case study 10
case study 10
- Created by: Jamie
- Created on: 02-06-11 13:27
Case study 10 Rosenhan insane and sane
Aims and context: physical and mentall illness regarded as the same/therefor treated the same/1930's several controversial practisices introduced e,g; electroshock therapy and lobotomy/1950's development of drugs and slowly phased out radical physical treatments/1960's movement started which challeneged the ideas and practices of mainstream psychiatry/argued that mental illness is an unclear combo of a medical and psychological concept/by labelling people mentally ill just allows to control people who deviate from social normality/argued that concepts of sanity and insanity were social constructs and did not reflect measureabl patterns of human behaviour/all it did was reinforce the power of the 'sane' over the 'insane'/aims to investigate if psychiatrists could reliably tell the difference between people who are genuinely mentally ill and those who aren't/wanted to know weather the characteristics of an insane person reside in the person themselves or in environments and contexts in which they are found.
Case study 10 Rosenhan insane and sane
Procedures:8 sane people attempted to enter 12 different hospitals one private hospital and all varying from old to new/ in 5 different US states/3 women and 5 men/3 psychologists a painter a housewife/described life events accurately and had no history of mental health/entered hospital with no knowledge of a disscharge date and had to get out by convincing staff they were sane/called hospital stating they could hear voices of the same sex but unfamiluar to them/saying 'empty' 'hollow' and 'thud'/symptoms chosen as they were simiular to ones already in exsistence/these symptoms were the only thing they lied about/apart from these symptoms the patients behaved perfectly normally/spent time talking to other patients and making notes of other patients and staff in the ward/originally done in secret but soon became aparent staff didnt care/if the patients were asked how they were feeling they responded that they were perfectly fine and were no longer experiencing symptoms/this research was publicised and one hospital challenged rosenhan to send fake patients to them and they would find them/told in the next 3 months one or more fake patients would enter/staff were asked to mark on ten point scale confidence in authenticity of patient
Case study 10 Rosenhan insane and sane
Findings and conclusions:all exhibited signs of sweating and all but one had the desire to be disscharged immediately/all except one were admitted with a diagnosis of schizophrenia/ranged from 7-52 days/average 19 days/average contact with doctor 6.8 minutes a day/whilts at the hospital 35 out of 118 patients claimed the fake patients were not genuinely mentally ill/in totall given 2,100 tablets/nurses recorded 3 of the patients had pathological writing behaviour/staff only left the office 11.3% of the time/concluded that we can't distinguish beween the insane and sane/the hospital creates an environment in which anything that is doen can be understood as insane/the negative effects of someone being mentally unstable e,g;labelling etc is counter theraputic/believed the diagnosis was missed as doctors more inclined to call a healthy person sick(type 2 error) than a sick person healthy(type 1 error)/once someone is labelled nothing can be done to overcome the label as all behaviours are coloured by this label/additional research:193 patients admitted during the time/41 fake by a member of staff/23 fake by doctor/none were sent in/while avoiding type 2 error did type 1/unreliabe due to massive error.
Case study 10 Rosenhan insane and sane
Methodology:participant observation/strength high ecological validity as investigated in a real environment/overt observation/staff unaware that they were being involved therefor no demand chracteristics/natural behaviour observed/weakness is impossible to control extraneous variables and impossible to replicate/finding connot be checked for reliability/sample involved doctors and nurses including a range of hospitals/strength a variety of ppt/fair representation of hospitals over america/weakness is that it is not safe to generalise to other cultures/data strength variety of data collected qualatative and quantatative data/ethics deception of staff and other patients/there was no informed consent given/invasion of privacy of patients/ethically justified as findings were so signifficant/however rosenhan had no idea what would be found
Case study 10 Rosenhan insane and sane
Alternative evidence:spitzer investigated individuals admitted with schizophrenia in his own and 12 other hospitals/found that the discharge diagnosis of S in remission is given very rarely/contrasting rosenhan saying that the fake patients disscharge was a result of their behaviour and not a result of the environment/especially dissagreed as rosenhan used legal terms (sane and insane) rather than psychiatric terms/ironic as rosenhan was investigating the use of psychiatric labelling/langweiler and liden sent fake patients to four doctors/all complained of the same symptoms but given 4 different diagnosis/prescribbed 4 types of different treatment/supports rosenhan as suggests the methods used for diagnosis were unreliable/slater presented herslef at several hospitals with same symptoms as rosenhans patients/was not admitted to any but given a prescription of drugs/support rosenhan as she was still offered treatment for her symptoms/also still not able to distinguish between sane and insaneb
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