Rosenhan+-+Period+1

Kaitlyn Grannemann and Brittany Thompson **D.L. Rosenhan's Study of Being Sane in Insane Places** 1973
 * Background Information:**
 * Starting in the 1950s, psychiatrists began to use the Diagnostic and Statistical Manual of Mental Disorders (DSM) to classify mental disorders and/or abnormal behavior.
 * In the 1960s, psychiatrists and psychotherapists began to criticize this medical approach - known as the Anti-Psychiatry Movement.
 * Rosenhan was a critic of the model and the study can be seen as an attempt to say that psychiatric classification in unreliable.
 * Type 1 error (false positive) - Diagnosing an insane person as sane.
 * Type 2 error (false negative) - Diagnosing a sane person as insane.




 * Aims:**
 * The main aim of the study was to test that psychiatrists cannot determine between those who are sane and those who are insane.


 * Participants:**
 * Two parts to the study.
 * Part 1:
 * Eight sane people (3 women, 5 men). Known as pseudo patients.
 * Careers of the eight - A psychology graduate, three psychologists, a pediatrician, a psychiatrist, a painter and a housewife.
 * Part 2:
 * None - staff in teaching hospitals were falsely informed.


 * Research Method:**
 * Part 1:
 * Field experiment (naturalistic observation).
 * Part 2:
 * Field experiment - observed how the staff reacted but, the staff also gave their own information on who was a pseudo patient (self report?).


 * How Was the Data Collected?:**
 * Data collected through written observations of the staff (part two) and of the eight pseudo patients' stay in the hospital (part one).
 * The pseudo patients' observations was first done in secret but, once they realized no one really cared to notice, the observations were written openly.
 * The pseudo patient's observations were mainly of the behavior and treatment of the staff towards the patients.


 * Type of Data Collected:**
 * The data collected was both qualitative and quantitative.
 * Qualitative = treatment of staff towards patients and the environment of the hospital. (part one)
 * Quantitative = how many of the staff (psychiatrists and nurses) made contact with the patient according to their response (part one) and the ratings the staff members gave on a 10 point scale - to see the likelihood of them being a pseudo patient (part two).


 * Procedure:**
 * Part 1:
 * Eight pseudo patients were attempting to gain admission to 12 different psychiatric hospitals.
 * Pseudo patients telephoned the hospital for an appointment and arrived saying that they "heard voices". They said the voices were unfamiliar, same gender as themselves, and the voices often said "empty", "hollow", and "thud".
 * Pseudo patients were given a false name and job but details of their lives were true (ex. relationships, up and downs of life, etc).
 * After pseudo patients were admitted, they stopped simulation any symptoms that they were previously "experiencing". They took place in regular psychiatric activities.
 * Pseudo patients spent time writing down their observations.
 * Each was diagnosed with Schizophrenia and were released with the psychiatrists felt that they were in remission.
 * Within the hospital, some of the other patients realized that they were faking their Schizophrenia but, the hospital staff didn't recognize this.
 * Part 2:
 * For this study, the staff was aware the the previous study (part one). They were then falsely informed that during the next three months, a pseudo patient would attempt to gain admission.
 * Staff members asked to rate their patients on a 10-point scale for the likelihood of them being a pseudo patient.


 * Special Equipment and Materials:**
 * Written observations about the hospital - written by the pseudo patients. (Part one)
 * Written records from the hospital staff about who could possibly be a pseudo patient. (Part two)

>>
 * Results:**
 * Part 1:
 * All of the pseudo patients didn't like the experience and wanted to be discharged immediately.
 * None of the pseudo patients were detected as being sane and all discharged with the diagnosis of Schizophrenia in remission. Remained in the hospital for 7 to 52 days (19 days was the average).
 * The patients that detected their suspicions of sanity (35 out of 118) said things such as, "You're not crazy".
 * Behaviors of the patients were misinterpreted by the staff many times and the pseudo patients were treated as if they were invisible.
 * Pseudo patients were given a total of 2.100 medication tablet but only two were swallowed - the others were disposed of without the staff's knowledge.
 * Part 2:
 * Many of the hospital's regular patients were judged to be pseudo patients. About 10% of the regular ones were judged by one psychiatrist and a staff member to be a pseudo patient.


 * Conclusions - Based off of Results:**
 * The experience for the pseudo patients was mainly of depersonalization and powerlessness - patients deprived of privacy (medical records open to all staff and personal hygiene monitored).
 * Rosenhan states that the study demonstrates that psychiatrists cannot tell the difference between people who are sane and people who are insane.
 * Part 1 showed the failure to detect a sane person.
 * Part 2 showed the failure to detect an insane person.
 * Psychiatric labels are more likely to stick - everything a person does is interpreted by the label given.
 * Rosenhan suggests that instead of labeling people, psychiatrists should focus on the person's behaviors and problems.


 * Strengths:**
 * Both qualitative and quantitative data.
 * Field experiment = high ecological validity.
 * Wide range of hospitals - results can be generalized.


 * Weaknesses:**
 * Hospital staff was deceived - unethical.
 * Experience of pseudo patients could have differed from actual patients.
 * Doctors more likely to make a type 2 error than a type 1 error.


 * Ecological Validity:**
 * High ecological validity. This is due to the fact that the settings and environments were real, with real use of medical equipment and professional psychiatrists and staff.
 * Field experiment adds to the high ecological validity rate.


 * Ethics:**
 * Unethical. Due to the use of deception on the hospital staff