Study in Detail - Rosenhan

Detailed look at Rosenhan's study 'on being sane in insane places'. Also a study in detail of Chadwick et al.

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STUDY IN DETAIL
Psychologist(s): Rosenhan D.L. Date: 1973
Title: On Being Sane in Insane Places
Aim: To see whether diagnostic procedures under DSMII were really tied to the
patient's symptoms or were also affected by the environment in which the diagnosis
takes place i.e. could a clinician tell the difference between a patient suffering from a
real mental disorder and a healthy `pseudo patient' who reported one symptom and
then acts normally.
Method and Procedure: Include method, design, sample, target pop., IV and DV if
appropriate, and any obvious controls.
Rosenhan and seven volunteers, five of whom were doctors or psychologists, (3 women and five
men), arrived at a range of hospitals reporting a single symptom. They all reported hearing voices
saying, `empty', `hollow' and `thud'. Once admitted to the hospital, they then acted the role of a
model patient, cooperating with staff and seeking to be released as soon as possible. They
recorded the responses of the doctors and nurses when they spoke to them.
Results: All 8 pseudopatients were admitted to hospitals. The average stay was 19
days, the range being 752. In every case they were released with a diagnosis of
schizophrenia in remission. In a number of cases, real patients had made comment
that these people had nothing wrong with them. In no cases did the doctors or nurses
notice that there was nothing wrong with them. In response to any questions from the
pseudopatients, psychiatrists on 71% of occasion, and nurses on 88% of occasions
looked away and walked away without responding. Only on 4% of occasions did
psychiatrists stop to talk to the pseudopatients the figure was even lower (0.5%) for
nurses.
Conclusion: Rosenhan concluded that the environment has a major impact on
diagnosis and the hospital staff could not tell the mentally disordered from the
mentally healthy. Secondly, once labelled with a condition like schizophrenia, patients
find it very difficult to escape the label and be judged as `normal'.
Evaluation: Consider design, method, sample, application, evidence, ethics,
replicability, generalisability, internal and ecological validity, temporal validity
Small sample but spread over several hospitals.
Ecological valid, taking place in a natural environment
Not able to replicate and ensure the similar results
Policies and attitudes change over time so temporal validity is low
Ethical issues, as deceptions were used and the findings may have caused
some distress to nurses, doctors and real patients.
Finding have application to the real world in terms of changing hospital
policies
Good qualitative data produced, but open to interpretation of the observed
behaviour

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STUDY IN DETAIL
Psychologist(s): Chadwick et al. Date: 2000
Title: Challenging the omnipotence of voices: group CBT for voices.
Aim: To test the effectiveness of CBT in group situations, in tackling the symptoms of
schizophrenia.
Method and Procedure: Include method, design, sample, target pop., IV and DV if
appropriate, and any obvious controls. A case study, involving 22 participants diagnosed with
schizophrenia, characterised with the symptoms of hearing voices. All 22 were assessed
beforehand with regard to their cognitive and emotional symptoms.…read more

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