Classic Study - Rosenhan 1973

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What were Rosenhan's aims?

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1

What were Rosenhan's aims?

To reveal flaws in the process of psychiatric diagnosis and demonstrate that psychiatrists are unable to distinguish the sane from the insane

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2

What did he provide evidence for?

The disorders lie with the person making the diagnosis not the individual

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3

What were the professions of the confederates?

A psychology student, paediatrician, psychiatrist, painter, housewife and three psychologists

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4

How many were male and female?

5 males, 3 females

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5

What symptoms did the pseudopatients complain of?

Hearing a same sex unfamiliar voice that was unclear but said 'hollow', 'empty', 'thud' (terms not usually linked to SZ)

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6

What did they lie about?

Their jobs and names but all other information provided was true, they said they were no longer hearing voices

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7

How many psychiatric hospitals did they approach?

12 along the east and west coast

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8

What did they have to do to be released?

Convince staff they were sane, so they behaved cooperatively, followed orders from staff and chatted to other patients

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9

How did the pseudopatients record their observations?

Initially in private in a journal but as staff paid little attention to activities, they wrote freely

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10

What happened in the follow up study?

some hospitals wanted to show this wouldn't happen in their workplace so Rosenhan agreed to send more pseudopatients

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11

What did staff have to do in the follow up study?

Rate new patients on a scale of 1 to 10, 1 being high confidence that they were fakers

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12

How many pseudopatients were sent in the follow up?

None

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13

What happened in the mini-experiment?

Pseudopatients approached a member of staff and asked a courteous question about release

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14

What were the findings of the mini-experiment compared to?

a similar encounter between people on Stanford University campus

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15

What were the pseudopatients admitted to the hospitals with?

7 with schizophrenia and 1 with bipolar disorder

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16

What was the diagnosis when they were released?

Schizophrenia in remission

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17

How long did the pseudopatients take to get released?

7 to 52 days, 19 on average

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18

What percentage of patients voiced suspicion to staff about the pseudopatients?

30%

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19

How many medication pills were the pseudopatients given?

2100, which they flushed down the toilet

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20

How much contact time did patients get with a psychiatrist?

7 minutes a day

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21

What percentage of time did nursing staff stay at the nurses station?

90%

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22

How many patients were given a rating of 1 in the follow up study?

41/193 by at least one staff member, 23/193 by a psychiatrist and a further 19 by both

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23

What percentage of pseudopatients got to speak to a psychiatrist/nurse in the mini-experiment, compared to the uni?

4% psychiatrist, 0.5% nurse, whereas 100% of lecturers stopped to talk if asked a courteous question

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24

What did Rosenhan conclude?

We can't distinguish the sane from the insane in psychiatric hospitals

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25

What does the hospital environment create?

Situational factors which lead to depersonalisation and segregation

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26

What can explain the overdiagnosis of pyschiatric illness?

Clinicians avoided calling a sick person healthy as this was potentially dangerous, they were encouraged to do the opposite in the follow up study

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