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.
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.
Foucault, Laing and Szasz state the way we
diagnose mental illnesses is both invalid and
unreliable.
Procedures
Participants
12 American hospitals and the staff inside.
Used opportunity sampling, some hospitals
were old, some new while one was private
and another was research based.
8 pseudopatients- 5 male, 3 female
Included three psychologists, a painter
and a graduate student.
fake patients, they were aware of the study
and what to do.
Lied about their jobs, age and the symptoms- 'thud', 'empty'
and 'hollow' audio hallucinations. All other information was
accurate and based on their life.
None of the
pseudopatients
had a history
of pschiatric
disturbance.
Had three studies within the study
STUDY ONE involved the pseudopatients gaining
an appointment from a pschiatrist and then being
referred to the hospital
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.
They were instructed to act as normal as possible, aside from the obvious nervousness and
tension of being found out
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'.
They were instructed to ask as normally as possible,
trying not to ask the same nurse more than once a day.
STUDY TWO was after Rosenhan had published his
results, another hospital challenged him saying that would
not happen in their hospital.
He told them that one or more pseudopatients
would visit their hospitalover a course of three
months.
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
High ecological validity
Done in real hospitals with nothing controlled apart from
the symptoms of the pseudopatients.
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
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.
Ethics
Both lack of deception and lack of informed
consent was broken.
However this was done in order to reduce demand characteristics and make behaviours
valid. Rosenhan overcame this by debriefing participants and gainning retrospective
consent.
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'.
Internal reliability
Lacks due to the study being independent measures, meaning the same participants
did not take part in the same study more than once.
This means we cannot see if behaviours are
consistent therefore cannot make accurate
predictions.
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.
Sampling
Obtained the hospitals and staff from opportunity
sampling, this is a good thing as it was a quick and easy
method for Rosenhan.
However, the sample may not be representative of the target
population which would be a weakness of using opportunity
sampling.
Time validity
Lacks as it was not repeated and
there are updated versions of the
DSM.
This is a weakness as it means results cannot be generalised to
different time eras with the different versions of the DSM.
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.