Classic Study - Rosenhan 1973

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

What did he provide evidence for?

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

What were the professions of the confederates?

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

How many were male and female?

5 males, 3 females

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)

What did they lie about?

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

How many psychiatric hospitals did they approach?

12 along the east and west coast

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

How did the pseudopatients record their observations?

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

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

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

How many pseudopatients were sent in the follow up?

None

What happened in the mini-experiment?

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

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

a similar encounter between people on Stanford University campus

What were the pseudopatients admitted to the hospitals with?

7 with schizophrenia and 1 with bipolar disorder

What was the diagnosis when they were released?

Schizophrenia in remission

How long did the pseudopatients take to get released?

7 to 52 days, 19 on average

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

30%

How many medication pills were the pseudopatients given?

2100, which they flushed down the toilet

How much contact time did patients get with a psychiatrist?

7 minutes a day

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

90%

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

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

What did Rosenhan conclude?

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

What does the hospital environment create?

Situational factors which lead to depersonalisation and segregation

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