1.1 Rosenhan was a psychiatrist who joined the anti-psychiatrist
league as he was against the way people are diagnosed.
1.1.1 This study is Rosenhan proving why doagnoses within psychriatric hospitals are so poor.
2.1 Field Experiment
2.2 Participant Observation
3.1 To test the hypothesis that the clasification system (DMS) used by
psychiatrists to diagnose whether someone was sane or not was reliable.
3.1.1 If psychiatrists could not reliably diagnose conditions such
as schizophrenia correctly then the DMS would not be valid.
3.2 Rosenhan believed that the experiment was infact comparing the influence
of disposition (individual character) and situation (psychiatric hospitals).
3.3 Was split into two studies.
4 Study 1
4.1.1 To see if sane individuals can be diagnosed as
insane and admitted to a psychriatric hospital.
4.2.1 8 psuedopatients who had no history of mental illness.
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.
4.2.2 Those within
Doctors, nurses, wards, patients.
4.3.1 Staff reaction within the hispitals when a pseudopatient tried to engage with them.
4.3.2 All Pseudopatientents were admitted - diagnosed with schizophenia or manic depression (which is now known as bi-polar).
4.3.3 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.
Still seen as insane but no longer presents characteristics of the illness.
4.3.4 Inability to detect pseudopatients were interperated as a feature of the diagnosis procedure.
184.108.40.206 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.
4.3.5 Type 2 mistake -
Sane people were
diagnosed to be
4.4.1 1) Each pseudopatient contacted a
hospital for an appointment and reported
that they were heading voices.
- The words heard (empty, hollow and thud).
4.4.2 3) Each participant would
remain in hospital until they
4.4.3 2) If patients were admitted and diagnosed as insane (DV) then
they stopped reporting hearing voices and behaved normally.
4.4.4 4) Whilst in hospital,
patients recorded their
experiences in a
notebook; interations with
the staff, patients, ect.
5 Study 2
5.1.1 Staff in the psychriatric hospitals.
5.2.1 To see if the insane can
be diagnosed as sane.
5.3.1 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.
5.3.2 3) Each member of staff were asked to rate the likelyhood that the
pseudopatients would try to get admitted into the hospitals.
5.3.3 4) In reality no pseudopatients would attempt to be admitted.
5.3.4 2) The staff were informed that
over the next 3 months more
psuedopatients would try to get
admitted into their hospital.
5.4.1 False negative type - Type 1 - Insane people were diagnosed to
be sane as they were trying to avoid type 2 mistakes.
5.4.2 For Rosenhan this indicates that the process of diagnosis is open to many errors.
6.1 Main Points
6.1.1 2) Once a patient had been labled with mental illness it is hard to remove that label.
6.1.2 3) Type 2 errors appear to be common in a medical diagnoses.
6.1.3 5) Patients may benefit more from community helath care than from being institutionalised.
6.1.4 1) The diagnosis of a mental illness is influenced by the context in
which behaviours are observered and the expectations of others.
6.1.5 4) It is more useful to focus on individual behaviours than overarching diagnosis.
6.2 It is not possible to distinguish the sane
from the insane in psychriatric hospitals.
The hospitals and the labels provide
influenced perceptions of behaviour which
is more likely to be nterpreted as insane.
6.3 Individuals with mental health
problems maybe better served by:
6.3.1 Community programs, intervention
centres and use of behaviour therepy.
6.3.2 More sensitive mental health workers.
6.3.3 A focus on behaviours, not 'global' diagnoses.
7.1 Highlights the diffuctly of applying a medical
model of diagnosis to mental health and has been
focus of how much debate about what can be
regarded as normal or abnormal behaviour.
7.2 Direct applications from the results of this study are related to to highlighting an awareness of the
longterm impact of pschodiagnostic labels and had to improve practise in mental health instituations.
The pseudopatients were not actually insane when means that their experiences would be different to those of the usual patients.
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.
8.3 It could be argued that Rosenhan only
used qualitative data that supported the
quantitative data within the study.
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.
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.
Highlights the difficulty in applying the medical model of diagnosis to mental health.
Raises awareness of how being diagnosed as mentally ill can make an impact on someones life.
9.2 Type of data
Both quantitative data and qualitiative data was used in the study.
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.
A variety of hospitals were used in the study meaning that it can be generalised to different institutions.
10.1 Stickiness of psychodiagnostic labels
10.1.1 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.
10.2 Powerlessness and Depersonalisation
10.2.1 Little respect was shown towards the patients, those diagnoses as
insane seemingly strict, stripped of their privileges as citizens.
Which occured both insaide and out of the hospitals.
10.3 Experiences of Psychriatric hospitalisation
10.3.1 Experiences recorded by pseudopatients seemed to be one of a particularly uncaring one.