flush medication down the toilet
7
Q

What were the quantitative results of Rosenhan’s first study?

A
  • Only 4% of psychiatrists stop and talk to patients
  • Only 10% of nurses make eye contact when asked questions by patients
  • 71% of psychiatrists and 88% of nurses walk on with their head averted when asked questions by patients
8
Q

Describe the conclusion of Rosenhan’s first study.

A
  • All pseudo patients were admitted based on one symptom
  • Type One error - when the professional diagnoses a sick person as healthy
  • Type Two error - when a professional diagnoses as healthy person as sick
  • Once diagnosed, it is hard to get rid of the label associated with the mental illness and so became depersonalised
  • Once tagged as abnormal, all behaviours were interpreted according to their institutional label
9
Q

What were the aims of Rosenhan’s second study?

A
  • To further test the reliability and validity of diagnosis

- To test the type one and type two error

10
Q

Who were used in the sample of the second study?

A

Staff in a research and teaching hospital with the ground of Stamford University.

11
Q

What type of method was used in the second study?

A

Field experiment

12
Q

Briefly describe the procedure of the second part of this classic study.

A
  • The hospital asked Rosenhan to send more pseudo patients due to not believing type one and two errors would occur in their institution
  • The staff were then informed that at some point in the next 3 months, one or more pseudo patients would attempt to be admitted
  • Each member of staff were asked to rate each new patient on the likelihood of being fake
13
Q

What was the IV and DV of the second study?

A
IV = Expectations of the staff
DV = Diagnosis of patient
14
Q

What were the results of Rosenhan’s second study?

A
  • 193 were admitted for treatment

- Staff concluded with high confidence that 41 were pseudo patients and 23 were suspect

15
Q

Describe the conclusion of Rosenhan’s second study.

A
  • Sane people can be diagnosed as being insane but when consequences are being measured, the diagnosis is reversed
  • Instead of making more type two errors, they tend to lean towards type one
16
Q

How has Rosenhan’s study influenced society and it’s approaches to mental health?

A
  • It has changed the ways in which a psychiatrist or psychologist diagnoses a patient with a mental disorder
  • Hospital conditions have improved
  • The DSM has improved by using axes to give a more detailed structure to follow to make sure diagnosis is accurate
17
Q

Evaluate the generalisablity using a high and low point.

A

P - High
E - Used a range of hospitals (e.g. short staffed, new, old)
E - Therefore generalising to other hospitals due to being representative
P - Low
E - Only used 12 institutions from USA
E - The small sample is ethnocentric and not representative of healthcare institutions in other countries

18
Q

Evaluate the reliability using a high and low point.

A

P - High
E - Standardised procedure such as all patients instructed to record observations
E - Easily replicable
P - Low
E - During the time of the study the hospital conditions were bad
E - Therefore it is unlikely to be reproduced today due to higher emphasis on care

19
Q

Are there any applications?

A

P - Yes
E - Due to highlighting how inaccurate diagnosis can be, it can be used to help improve the way people are diagnosed and treated
E - Therefore improving the validity and reliability of diagnoses by raising awareness

20
Q

Evaluate validity using a high and low point.

A

P - High ecological
E - Staff were assessed in their natural environment of the hospital
E - Therefore their behaviour and actions were natural
P - Low
E - In the follow up study the staff were expecting patients to be sent
E - And so demand characteristics for being suspicious of patients therefore not reflecting true behaviour

21
Q

Using the acronym ‘PEEJ’, evaluate 2 ethics points.

A

P - Low
E - Presence of pseudo patients meant limiting time spent on real patients
E - Protection from harm for patients compromised
J - The fake patients being there highlighted the poor conditions of hospitals that later improved due to study
P - Low
E - Only consent give was from the hospital administrators
E - Compromised consent and right to withdraw of staff and patients
J - Study highlighting inaccuracies with diagnosis led to improving DSM