Issues in Mental Health- Key study: Rosenhan (1973) summary

experiment 1 aim?
To investigate whether using the DSM (a standardised diagnostic manual) is a reliable way of diagnosing mental illness. He was also interested in observing the consequences of being labelled insane.
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SAMPLE?
The staff and patients at 12 hospitals located across 5 US states
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PROCEDURE?
Pseudopatients, of a variety of genders and occupations, telephoned the hospitals asking for an appointment. At the hospital, they gave false names and addresses, but reported their life history accurately.
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procedure 2?
All pseudopatients had no history of mental illness. They reported a false symptom: hearing an imaginary say ‘dull, thud, hollow’. They measured the diagnoses they received.
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procedure 3?
After admittance to hospital, they behaved normally, reported no symptoms, and cooperated with hospital staff. They conducted a participant observation, recording in note books qualitative and quantitative information on behaviour ofstaff + pacients
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procedure 4?
They also measured staff responses to their requests, asking nurses and doctors when they thought they would be released. All pseudopatients remained in the hospital until they were released, and only pretended to take any medication they were given
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FINDINGS/ CONCLUSIONS?
Diagnosis is unreliable and invalid because of a bias towards making a Type 2 error (a false positive) which may be inappropriate for a psychological disorder because of the stigma attached to a diagnosis. all diagnosed with mental illness 11/12 sciz
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findings and conclusions 2?
Patients in mental hospitals are depersonalised and powerless -They were ignored by the majority of staff when making requests: 88% of nurses and 71% of doctors averted their gaze; only 2% of nurses and 2% of doctors responded to their request.
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findings and conclusions 2 extra?
Mean average daily contact with doctors was 6.8mins * The toilet doors were removed; patients were often monitored during bath and toilet times
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findings and conclusions 2 extra?
Orderlies were brutal towards patients in front of other patients, but the abuse stopped when other staff were present (implies they didn’t view patients as credible witnesses)
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findings and conclusions 3?
Labels, once assigned, are sticky/ Behaviour is interpreted in the context of the situation They were hospitalised for an average of 19 days and released with diagnoses of ‘Schizophrenia in remission’
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findings and conclusions 3 extra?
Pseudopatients’ note taking was interpreted as ‘writing behaviour’ in the patient notes, and turning up early for lunch was interpreted as ‘oral acquisitive behaviour’
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experiment 2? sample
1 teaching and research hospital, US
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procedure?
The hospital were told that ONE or more pseudopatients would be sent to the hospital in the following three months. Staff at the hospital rated all patients during this period on a scale of 1-10 (1 being not genuine, and 10 being genuine patient).
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FINDINGS?
Out of 193 patients ‘assessed’: * 41 rated as a pseudo-patient (by at least one member of staff) * 23 rated as pseudo-patient (by at least one psychiatrist) * 19 rated as pseudo-patient (by both a psychiatrist and at least one other member of staf
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CONCLUSIONS?
Diagnosis was unreliable: staff were biased towards a false negative (Type 1 error) because they had been made aware of the results of Rosenhan’s first study.
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Card 2

Front

SAMPLE?

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The staff and patients at 12 hospitals located across 5 US states

Card 3

Front

PROCEDURE?

Back

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Card 4

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procedure 2?

Back

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Card 5

Front

procedure 3?

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