While the Exam could ask general questions about the procedure or evaluation, it could also ask specific questions, like, What did the pseudopatients say about their symptoms? It is a famous naturalistic observation with aspects of a field experiment included. Rosenhan was a young academic who attended R. Rosenhan wanted to test the reliability of diagnosis for mental disorders.
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Published June 22, Updated November 4, How the Rosenhan experiment showed that "it is clear that we cannot distinguish the sane from the insane in psychiatric hospitals. David Rosenhan. What does it mean to be sane? How reliably can even medical professionals distinguish the sane from the insane? Psychologist Dr. David Rosenhan of Stanford University had long been interested in these age-old questions and, in , devised a unique experiment to put them to the test.
Rosenhan and seven other perfectly sane subjects went undercover inside various psychiatric hospitals from and acted insane in order to see if the doctors there could tell that they were faking. The doctors could not. Elizabeths Hospital in Washington, D. These pseudopatients consisted of three women and five men, including Rosenhan himself, whose occupations ranged from actual psychologist to painter.
On the basis of these appointments, every single pseudopatient was admitted to the hospital that they contacted. All they had done was feign auditory hallucinations. They exhibited no other symptoms and invented no false details about their lives aside from their names and professions.
Yet they were diagnosed with serious psychological disorders. Once checked into the hospitals and diagnosed, the pseudopatients were on their own. None knew when the doctors would deem them fit for release — or find out that they were faking first. The Disturbing Results U.
Elizabeths Hospital. Circa s. But as it turned out, there was no need to worry on this account. The pseudopatients showed no new symptoms and even reported that the strange voices had gone away, yet the doctors and staff continued to believe that their diagnoses were correct.
In fact, hospital staff would observe totally normal behavior on the part of the pseudopatients and characterize it as abnormal. For instance, Rosenhan instructed the pseudopatients to take notes on their experiences.
And given that he is a disturbed, continuous writing must be a behavioral manifestation of that disturbance, perhaps a subset of the compulsive behaviors that are sometimes correlated with schizophrenia. And in addition to stubbornly sticking to their diagnoses, hospital staff would treat the pseudopatients coldly.
Interactions with the staff ranged from disinterested at best to abusive at worst. Even when the pseudopatients attempted to engage with staff in a friendly, conversational manner, responses were perfunctory when given at all. But while hospital staff treated the pseudopatients poorly and never realized they were faking, the actual patients often had no trouble detecting them. Rather the evidence is strong that, once labeled schizophrenic, the pseudopatient was stuck with that label.
This kind of thinking is understandable to a point: failing to diagnose a sick person usually has more severe consequences than misdiagnosing a healthy one. However, the consequences of the latter can be dire. Either way, the results of the Rosenhan experiment caused a sensation. People were astonished about the unreliability of psychiatric diagnoses and the ease with which hospital staff had been duped. Of course, even Rosenhan was not the first American to bring the darker side of the mental health system to light in this way.
Almost a century later, Rosenhan showed that the mental health profession still had a long way to go in being able to reliably and consistently distinguish the sane from the insane.
The new version of the manual, published in , presented a more thorough list of symptoms for every mental illness and stated that, in order to diagnose a patient with a certain disorder, multiple symptoms had to be present as opposed to just one.
These changes in the manual survive to this day, although it has yet to be conclusively determined whether it has been successful in preventing false diagnoses. Perhaps the Rosenhan experiment could be duplicated today. And such documentation, Cahalan found, actually contradicted the results that Rosenhan published on certain points. For one, Cahalan claimed that Rosenhan himself, when undercover in an institution as part of his own experiment, told doctors there that his symptoms were quite severe, which would explain why he was so quickly diagnosed.
But Rosenhan allegedly ignored this data when drafting his report.
While his methods were a little suspect, the study seemed to make the point Rosenhan was hoping for. Background Information One of the most influential studies conducted investigating the difficulties in defining normality and abnormality, and the inherent repercussions for valid and reliable diagnoses of psychological disorders, was conducted by David Rosenhan. This research was published in , a time when psychiatric hospitals were quite different to the way they are today. Aims Prior to this study, some researchers had conducted participant observations of psychiatric hospitals, but this was often for a short time and the hospital staff knew of their presence. Rosenhan wanted to take this research one step further and so he conducted a participant, naturalistic, covert observation. They were an eclectic mix of people who used false names and occupations. There was a graduate student of psychology, three psychologists, a pediatrician, a psychiatrist, a painter and a housewife.
Learn how and when to remove this template message Rosenhan himself and seven mentally healthy associates, called "pseudopatients", attempted to gain admission to psychiatric hospitals by calling for an appointment and feigning auditory hallucinations. The hospital staff were not informed of the experiment. The pseudopatients included a psychology graduate student in his twenties, three psychologists, a pediatrician, a psychiatrist, a painter, and a housewife. None had a history of mental illness. Pseudopatients used pseudonyms, and those who worked in the mental health field were given false jobs in a different sector to avoid invoking any special treatment or scrutiny. Apart from giving false names and employment details, further biographical details were truthfully reported. During their initial psychiatric assessment , the pseudopatients claimed to be hearing voices of the same sex as the patient which were often unclear, but which seemed to pronounce the words "empty", "hollow", or "thud", and nothing else.
Key study: “On being sane in insane place” (Rosenhan, 1973)