On being sane in insane places - Rosenhan, D.L. (1973)
Don't forget the second study...
Don't forget this second study when discussing Rosenhan's conclusions and applications, as it shows that therapists' diagnosis can be manipulated the other way as well! When they are primed to be more careful, they can be made to make the opposite mistake that that they did in the first study.
This shows very clearly that the diagnosis of mental illness is hugely influenced by labelling, and that by altering the label that they are likely to give to a newly arrived patient, they could alter the disgnosis that they were likely to get. As Rosenhan is careful to point out, it does not imply that the doctors are hopeless, merely that the label makes a big difference to the diagnosis, and the second study is crucial in illustrating this conclusively.
The original study can be read here.
The Holah site has a nice summary and evaluation of the study here. Then...
Test your knowledge:
Lewis Carroll - Alice in Wonderland
Big Issue - The Individual Differences Approach
Assignment 1 - Alternative study - Rosenhan as an experiment
Rosenhan et al conducted a (naturalistic) participant observation. An alternative study method might have been to perform a laboratory experiment.
1. Describe types of observation in Psychology research. (5)
2. How could they have conducted an experiment with a similar aim, but in a lab? (10)
3. What would the advantages and disadvantages of such an experiment be, compared to the original? (10)
Write a description of the study, including the who, what, where and how. Submit it through the form on the home page. If you are really struggling to think of anything, a nice idea for an experiment is given in this Claudia Hammond 'Mind Changers' podcast for the BBC. Try to think of your own one first though!
Assignment 2 - You are the examiner
The document below is an essay written about the ecological validity of Rosenhan's study.
Read the essay and then use the mark scheme given to come up with a score for it. Post your score, plus a justification for your mark, in the appropriate document in the shared Google drive.
"Relax ladies, I'm a scientist!" Participant observations throughout the ages
Rosenhan conducted a participant observation, where the researcher became a part of the group that they were observing. This is a very interesting technique, with some major advantages and disadvantages.
A nice summary of some of the reasons why participant observations are not used very frequently any more can be found here. The same blog (Mindhacks) also published this account of a hilarious participant observation from the 1930s where researchers hid under beds to listen to conversations!.
Watch the video, then complete the study description in as much detail as you can without notes.
Labelling in education
This video is worried about the potentially harmful effects of labelling children with special needs conditions. Do agree that being diagnosed with a condition can be more harmful than it is helpful?
D.L.Rosenhan's "On Being Sane in Insane Places", also called the "Rosenhan experiment" is a critical study regarding the validity of psychiatric diagnosis.
The background for Rosenhan's study is the question of how can we tell sanity from insanity, arguing that there are many inconsistencies regarding the credibility and applicability of concepts of mental health and psychopathology which might be cultural dependent. Rosenhan holds that at the heart of the diagnosis of insanity lies one crucial issue: do the characteristics that lead to a diagnosis come from the patient of the surrounding context? Rosenhan suspects that the approach of determining the occurrence of mental condition based of a catalog of symptoms is not as objective as thought and is highly effected by the tendencies of the person doing the diagnosis.
In order to test his hypothesis Rosenhan thought of an experiment in which normal people are committed to mental institutions in order to see how they are diagnosed. If they are declared sane then the system can be trusted. But if "fakers" will be diagnosed as suffering from mental illness this will attest to a context related bias.
The first Rosenhan experiment
Rosenhan therefore devised two experiments for his study described in "On Being Sane in Insane Places". In the first experiment of the study eight sane people committed themselves to twelve psychiatric institutes without their crew being aware. Aside from Rosenhan himself the experiment included 3 psychologists, one psychology student, a pediatrician, a psychiatrist, a painter and a homemaker. Hospitals chosen for the experiment were also varied.
In their sessions the fake patients complained of auditory hallucinations in which very unclear voices utter vague words. The name, occupation and symptoms of the patients were made up but their personal history and behavior were authentic. None of them had any past of present pathological behavior.
The fake symptoms disappeared right after the patients were admitted, although some of the cases presented mild and passing anxiety. Patients acted inside the institution as they would act outside of it, and they were obviously motivated to be declared sane in order to be discharged. Nurse reports confirm that they were friendly, cooperative and did not exhibit any abnormal behavior.
The fake patients kept (first hidden and then overt) accounts of their experience. Fake patients in the first Rosenhan experiment spent 17 to 52 days in the institutions (an average of 19 days). They all displayed normative behavior but were all but one discharged with a diagnosis of "schizophrenia in remission". None of the files indicated any doubts regarding the diagnosis. Once diagnosed, nobody thought of second guessing the initial judgment. They were not thoroughly examined but not due to lack of time. The other real patients in the institute noticed that the fake patients were normal but the staff did not and they even thought them to be a researcher or journalist. Rosenhan concluded his first experiment in "On Being Sane in Insane Places" with the assertion that doctors tend to over-diagnose in order to be on the safe side and not miss a sick person. But this tendency can cause damage when adopted by psychiatrists due to the social and legal repercussions of a mental condition.
The second Rosenhan experiment will be discussed in part 2 of the summary of "On Being Sane in Insane Places".