Rosenhan

Rosenhan

Aims and Context
1. Insane are people who do not follow social norms nor the rules of society. Whereas sane are the ones who do. We all assume that doctors are sane.
  1. Psychiatrists launched the anti-psychiatry movement in the 1960s. Challenged the way we diagnose mental disorders is incorrect, as we do so by using the medical model.
    1. Foucault, Laing and Szasz state the way we diagnose mental illnesses is both invalid and unreliable.
Procedures
1. Participants
  1. 12 American hospitals and the staff inside.
  2. Used opportunity sampling, some hospitals were old, some new while one was private and another was research based.
2. 8 pseudopatients- 5 male, 3 female
  1. Included three psychologists, a painter and a graduate student.
  2. fake patients, they were aware of the study and what to do.
  3. Lied about their jobs, age and the symptoms- 'thud', 'empty' and 'hollow' audio hallucinations. All other information was accurate and based on their life.
  4. None of the pseudopatients had a history of pschiatric disturbance.
3. Had three studies within the study
  1. STUDY ONE involved the pseudopatients gaining an appointment from a pschiatrist and then being referred to the hospital
    1. Once in the hospitals they were to follow rules (apart from taking tablets) as well as making notes of observations, initially in secret but when nurses found out they were not bothered and so carried on doing so publicly.
      1. They were instructed to act as normal as possible, aside from the obvious nervousness and tension of being found out
  2. STUDY THREE was within study one, it involved the pseudopatients going up to nurses during the day and asking them as normally as possible when they would be 'eligible for grounds leave' or when they were 'likely to be let out'.
    1. They were instructed to ask as normally as possible, trying not to ask the same nurse more than once a day.
  3. STUDY TWO was after Rosenhan had published his results, another hospital challenged him saying that would not happen in their hospital.
    1. He told them that one or more pseudopatients would visit their hospitalover a course of three months.
      1. The staff were told to rate the participants on a 10 point scale on how confident they were on the diagnosis that they were genuinely mentally ill. 1 was high confidence and 10 was low confidence.
        In actual fact, Rosenhan did not send any pseudopatients to the hospital.
Findings and Conclusions
With reference to alternative evidence, critically asses
Evaluate the methodology of Rosenhan
1. High ecological validity
  1. Done in real hospitals with nothing controlled apart from the symptoms of the pseudopatients.
    1. This is a good thing as results and behaviours can be generalised to real life situations, suggesting the way we diagnose mental illnesses is inaccurate
      1. However, there is an element of control- pseudopatients age, job and symptoms- which can be misleading for the psychiatrists as they rely on verbal accounts from patients in order to diagnose.
2. Ethics
  1. Both lack of deception and lack of informed consent was broken.
    1. However this was done in order to reduce demand characteristics and make behaviours valid. Rosenhan overcame this by debriefing participants and gainning retrospective consent.
      1. Although the pseudopatients were fully aware of the aims of the experiment, as they were surrounded by mentally ill people they were at risk of becoming mentally ill themselves, breaking the ethical guideline harm. Also pseudopatients were never able to remove their mentally ill label even though the symptoms were manipulated, they were always classed as 'in remission'.
3. Internal reliability
  1. Lacks due to the study being independent measures, meaning the same participants did not take part in the same study more than once.
    1. This means we cannot see if behaviours are consistent therefore cannot make accurate predictions.
      1. However, due to 11 of the 12 pseudopatients all being diagnosed with the same mental illness, schizophrenia, you could say that results are reliable even though the way in which we diagnose mental illnesses is invalid.
4. Sampling
  1. Obtained the hospitals and staff from opportunity sampling, this is a good thing as it was a quick and easy method for Rosenhan.
    1. However, the sample may not be representative of the target population which would be a weakness of using opportunity sampling.
5. Time validity
  1. Lacks as it was not repeated and there are updated versions of the DSM.
    1. This is a weakness as it means results cannot be generalised to different time eras with the different versions of the DSM.
      1. This develops Rosenhan's study as it suggests the way in which we diagnose mental disorders is wrong and that we cannot base the way we diagnose medical illnesses on the medical model.

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