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A / AS Psychology.. Key Studies
• Abnormal Psychology
• Key study
• D L Rosenhan (1973)
D L Rosenhan (1973)
On being sane in insane places!
The Question…….
If sanity and insanity exist
How shall we recognise them?
Specifically…….
• Do the characteristics of abnormality reside in the patients?
• or
• In the environments in which they are observed?
– Does madness lie in the eye of the observer?
Before we begin…….
• 1 List two behaviours that YOU consider to be a sign of
psychological abnormality
• 2 Write down why you think each of these behaviours is abnormal
Some definitions of abnormality
• Stratton & Hayes (1993) .. Abnormality IS• Behaviour which deviates from the norm
– most people don’t behave that way
• Behaviour which does not conform to social demands – most people don’t like that behaviour
• Behaviour which is maladaptive or painful to the individual
– its not normal to harm yourself
Look at your examples:
• Did your examples fall into those three categories?
• Can you think of any other useful definitions of abnormality?
What was Rosenhan’s interest?
• How reliable are diagnoses of abnormality?
The astonishing study……….. On being sane in insane places…...
• D L Rosenhan (1973)
• What did he do?
• Who were involved?
The brave volunteers…… .
• EIGHT sane people!
– one graduate student
– three psychologists
– a paediatrician
– a painter
– Housewive
– Psychiatrist
What did they DO?The procedure……………………..
• telephoned 12 psychiatric hospitals for urgent appointment (in five USA states)
• arrived at admissions
• gave false name and address
• gave other ‘life’ details correctly
What else did they do?
• complained of hearing unclear voices … saying “empty, hollow, thud”
• Said the voice was unfamiliar, but was same sex as themselves
– Simulated ‘existential crisis’– “Who am I, what’s it all for?”
What happened? ………..
• All were admitted to hospital
• All but one were diagnosed as suffering from schizophrenia
• Once admitted the ‘pseudo-patients’ stopped simulating ANY symptoms
• Took part in ward activities
What happened on the wards?
• The pseudo-patients were never detected
• All pseudo-patients wished to be discharged immediately
• BUT - they waited until they were diagnosed as ‘fit to be discharged’
How did the ward staff see them?
• Normal behaviour was misinterpreted
• Writing notes was described as -– “The patient engaged in writing behaviour”
• Arriving early for lunch described as – “oral acquisitive syndrome” – Behaviour distorted to ‘fit in’ with theory
The pseudo-patient’s observations…
• If they approached staff with simple request
• (NURSES & ATTENDANTS)
• 88% ignored them – (walked away with head averted)
– 10% made eye contact– 2% stopped for a chat
• (1283 attempts)
The pseudo-patient’s observations…
• If they approached staff with simple request
• (PSYCHIATRISTS)
• 71% ignored them – (walked away with head averted)
– 23% made eye contact– 2% stopped for a chat
• (185 attempts)
How long did they stay in hospital?
• The shortest stay was 7 days
• The longest stay was 52 days
• The average stay was 19 days– They had agreed to stay until they
convinced the staff they were sane!!
Were they treated in the same way as normal patients...
• Given total of 2100 medication tablets– they flushed them down the loos
– Noted that other patients did the same and that this was ignored as long as patients behaved themselves !!
What sorts of records did they keep …….?
• Nurses stayed in ward offices 90% of time
• Each ‘real patient’ spent less than 7 minutes per day with psychiatric staff
Perhaps they behaved ‘abnormally’
• Pseudo-patient’s visitors detected “No serious behavioural consequences”
• DID ANYONE SUSPECT?
What about the REAL patients?
• 35 out of 118 patients voiced their suspicions
On release ………………...
• The pseudo-patients were diagnosed as
• Schizophrenia “IN REMISSION”
RosenhanThe follow up study……………..
• A teaching & research hospital was told of the first study
• and warned that …
• Over the next three months ONE OR MORE pseudo-patient would attempt to be admitted
What happened……….?
• Staff members rated ‘new patients’ on scale 1 - 10 as ‘how likely to be a fraud’
• 193 patients ‘assessed’
• 41 rated as a pseudo-patient (by staff)
• 23 rated as pseudo-patient (by psychiatrist)
• 19 rated as pseudo-patient (by both)
How many of these SUSPECTSwere pseudo-patients?……...
• NONE
• No pseudo-patients were sent– Staff were rating their regular intake
What did Rosenhan conclude?
• Remember .. His question was …
• Do the characteristics of abnormality reside in the patients?
• or
• In the environments in which they are observed?– Does madness lie in the eye of the observer
Rosenhan’s conclusion…..
• “It is clear that we are unable to distinguish the sane from the insane in psychiatric hospitals”– In the first study – We are unable to detect ‘sanity’– In the follow up study– We are unable to detect ‘insanity’
Rosenhan’s study highlighted ...
• The depersonalisation and powerlessness of patients in psychiatric hospitals
• That behaviour is interpreted according to expectations of staff and that these expectations are created by the labels
• SANITY & INSANITY
Another Rosenhan note……..
• The pseudo-patients described their stay in the hospitals as a negative experience
• This is not to say that REAL patients have similar experiences
• Real patients do not know the diagnosis is false & are NOT pretending
– (Remember Zimbardo)
Questions YOU should be able to answer...
• Methodology -
• This was a participant observation
• Who were the OTHER participants?
• Was this study ethical? If not why not?
Questions YOU should be able to answer…….
• Why might the reports of the pseudo-patients have been unreliable?
Look back at your ‘list’ of abnormal behaviour ……...
• How can we devise some general rules
• to describe
• NORMAL and ABNORMAL behaviour
Rosenhan ….. YOU must read this study up
• It is one of the most influential studies in Abnormal Psychology
• If there are such things as
• SANITY and INSANITY
• HOW SHALL WE KNOW THEM?
On being sane in insane places...
•D L Rosenhan (1973)THE END
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