Rosenhan's 1973 Study

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  • Rosenhan's Study (1973)
    • Aim
      • To test the diagnostic system in use at the time of the study (DSM IV) to see if it was valid and reliable
      • To observe and report on the experience of being a patient in a psychiatric hospital
    • Sample
      • The pseudo patients were eight sane people (five men, three women)
      • the members of staff at the hospitals together with the genuine patients also becoming participants.
      • 12 hospitals
    • Procedure
      • Experiment One
        • Pseudo patients called the hospital and arranged an appointment at the hospital. On arrival they reported they had been hearing voices which were unclear, unfamiliar, of the same sex as themselves, and said, “empty”, “hollow “and “thud”
        • They were administered medication but was not to actually take any of it
        • They sought admission to 12 hospitals (of varying ages, resources and staff ratios) across five states in the USA.
        • Once admitted, pseudo patients immediately behaved normally. They interacted with staff and patients and participated in ward activities.
        • Pseudo patients had the responsibility of persuading hospital staff that they were sane and could therefore be discharged.
      • Experiment Two
        • One of the hospitals from the original sample was used again
        • They were warned that more pseudo patients would enter into the hospital over the next three months
          • None actually did
        • The staff were asked to rate each patient who arrived on the likelihood of being a pesudo patient
          • A 10 point scale was used with 1 and 2 reflecting high confidence the patient was pseudo
    • Results
      • Experiment One
        • All participants were administered stay in the hospitals
          • the length of stay varied over 7-52 days for all pseudo patients (mean of 19)
          • 7/8 were diagnosed with schizophrenia whilst the other was diagnosed with manic-depressive psychosis (bipolar)
        • all behaviours the patients displayed were misinterpreted by the staff as part of their condition
          • notes from the staff include "Patient engages in writing behaviour"
            • queuing early for lunch was a characteristic of their disorder even though it was mostly due to boredom
        • Many real patients detected the pseudo patients (35/118 genuine patients voiced their suspicions)
          • The genuine patients also made some comments: "You're not crazy, you're a journalist or professor" or "You're checking upon the hospital"
        • Staff tended to keep away from many of the patients unless it was necessary
          • Personal hygiene and waste evacuation were often monitored. Many water closets had no doors.
            • All pseudo patients experienced powerlessness and depersonalisation
      • Experiment Two
        • 41/193 genuine patients were judged with high confidence of being fake
    • Conclusion
      • Psychiatric diagnosis is extremely inaccurate
      • Hospitals seem to be special environments where behaviour gets easily distorted
      • Significant labelling can be in producing expectations and influencing behaviour
        • once a patient has been labelled ‘insane’, all subsequent behaviour is seen in the light of the label given


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