Aim: To test the hypothesis that psychiatrists can not reliably tell the difference between people who are sane and those who are not.
Procedure: 8 psuedo-patients participated in the experiment. Rosenhan, 2 psychologists, a psychology student, a paediatrition, a psychiatrist, a painter and a housewife tried to get admitted into a psychiatric hospital by saying they were hearing 'voices'. After diagnosis and admition into hospitals, the psuedo-patients then had to try to get out of the hospitals.
Findings: The time taken took 2 days to 52 days, with the average being 19.
Conclusions: It isn't as clear as originally thought.
Procedure: Staff in a hospital were falsely informed that one or more psuedo-patients would try to gain admission in the next few weeks. 193 patients were asked to visit the hospital to gain a diagnosis. The staff were asked to rate them on a 10 point scale.
Findings: 83 actual patients were thought to be pseudo-patients by the staff.
Andrews et al (1999)
Aim: To see the difference between ICD-10 and DSM-IV criterion for diagnosis
Procedure: Researchers chose an enriched sample (several people, more than the prevelance rate) of people that had different psychological disorders. They then compared the criteria for diagnosis between the two classification systems and whether a person would be diagnosed with the disorder.
Findings: There was a low concordance rate for disorders such as PTSD and Panic Disoder, where as there was a high concordance rate for disorders such as Depressive episode and Generalised anxiety disorder.
Conclusion: This shows there is a problem with reliability, as the concordance rate between the ICD and DSM for disorders is lower for some, meaning they cannot reach the same diagnosis.
Cooper et al (1972)
Aim: To investigate reliability of diagnosis of depression and schizophrenia
Procedure: Researchers asked American and British psychiatrists to diagnose patients by watching a number of videotaped clinical interviews.
Results: The British psychiatrists diagnosed the patients in the interview to be clinically depressed twice as often. The American psychiatrists diagnosed the same patients to be suffering from schizophrenia twice as often.
Conclusion: The results indicated that the same cases did not result in similar diagnosis in the two countries. This points towards problems of reliability as well as cultural differences in interpretation of symptoms and thus in diagnosis. Additionally, there was stigma in Europe around the diagnosis of schizophrenia, therefore psychiatrists may have been less likely to diagnose it.
Di Nardo (1993)
Aim: To study the reliability of DSM-II in the diagnosis of anxiety disordders
Procedure: Two clinicians seperately diagnosed each of 267 people seeking treatment for anxiety anad stress disorders. Researchers used Kappa to see the similarities.
Findings: There was high reliability for OCD, but lower reliability for generalised anxiety due to how "excessive" a person worries.
Aim: To investigate how expert influence affects diagnosis
Procedure: Participants watched a video-taped interview of a healthy individual talking about a seemingly normal life. The authority claimed that even though the person only seemed to be neurotic, he was actually psychotic.Participants were then asked to judge the person’s mental health.
Findings: Clinically trained psychiatrists were influenced by the authority figure (expert influence)
Jenkins-Hall and Sacco (1991)
Procedure: Researchers presented videotapes of a person in therapy to a number of European American male and female therapists. The videos presented different situations (male or female, black or white, depressed or non-depressed symptoms). They were asked to diagnose the patients.
Findings: White therapist were more likely to make a false-positive diagnosis if the patient was black. For example, a black patient would be diagnosed as depressed even in the absence of deprresed symptoms.
Conclusion: Culture can affect the validity of diagnosis. (Ethnicity Bias)
Brown and Harris (1978)
Aim: To investigate to what extent social and cultural factors play a role in the onset of depression in women
Procedure: 458 women in South London were surveyed on their daily lives and depressive episodes, including life events and difficulties faced, and then were asked to rate their severity
Findings: Working women with young children were 4 times more likely to become depressed than middle class women. 8% had been depressed in the previous year. 30 of the 32 women who had depressed had experienced an adverse life event or serious difficulty. Only 30% of women not depressed suffered adversity.
Conclusion: Three major factors were found: protective factor (intimacy, social support), vulnerability factor (loss of mother before 11, lack of relationship, +3 kids under 14, unemployment) and provoking factor (stressors)
Weisman et al. (1996)
Procedure: 10 countries participated in the study: the United States, Canada, Puerto Rico, France, West Germany, Italy, Lebanon, Taiwan, Korea, and New Zealand. The rates of prevelance, demographics and ages of onset of major depressionwere measured.
Findings: The study found that the lifetime prevalence of depression ranged from 19.0 % (Beirut in Lebanon) to 1.5 % (Taiwan). Korea had rates of depression twice as high as those in Taiwan (2.9%) although they are both Asian countries. Paris had a rate (16.4%) close to that of Beirut although Beirut had experienced war for 15 years. Women had a higher rate than men in all countries.
Criticism: The researchers argue that different risk factors, social stigma, cultural reluctance to endorse mental symptoms as well as methodological limitations of the study may account for some of the differences.
Nicholson et al (2008)
Method: A cross-sectional study examined 12,053 men and 13,582 women in Russia, Poland and the Czech Republic. Depressive symptoms were examined in relation to socio-economic circumstances at three phases of the lifecourse: childhood, own education, and current circumstances.
Results: Men in the most socially disadvantaged groups in these countries were five times more likely to report depressive symptoms in their compatriates in higher socio-economic groups.
Boury et al (2001)
Aim: To investigate Becks cognitive triad
Procedure: Researchers monitored student's negative thoughts with the Beck Depression Inventory (BDI), a self-report questionnaire.
Findings: There was a correlation between the amount of automatic negative thoughts and the severity of depression. They also found that the duration of depression was influenced by te frequency of these thoughts.
Lewinsholn et al (2001)
Procedure: Longitudinal prospective study of 1500 adolescents