Rosenhan 1973 Study - Clinical Psychology

Overview

• Aim: Investigate if sane individuals can be distinguished from the insane.
• Methodology: Field experiment with independent groups design.
  • Independent Variable: Schizophrenic symptoms displayed by pseudo patients.
  • Dependent Variable: Diagnostic label assigned.
  • Participant Observation.

Participants

• Sample: 8 sane volunteers (3 women, 5 men).
• Location: 12 psychiatric institutions across 5 US states.

Procedure

• Pseudo patients faked auditory hallucinations ("empty," "thud," "hollow").
• Used false names and jobs, but truthful personal histories.
• All but one diagnosed with schizophrenia; one with manic depression.
• Upon admission, they stopped faking symptoms and behaved normally.
• Role: Observe staff treatment of other patients.
• Did not take given medication, disposed of secretly.

Findings

• None of the pseudo patients detected by hospital staff.
• Hospitalization lasted between 7 to 52 days (average 19 days).
• 35 of 118 real patients suspected pseudo patients were faking.
• Normal behaviors misinterpreted as mental illness signs.
  • Note-taking labeled as "writing behavior."
  • Corridor walking seen as "nervousness."
  • Early lunch waiting interpreted as "oral acquisitive syndrome."
• Minimal interaction with staff:
  • Nurses spent 90% of time in offices.
  • Average staff interaction: Less than 7 minutes per day.
• 70% of pseudo patients' queries ignored.
• Verbal and physical mistreatment reported.
• Powerlessness and depersonalization common.

Evaluation

Strengths

• Standardized Procedure: Higher reliability.
  • Identical training and symptom reporting for all pseudo patients.
• Generalizability: Findings applicable across varied hospital types and locations.
• Reliability: Consistent findings across multiple hospitals.

Weaknesses

• Validity Issues: Hallucinations are classic schizophrenia symptoms, making misdiagnosis unsurprising.
• Ethical Issues: Deception and potential harm due to space occupied by pseudo patients.
  • Counterargument: Minimal attention given to patients anyway.

Supporting and Contradicting Studies

• Support: Laurence Sther (2004) study showing misdiagnosis in ERs.
• Contradiction: Spitzer (2005) study showed that many psychiatrists ruled out psychotic behavior.

Conclusion

• Contextual Influence: Diagnosis heavily influenced by expected behaviors.
• Unreliable Diagnostic Processes: Demonstrated by differing diagnoses despite consistent symptoms.
• Stigma: Psychiatric labels can lead to a self-fulfilling prophecy.

Final Remarks

• Importance of context and expectation in psychiatric diagnosis.
• The study highlights both diagnostic challenges and the potential for labeling to affect patient self-perception.