On Being Sane In Insane Places Case Study
Psychological Issues
Assignment 1
Case Study
STUDENT: 21237964
MODULE LEADER: Rosemary Stock
Through history people have attempted to understand and classify abnormal behaviour and the medical module was seen as the most accepted way of doing so. This approach has used the Diagnostic and Statistical Manual of Mental Disorders (DSM) to classify this behaviour. The study conducted by the psychologist David Rosenhan (1973) ‘On being sane in insane places’, came as a critic to the medical mode. The aim of this study was to find out whether psychiatrists could distinguish between those who were mentally sane and those who were not. Other more recent studies have been done within this area of research. Slater …show more content…
(2004) presented herself in nine different psychiatric facilities clamming that she was suffering from hallucinations. Her study will be used in comparison to the previous one.
Procedure and Findings
Rosenhan’s main study involved eight ‘pseudo-patients’, none had a history of mental hilliness, (among them was a ‘housewife’, three psychologists, a psychology student, one psychiatrist, a painter and Rosenhan himself) who attempted to gain admission in 12 psychiatric facilities.
The procedure began with the participants calling the hospitals for an appointment and complaining of auditory hallucinations. They said they could hear the words ‘hollow’, ‘empty’ and ‘thud’, but that the voice was often unclear. They described their mental state precisely and all eight were admitted, seven being then diagnosed with schizophrenia and one with bipolar disorder. All participants gave false names and occupations to ensure that the diagnosis would not be added to their records. After being accepted, the pseudo-patients did not report any other symptoms. They acted normally around both staff and the genuine patients and always accepted the medicine that was given to them but did not take it. While the hospital staff failed to identify sanity and the participants were hospitalized from 7 to 52 days (with an average of 19 days) prior to being considered sane and being discharged. While the staff failed to identify sanity, 3 out of the 8 participants noticed that 35 out of a total of 118 real patients, suspected in some way that the pseudo-patients were not insane. Pseudo-patients normal behaviours were overlooked or misinterpreted.
Slater, in contradiction to Rosenhan’s pseudo-patients, had been previously diagnosed with depression. Slater presented herself in nine psychiatric rooms clamming she heard the word ‘thud’ (replicating some of Rosenham’s procedure). This specific symptom was partly chosen because it raises concerns about the meaning of life. She was later on diagnosed with psychotic depression from all the hospitals and prescribed medication.
Evaluation of the Procedure
In Rosenham’s research he used a field study. One of the strengths of doing so is that it is possible to gather both qualitative and quantitative data, so plenty of conclusions can be drawn. The participation observation method allows the participants from the first study to experience the world coming from a patient perspective while maintaining their objectivity.
Although a strength in both Rosenhan’s and Slater’s experiment is that it was used a wild range of psychiatric hospitals, allowing the results to be generalized, they lack realism. The fact that the psychiatric system can be tricked does not necessarily mean that it doesn’t work effectively on genuine patients. Both Doctors and psychiatrists are most likely to make a type two error (this meaning, they are more likely to consider someone healthy as sick) than a type one (this meaning, diagnosing a sick person as being healthy).
The studies methodology can also be evaluated in terms of ethnic.
They both deceived the hospital and no member of staff gave consent on being a part of the study and/or being observed.
However, a strength of both studies reliability, is that it was conducted in various hospitals, the same symptom was reported in all of them and the same diagnosis was given (in Rosenham’s experiment, in 10 out of 11 hospitals). This shows the consistency on the diagnoses. And the fact that none of the participants on Rosenham’s study had a history of mental hilliness makes in more reliable. The same does not happen with Slater’s experiment which could have been deceived considering that Slater had previously been diagnosed with depression, which could have leaded her into acting in a way that would affect the diagnosis.
When Rosenhan conducted this study the psychiatric classification was the DSM-II. However, and even though there have been new classifications introduced, in Slater’s study, dated to 2004 the same errors occurred. It was to expect that with the introduction of the newer classification DSM-III, in 1980s, and more recently the DSM-IV, psychiatrists would make less mistakes and the problem of unreliability, especially unclear criteria, would be solved.
Conclusion
These studies are very similar in some points, they share many of their weaknesses and strengths. From both of them it can be concluded that health professionals were willing to make the diagnosis based on false symptoms and that they struggle to distinguish the difference between those with real mental problems and those without. ‘Normal’ behaviour was misinterpreted as being ‘abnormal’, what suggested the non reliability of and validity of psychiatric diagnoses. ‘It is clear that we cannot distinguish the sane from the insane in psychiatric hospitals’ This studies can be seen as an attempt to classify mental hilliness as a social phenomenon and as a simple consequence of the human necessity to label. However their weaknesses undermine the reliability of the experiments.
REFERENCES
Banyard, P & Grayson, A (2000) Introducing Psychological Research: (2nd Ed). London: Palgrave Macillan.
Rosenhan, D.L. (1973) On being sane in insane places. Science, pp 179, 250-258
Slater, L. (2004) Opening Skinnner’s Box: Great Psychological Experiments of the Twentieth Century.
Kornblum, W (2011). Mitchell, E. & Jucha, R. & Chell, J. Sociology in a Changing World (Google Books) (9th ed.) pp 195
Spitzer, R. L. On Pseudoscience in Science, Logic in Remission, and Psychiatric Diagnosis: A Critique of Rosenhan 's 'On Being Sane in Insane Places '. Journal of Abnormal Psychology; (1975) vol. 84 no. 5; pp 442-452.
Assignment 1
Case Study
STUDENT: 21237964
MODULE LEADER: Rosemary Stock
Through history people have attempted to understand and classify abnormal behaviour and the medical module was seen as the most accepted way of doing so. This approach has used the Diagnostic and Statistical Manual of Mental Disorders (DSM) to classify this behaviour. The study conducted by the psychologist David Rosenhan (1973) ‘On being sane in insane places’, came as a critic to the medical mode. The aim of this study was to find out whether psychiatrists could distinguish between those who were mentally sane and those who were not. Other more recent studies have been done within this area of research. Slater …show more content…
(2004) presented herself in nine different psychiatric facilities clamming that she was suffering from hallucinations. Her study will be used in comparison to the previous one.
Procedure and Findings
Rosenhan’s main study involved eight ‘pseudo-patients’, none had a history of mental hilliness, (among them was a ‘housewife’, three psychologists, a psychology student, one psychiatrist, a painter and Rosenhan himself) who attempted to gain admission in 12 psychiatric facilities.
The procedure began with the participants calling the hospitals for an appointment and complaining of auditory hallucinations. They said they could hear the words ‘hollow’, ‘empty’ and ‘thud’, but that the voice was often unclear. They described their mental state precisely and all eight were admitted, seven being then diagnosed with schizophrenia and one with bipolar disorder. All participants gave false names and occupations to ensure that the diagnosis would not be added to their records. After being accepted, the pseudo-patients did not report any other symptoms. They acted normally around both staff and the genuine patients and always accepted the medicine that was given to them but did not take it. While the hospital staff failed to identify sanity and the participants were hospitalized from 7 to 52 days (with an average of 19 days) prior to being considered sane and being discharged. While the staff failed to identify sanity, 3 out of the 8 participants noticed that 35 out of a total of 118 real patients, suspected in some way that the pseudo-patients were not insane. Pseudo-patients normal behaviours were overlooked or misinterpreted.
Slater, in contradiction to Rosenhan’s pseudo-patients, had been previously diagnosed with depression. Slater presented herself in nine psychiatric rooms clamming she heard the word ‘thud’ (replicating some of Rosenham’s procedure). This specific symptom was partly chosen because it raises concerns about the meaning of life. She was later on diagnosed with psychotic depression from all the hospitals and prescribed medication.
Evaluation of the Procedure
In Rosenham’s research he used a field study. One of the strengths of doing so is that it is possible to gather both qualitative and quantitative data, so plenty of conclusions can be drawn. The participation observation method allows the participants from the first study to experience the world coming from a patient perspective while maintaining their objectivity.
Although a strength in both Rosenhan’s and Slater’s experiment is that it was used a wild range of psychiatric hospitals, allowing the results to be generalized, they lack realism. The fact that the psychiatric system can be tricked does not necessarily mean that it doesn’t work effectively on genuine patients. Both Doctors and psychiatrists are most likely to make a type two error (this meaning, they are more likely to consider someone healthy as sick) than a type one (this meaning, diagnosing a sick person as being healthy).
The studies methodology can also be evaluated in terms of ethnic.
They both deceived the hospital and no member of staff gave consent on being a part of the study and/or being observed.
However, a strength of both studies reliability, is that it was conducted in various hospitals, the same symptom was reported in all of them and the same diagnosis was given (in Rosenham’s experiment, in 10 out of 11 hospitals). This shows the consistency on the diagnoses. And the fact that none of the participants on Rosenham’s study had a history of mental hilliness makes in more reliable. The same does not happen with Slater’s experiment which could have been deceived considering that Slater had previously been diagnosed with depression, which could have leaded her into acting in a way that would affect the diagnosis.
When Rosenhan conducted this study the psychiatric classification was the DSM-II. However, and even though there have been new classifications introduced, in Slater’s study, dated to 2004 the same errors occurred. It was to expect that with the introduction of the newer classification DSM-III, in 1980s, and more recently the DSM-IV, psychiatrists would make less mistakes and the problem of unreliability, especially unclear criteria, would be solved.
Conclusion
These studies are very similar in some points, they share many of their weaknesses and strengths. From both of them it can be concluded that health professionals were willing to make the diagnosis based on false symptoms and that they struggle to distinguish the difference between those with real mental problems and those without. ‘Normal’ behaviour was misinterpreted as being ‘abnormal’, what suggested the non reliability of and validity of psychiatric diagnoses. ‘It is clear that we cannot distinguish the sane from the insane in psychiatric hospitals’ This studies can be seen as an attempt to classify mental hilliness as a social phenomenon and as a simple consequence of the human necessity to label. However their weaknesses undermine the reliability of the experiments.
REFERENCES
Banyard, P & Grayson, A (2000) Introducing Psychological Research: (2nd Ed). London: Palgrave Macillan.
Rosenhan, D.L. (1973) On being sane in insane places. Science, pp 179, 250-258
Slater, L. (2004) Opening Skinnner’s Box: Great Psychological Experiments of the Twentieth Century.
Kornblum, W (2011). Mitchell, E. & Jucha, R. & Chell, J. Sociology in a Changing World (Google Books) (9th ed.) pp 195
Spitzer, R. L. On Pseudoscience in Science, Logic in Remission, and Psychiatric Diagnosis: A Critique of Rosenhan 's 'On Being Sane in Insane Places '. Journal of Abnormal Psychology; (1975) vol. 84 no. 5; pp 442-452.