Classic Study: Rosenhan (1973) On being sane in insane places.

You need to start by reading the original paper: http://psychrights.org/articles/rosenham.htm

Answer the questions on this sheet to help with reading comprehension/reading for meaning: rosenhan-research-questions

We will be watching the following clip in class to introduce Rosenhan but also to lead into the next section on the reliability and validity of diagnosis: https://vimeo.com/112905501

Here is another clip about the study: https://www.youtube.com/watch?v=D8OxdGV_7lohttps://www.youtube.com/watch?v=D8OxdGV_7lo

Once you have done this you can embark on task to consolidate and enrich your understanding:

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Some pupils answers to help with peer assessment: pupil-work-rosenhan

This is for the plenary of the lesson: learning-tree-afl

rosenhan-complex-ao2-and-3-questions

rosenhan-dont-be dre:

Ignore, Don’t be Dre Rosenhan sheet Edexcel can’t ask this question and I need to revise this sheet to somehtign they can ask 🙂

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rosenhan-1973-results

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Extra chain in addition to textbook spread:

One strength of Rosenhan’s study was the use of a standardised procedure up to the point of admission, whereby patients were briefed on exactly what they should say.

All patients phoned for an appointment and then presented on the same day saying they heard were hearing voices. The voices were unfamiliar and same-sex voices and said ’empty’, ‘hollow’ and ‘thud’. This procedure allows for replication to determine whether the results are reliable. Journalist, Lauren Slater (2005) did just this when she presented at nine psychiatric emergency wards reporting the exact same issue. She says she was consistently diagnosed with psychotic depression and prescribed a variety of medication.

This replication suggests that Rosenhan’s claims were not era-bound despite the transformation of the DSM since version II, used in the original study.

Competing argument: This said, her book chapter has provoked widespread condemnation; a detailed summary of her ‘study’ was reviewed by 74 psychiatrists, 96% of whom indicated that they would not have diagnosed psychotic depression based on this sole symptom and her claims that diagnostic labeling is driven by the desire to prescribe have been rejected by many eminent psychiatrists, (Spitzer, 2005).


 

One weakness of the study is that Spitzer (1975) argues that Rosenhan misinterprets his own data and fails to report evidence for some of his claims.

For example, he argues that ‘schizophrenia in remission’ was an extremely rare phrase at this time, and provides evidence from copious discharge records for real people with schizophrenia, none of which use this phrase. He concludes that the psychiatrists were indeed capable of detecting ‘sanity’ in these patients, hence the use of this unusual phrase.

This suggests that Rosenhan’s claims may have been distinctly over-stated and lacking in validity.


The ninth pseudopatient

A weakness of the study is that Rosenhan did not report all of the data that was collected, suggesting his account is highly subjective.

Harry Lando was also diagnosed with schizophrenia but describes his 19 day admission as ‘extremely favourable’. While Rosenhan reports that staff spent an average of only 6.8 minutes a day with patients, Lando says patients and staff were engaged for at least an hour a day in activities such as group and drama therapy, watching television/playing cards. He notes that patients were respected and listened to by caring and attentive staff.

This suggests that Rosenhan’s data are highly subjective and Lando’s account

(Lando 1976) seriously detracts from the Rosenhan’s credibility.

<C> Experimental data

One strength of Rosenhan’s study is that he also collected some more experimental data to support his claims about depersonalisation.

He found that when pseudopatients politely asked simple questions of psychiatrists they were answered just 4% of the time (n= 185) and this dropped to just 0.5% when nurses were approached, (n=1283). However, when a confederate approached busy staff members on campus at Stanford, all 14 questions were answered. However, when the confederate asked where to find a psychiatrist, the response rate dropped to 78%.

The use of a control group in this field experiment adds to the validity and the findings corroborate Rosenhan’s conclusions regarding the treatment of psychiatric patients compared with people perceived as non-patients


Wider Reading

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  1. Spitzer’s reply to the Rosenhan study (1975):

http://facstaff.bloomu.edu/jleitzel/classes/introabnormal/spitzer_1975.pdf

2. Lauren Slater’s chapter about the Rosenhan study and her replication: http://ep.gdufs.edu.cn/__local/6/08/0D/3A00E0E5F48443DEB12B7E585F7_9779D459_128F1B.pdf

3. http://psycnet.apa.org/fulltext/1976-21263-001.pdf