case study 10

case study 10

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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.

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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

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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.

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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

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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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