Rosenhan: Being Sane in Insane Places

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Classic study: Being Sane in Insane Places

AIM

  • Study conducted in 1973 by David Rosenhan, who was a participant himself in the study. It was a naturalistic observation with aspects of a field experiment included.

  • Rosenhan wanted to test the reliability of diagnosis for mental disorders.

PROCEDURE

  • He had a group of pseudopatients (fake patients). 3 women and 5 men - a psychology graduate, three psychologists, a paediatrician, psychiatrist, a painter and a housewife.

  • In order to be admitted, pseudopatients had to attend a clinical interview. Told the truth about their backgrounds. All of them reported the same symptoms; hearing an unfamiliar voice repeating the words ‘empty’, ‘hollow’ and ‘thud’.

  • All eight were admitted with a diagnosis of schizophrenia. At the time the DSM-II was in use.

  • 12 hospitals were used, across 5 different states. Some were old and shabby, some were new, some were understaffed, some had good patient-staff ratios.

  • After they were admitted, pseudopatients began to act normally and stopped reporting hearing voices. Recorded what they heard and saw in the hospital (unstructured observation).

RESULTS

  • All 12 hospitals diagnosed pseudopatients as mentally ill. 11 diagnosed schizophrenia, 1 diagnosed manic depression.

  • Took between 7 - 52 days for pseudopatients to be discharged - the average stay was 19 days.

  • Discharged with a diagnosis of schizophrenia - in remission.

  • Pseudopatients observed many disturbing things:

  • Staff abusing patients.

  • Patients refusing medication. Often patients flushed their tablets down the toilet.

  • Depersonalisation and powerlessness. Patients not treated as people. No doors on toilet cubicles and staff would inspect medical records and personal belongings without asking permission. Staff would not make eye contact and

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