Mental Health: Key Research

Question 1

Who did the study ‘on being sane in insane places’

Answer 1

Rosenhan (1973)

Question 2

What was study one about in the Rosenhan experiment

Answer 2

study one = Admitting ‘sane’ individuals into psychiatric hospital and the effects of this

Question 3

What was the aim of study one in the Rosenhan experiment

Answer 3

• To illustrate the problems involved in determining normality and abnormality, in particular:
• Poor reliability of classification systems for mental disorders
• Negative consequences of being diagnosed as abnormal and effects of being institutionalized

Question 4

What were the research methods used in study one in the Rosenhan experiment

Answer 4

Covert
Field observation
(participant)

Question 5

What was the sample used in study one of the Rosenhan experiment

Answer 5

12 hospitals across the USA

-The researchers were not the sample but there were 8 people, 3 female and 3 male from a small variety of occupations using fake names and occupations

Question 6

In the procedure of study one in the Rosenhan experiment, how did the pseudo-patients get admittance to hospital?
and what does this tell us about diagnosis of mental illness?

Answer 6

They attempted to get a diagnosis of schizophrenia by phoning up and using key words like “empty, hollow, thud”
–> this tells us that institutions are unreliable and possible not competent

Question 7

In the procedure of study one in the Rosenhan experiment, What did the pseudo-patients do once they were in

Answer 7

They acted like themselves, with no schizophrenic symptoms and responded normally

Question 8

In the procedure of study one in the Rosenhan experiment, what did the pseudo patients make notes on

Answer 8

• Observed and recorded the experience of the institutionalized mentally disordered patient
• Lack of monitoring
• Effect of institution, depersonalized and powerlessness

Question 9

From the data gathered in study one in the Rosenhan experiment, How did the pseudo-patients collect qualitative data

Answer 9

-They took notes on the institution experience

Question 10

From the data gathered in study one in the Rosenhan experiment, how did the pseudo-patients collect quantitative data

Answer 10

• Length of days stayed at the institution (7-52 days, average 19 days)
• Number of incorrect diagnosis
• Time staff spent with patients
• % of doctors and nurses responding to questions

Question 11

From the results in study one in the Rosenhan experiment, how were the pseudo-patients seen as abnormal inside the hospital

Answer 11

Every behaviour was labelled as schizophrenic:

• emotional and unstable
• note taking was seen as part of the disorder
• pacing corridors out of boredom was seen as part of the disorder
• waiting outside the cafeteria was seen as ‘oral acquisitive’ nature of the syndrome

Question 12

From the results in study one in the Rosenhan experiment, what quantitative results are there that shows that patients were not spoken to or had much interaction with doctors or nurses

Answer 12

• length of stay ranged from 7-52 days, never been detected as sane in 52 days
• 71% of staff ignored patient and only 4% stopped

Question 13

From the results in study one in the Rosenhan experiment, how long did it take the pseudo-patients to be released from hospital?
What happened even when released

Answer 13

• 7-52 days and average of 19 days

- All except 1 were diagnosed as ‘schizophrenic in remission’ and not as sane

Question 14

From the conclusions in study one in the Rosenhan experiment, what error of diagnosis was being made and what does the study tell us about the validity of diagnosis

Answer 14

• Schizophrenia = there are deficiencies in the classification system and diagnosed as ‘schizophrenic in remission’
• Diagnosis is very subjective and opinionated

Question 15

From the conclusion in study one in the Rosenhan experiment, what does the study tell us about the stickiness of labels

Answer 15

• Labels will stay with you, not just labelled as sane after being released but as ‘schizophrenic in remission’
• ‘Doctors and nurses are unable to diagnose patients correctly’

Question 16

What was study two in the Rosenhan experiment, about

Answer 16

Would genuine patients be misidentified as ‘sane’

Question 17

From the procedure in study two in the Rosenhan experiment, what did Rosenhan say he would do as a result of the complaints made by hospitals and what did he actually do

Answer 17

• He said he was going to send more pseudo-patients to the hospitals over 3 months
• He actually didn’t send any pseudo-patients to any of the hospitals

Question 18

From the procedure in study two in the Rosenhan experiment, how did Rosenhan collect data on ‘misdiagnosis’

Answer 18

Staff rated the patient on scale of 1-10 on how fake patient was

Question 19

What was the sample from study two in the Rosenhan experiment

Answer 19

1 teaching hospital staff

Question 20

From the results in study two in the Rosenhan experiment, how many people were ‘misidentified’ as sane

Answer 20

• 41 out of 193 were misidentified as sane by all staff

- 19 were misidentified by psychiatrists

Question 21

From the conclusions in study two in the Rosenhan experiment, what error of diagnosis was being made and why is this error perhaps worse than the error made in study one

Answer 21

Type 1 - (according to Rosenhan) - where they would diagnose a sick person as being sane
Type 2 - (according to Rosenhan) - Where they would diagnose a sane person as being ill

-This was worse than study one because at least everyone was being kept safer in the institution

Question 22

What was the method used in the Gottesman study

Answer 22

A - 2 parents admitted with diagnosis of Schizophrenia / Bipolar/ depression
B - 1 parent admitted with diagnosis of Schizophrenia/ Bipolar/ Depression
C - Neither parent admitted with diagnosis
D - No restrictions or data on parental admissions

Question 23

What was the sample used in the Gottesman study

Answer 23

• 2.6 million people born in Denmark alive in 1968 or later

- Investigation was restricted to persons aged 10 or over before 1 January 2007

Question 24

What was the procedure in the Gottesman study

Answer 24

• Patients were diagnosed using ICD 8 and ICD 10

- The study measured cumulative indices of schizophrenia and bipolar disorder in the offspring up to the age of 52

Question 25

What were the results from the Gottesman study for bipolar disorder

Answer 25

Percentage offspring affected by bipolar:

Both parents schizophrenia = 10.8%
Both parents with bipolar = 24.95%

1 parent with bipolar = 4.4%
1 parent with schizophrenia, 1 parent with bipolar = 11.7%

Neither parent admitted = 0.48%
General population = 0.63%

Question 26

What does the Gottesman study tell us about the inheritance of mental disorders

Answer 26

• There is a link between parents and offspring in diagnosis of mental health
• Offspring are 31.7 times more likely to have schizophrenia when both parents have schizophrenia
• Offspring are 51.9 times more likely to have bipolar when both parents have bipolar disorder

Question 27

Who did the study into the myth of mental illness: 50 years later

Answer 27

Szasz (2011)

Question 28

In the Szasz study who was responsible for mental health care in 1960 and 2010

Answer 28

1960 = Health care for mental patients consisted of mental hospitals or private non-medical practitioners (forced)

2010 = Regulated and paid for by public money, the Government and pharmaceutical company

Question 29

In the Szasz study how was mental illness viewed as a disease in 1960 and 2010

Answer 29

1960 = Mental illness is not like a physical disease, but it was a disease and medicated them

2010 = Labelled as mental illness as a disease and included non-diseases such as ADHD, seen as a disorder of the brain

Question 30

In the Szasz study what did Szasz believe about the view of mental illness in 1960 and 2010

Answer 30

1960 = Mental illness doesn’t exist and is foolish to look for cures or causes. It is not a disease

2010 = A false belief is that all mental illness can be diagnosed accurately and treated successfully, no scientific evidence of disorder of the brain.
=People are seen as bad if the government say so

Question 31

In the Szasz study, how are those with mental illness treated by psychiatrists in 1960 and 2010

Answer 31

1960 = Like prisoners and are unable to leave, with psychiatrists acting as judge and jury with no ability to appeal (torture)

2010 = Physicians see the goal as curing the patient whereas doctors don’t see people as bad, it they do something that is down to mental illness

Question 32

What did Szasz believe about mental illness in 1960 and 2010

Answer 32

1960 = It doesn’t exist, so it is foolish to look for causes or cures. It is a myth

2010 = Mental illness isn’t caused by bacteria or viruses people have reasons for behaviours that need to be understood, not treated medically