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  • Created by: lauren
  • Created on: 27-04-14 15:05



aimed to investigate whether psychiatrists could distinguish between people who are generally  mentally ill and those who are not, he also aimed to see whether situation or personaility determines a diagnosis.
he argues is pseudopatients were diagnosed as sane this would show that the sane individual can be distinguished from the insane context- but if the pseudopatients were diagnosed as insane then it is the context rather than the individuals characteristics 


  • anti-psychiatric movement became popular in the 1960s
  • Foucalt(1961) argued that the concepts of sanity were social constructs (not real)
  • Laing(1960) argued schizophrenia was best understood in someones experience not symptons
  • Szasz(1960) medical model is more sophisticated-mental illness excluded no conformists
  • what is seen as normal in one culture is not normal in another
  • diagnosis can be over someones opinion, people have opposing views
  • rosenahn was interested in the legal implications of understanding sanity (in court)
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  • pseudopatients- 5 men and 3 women with various occupations
  • psychiatric hospitals- 12 different hospitals in 5 states of usa
  • said they had been hearing voices (empty hollow thud) non had had any history of abnormality
  • the pseudopatients were intructed to behave normal once admitted, spent time talking to patients and making notes. secretly didnt take mediation


  • one hospital was suprosed and refused to believe it happened in their hospital
  • Rosenhan informed them some pseudopatients would arrive in the next 3 months
  • staff asked to rate out of 10 how confident they were on diagnosing patient
  • 193 genuine patients and 0 pseudopatients were admitted


  • rosenhan tested how staff responded to pseudopatients, pseudopatients approached staff and asked a question 
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  • 1  all pseudopatients were admitted, one was diagnosed with schizophenia
  • hospitalisation lasted 7-52 days with an average of 19 days
  • staff only spent 11% of time out of their quaters and that was for chores
  • on average, psychiatrists appeared on ward 6.7 times a day and daily contact 6.8 mins per day
  • real patients regularly voiced their suspicions about the pseudopatients
  • nurses judged normal behaviour lie walking or writing as abnormal
  • pseudopatoints were given 2100 tablets
  • 2  over the 3 months 193 pateints were admitted but non were pseudopatients.
  • at least one staff member judged 41 (21%) to be pseudo
  • at least one psychaitrist judged 23 (12%) to be pseudo
  • 3  staff mainly gave a breif reply and continued walking without making eye contact
  • 4% of psychiatrists and 0.5% nurses actually stopped
  • 2% in each group paused and chatted
  • as a control a young lady approached staff members and all stopped and answered questions keeping eye contact.
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    • TYPE 1 -person is sick but diagnosed as healthy
    • TYPE 2 -person is healthy but diagnosed as sick
    • in study 1, psychiatrists were biased towards TYPE 2 - more dangerous to misdiagnose
    • in study 3 the hopsital made more TYPE 1 errors, avoiding making type 2 errors like study1
    • ASCH(1964) found personality trauts 'warm and cold' affected perception of person
    • once someones labelled as abnormal all data interpreted in that light 'schizophrenia in remisson' still ill but temporarily sane
    • behaviour of staff in study 3 showed  patients were depersonalised because contact was avoided, lack of personal privacy, lack of respect from staff, use of psychotropic drugs
    • Rosenhan- we prefer to invent knowledge rather than admit we dont know. 
    • we cannot distinguish the sane from the insane, we could;
      • use community health facilities to avois effects of institutional setting
      • use behavior therapies which avoid psychiatric labels
      • increase sensitivity of mental health workers
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  • DESIGN- naturalistic observation
    • means there was no demand characteristics by any of the particpants
    • ethical issues
    • ecological valid
  • ETHICS- deception
    • didnt inform the staff they were being observed
    • soctors proffession questioned more likely to make type 1 errors
    • informed consent
  • RELIABILTY- support
    • two studys conducted in two different ways- cant be compared
    • study 1; 12 hospitals  study 2; 1 hospital
  • VALIDITY- low
    • doctors werent used too the situation - not real
    • different hopsital increase validity as it gives a range 
    • slater found psychiatrists diagnosed mental illness based on one sympton of hallucination - confirming rosnhans findings (external validity)
  • SAMPLE- nurses and doctors
    • deception, uninformed consent, confedentiallity
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SLATER (2004) presented herself to 9 psyciatric emergency rooms with auditory hallucinations 'thud' in most cases she was diagnosed with psychotic depression and was prescribed with antipsychotics or antidepressants.

SPITZER (2005) gave 74 emergency room psychiatrists a detailed case description of Slater's clinical depression- only 3 psychiatrists offered diagnosis of depression, only 1/3 gave medication

KETY (1974) same thing could happen with physical illness, if you vomited blood (which you had just drunk) you would be diagnosed with having a peptic ulser

SPITZER (1976) discharge diagnosis of schiz in remission is hardly used

DSM strictor criteria now after a lot of research into reliability, now have to agree on diagnosis

WHALEY (2001) lower inter-rater reliability

LANGWEILER AND LINDEN (1993) 4 pateints went with same symptons and came back with different diagnosis and treatments

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  • experimentl design- natural setting
  • high ecological validity
  • reliable - supporting studies
  • no demand charcteristics
  • range of hospitals


  • small sample
  • unethical
  • only american hospitals
  • internal validity- bad acting
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