Individual Differences - Rosenhan (1973)

1. This study is Rosenhan proving why doagnoses within psychriatric hospitals are so poor.

1. If psychiatrists could not reliably diagnose conditions such as schizophrenia correctly then the DMS would not be valid.

1. To see if sane individuals can be diagnosed as insane and admitted to a psychriatric hospital.

1. 8 psuedopatients who had no history of mental illness.

   Nota:

   • 5 male, 3 female.
   • One of the males were Rosenhan.
   • They changed the participants name and occupation (if related to psychology) but otherwise kept their detailsof their lives accurate.
2. Those within the hospital.

   Nota:

   • Doctors, nurses, wards, patients.

1. Staff reaction within the hispitals when a pseudopatient tried to engage with them.
2. All Pseudopatientents were admitted - diagnosed with schizophenia or manic depression (which is now known as bi-polar).
3. Pseudo patients spent between 7 and 52 days in hospital and when they were discharged they had a diagnosesof 'in remission'. i.e. they were still declared schizophrenic.

   Nota:

   • Still seen as insane but no longer presents characteristics of the illness.
4. Inability to detect pseudopatients were interperated as a feature of the diagnosis procedure.
   1. The doctors were more lkely to diagnose a sane person as insane as it is 'safer' to misdiagnose an illness. The consequence of not admitting an insane person are potentially more serious than admitting a sane person incorrectly.
5. Type 2 mistake - Sane people were diagnosed to be insane.

1. 1) Each pseudopatient contacted a hospital for an appointment and reported that they were heading voices.

   Nota:

   • Indepent Variables - The words heard (empty, hollow and thud).
2. 3) Each participant would remain in hospital until they were discharged.
3. 2) If patients were admitted and diagnosed as insane (DV) then they stopped reporting hearing voices and behaved normally.
4. 4) Whilst in hospital, patients recorded their experiences in a notebook; interations with the staff, patients, ect.

1. Staff in the psychriatric hospitals.

1. To see if the insane can be diagnosed as sane.

1. 1) Set in a psychriatric teaching and research hospital that was aware of the finding from the first study - the staff beleived such an error couldn't occur in their hospital.
2. 3) Each member of staff were asked to rate the likelyhood that the pseudopatients would try to get admitted into the hospitals.
3. 4) In reality no pseudopatients would attempt to be admitted.
4. 2) The staff were informed that over the next 3 months more psuedopatients would try to get admitted into their hospital.

1. False negative type - Type 1 - Insane people were diagnosed to be sane as they were trying to avoid type 2 mistakes.
2. For Rosenhan this indicates that the process of diagnosis is open to many errors.
3. 19

1. 2) Once a patient had been labled with mental illness it is hard to remove that label.
2. 3) Type 2 errors appear to be common in a medical diagnoses.
3. 5) Patients may benefit more from community helath care than from being institutionalised.
4. 1) The diagnosis of a mental illness is influenced by the context in which behaviours are observered and the expectations of others.
5. 4) It is more useful to focus on individual behaviours than overarching diagnosis.

1. Community programs, intervention centres and use of behaviour therepy.
2. More sensitive mental health workers.
3. A focus on behaviours, not 'global' diagnoses.

Nota:

• The pseudopatients were not actually insane when means that their experiences would be different to those of the usual patients.

Nota:

• From the psychriatric community after the study was published.
• As the pseudopatients were pretending to be unwell, then it should be expected by the those diagnosing them to play safe to have them admitted and diagnosed with a form of mental illness.

Nota:

• The pseudopatients lied to the other participants within the study, acting as if they had a mental illness which is deception and therefore an ethical issue.

Nota:

• The sample of pseudopatients was small and biased towards those who have an understanding of psychological issues.
• 6/8 of the pseudopatients had psychological backrounds which may have had an impact of how they acted within the wards.

Nota:

• Highlights the difficulty in applying the medical model of diagnosis to  mental health.

1. Practical Applications

   Nota:

   • Raises awareness of how being diagnosed as mentally ill can make an impact on someones life.

Nota:

• Both quantitative data and qualitiative data was used in the study.

Nota:

• The study was as ecological valid as possible as it manages to observe in a completely natural envioment without any chance of demand characteristics.
• Uses pseudoparticipants meant that Rosenhan could gain covert insight into the experiences of being in a psychriatric hospital.

Nota:

• A variety of hospitals were used in the study meaning that it can be generalised to different institutions.

1. Once a patient is diagnosed, that label 'sticks', influencing how others percieve them, acting as a powerful personality trait that infuences how normal behaviour is percieved.

1. Little respect was shown towards the patients, those diagnoses as insane seemingly strict, stripped of their privileges as citizens.

   Nota:

   • Which occured both insaide and out of the hospitals.

1. Experiences recorded by pseudopatients seemed to be one of a particularly uncaring one.