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Encyclopedia > Rosenhan experiment

The Rosenhan experiment was a famous experiment into the validity of psychiatric diagnosis conducted by David Rosenhan in 1972. It was published in the journal Science under the title "On being sane in insane places". The following is a list of historically important scientific experiments and observations. ... Psychiatry is a branch of medicine dealing with the prevention, assessment, diagnosis, treatment, and rehabilitation of the mind and mental illness. ... In general, a diagnosis (plural diagnoses) has two distinct dictionary definitions. ... David Rosenhan is a psychiatrist See also: Rosenhan experiment On being sane in insane places Categories: People stubs ... Year 1972 (MCMLXXII) was a leap year starting on Saturday (link will display full calendar) of the Gregorian calendar. ... Science is the journal of the American Association for the Advancement of Science (AAAS). ...


Rosenhan's study consisted of two parts. The first involved the use of healthy associates or 'pseudopatients', who briefly simulated auditory hallucinations in an attempt to gain admission to 12 different psychiatric hospitals in 5 different states in various locations in the United States. The second involved asking staff at a psychiatric hospital to detect non-existent 'fake' patients. In the first case hospital staff failed to detect a single pseudopatient, in the second the staff falsely detected large numbers of genuine patients as impostors. The study is considered an important and influential criticism of psychiatric diagnosis. A hallucination is a sensory perception experienced in the absence of an external stimulus, as distinct from an illusion, which is a misperception of an external stimulus. ... A psychiatric hospital (also called, at various places and times, mental hospital or mental ward, historically often asylum, lunatic asylum, or madhouse), is a hospital specialising in the treatment of persons with mental illness. ...


The study concluded "It is clear that we cannot distinguish the sane from the insane in psychiatric hospitals" and also illustrated the dangers of depersonalization and labelling in psychiatric institutions. It suggested that the use of community mental health facilities which concentrated on specific problems and behaviors rather than psychiatric labels might be a solution and recommended education to make psychiatric workers more aware of the social psychology of their facilities. A mental illness or mental disorder refers to one of many mental health conditions characterized by distress, impaired cognitive functioning, atypical behavior, emotional dysregulation, and/or maladaptive behavior. ...

Contents

The Pseudopatient Experiment

For the purposes of the study, eight 'pseudopatients' (associates of Rosenhan selected to be a group of varied and healthy individuals) attempted to gain admission into psychiatric hospitals. During psychiatric assessment they claimed to be hearing voices that were often unclear, but noticeably said the words "empty", "hollow" and "thud". No other psychiatric symptoms were claimed, and apart from giving false names and employment details, further biographical details were truthfully reported. If admitted, the pseudopatients were asked to 'act normally', report that they felt fine and no longer heard voices. A psychiatric hospital (also called, at various places and times, mental hospital or mental ward, historically often asylum, lunatic asylum, or madhouse), is a hospital specialising in the treatment of persons with mental illness. ...


The pseudopatients were: 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. After being admitted, the experimental subjects acted normally and did not display any obvious psychopathology. Subjects were to remain as inpatients until they were discharged by the staff at their hospitals, who were not privy to the experiment and believed the subjects to be real psychiatric patients.


All eight were admitted, seven with a diagnosis of schizophrenia, the last with bipolar disorder. None of the pseudopatients were detected during their admission by hospital staff, although other psychiatric patients seemed to be able to correctly identify them as impostors. While the staff failed to identify sanity, in the first three hospitalisations notes of patient responses were kept and 35 of the total of 118 patients did express a suspicion that the pseudopatients were sane. All were discharged with a diagnosis of schizophrenia "in remission". Their stays ranged from 7 to 52 days and the average was 19 days. For other uses, see Bipolar. ...


During their stay, hospital notes indicated that staff interpreted much of the pseudopatient's behaviour in terms of mental illness. For example, one observer, apparently oblivious to the irony, labeled the note-taking of one pseudopatient as "writing behaviour" and considered it pathological. Psychopathology is a term which refers to either the study of mental illness or mental distress, or the manifestation of behaviors and experiences which may be indicative of mental illness or psychological impairment. ...


The non-existent impostor experiment

For this experiment, Rosenhan used a well-known research and teaching hospital, whose staff had heard of the results of the initial study but claimed that similar errors could not be made at their institution. Rosenhan arranged with them that during a three month period, one or more pseudopatients would attempt to gain admission and the staff would rate every incoming patient as to the likelihood they were an impostor. Out of 193 patients, 41 were considered to be impostors and a further 42 were considered suspect. In reality, Rosenhan had sent no pseudopatients and all patients suspected as impostors by the hospital staff were genuine patients (unless they were other impostors unknown to the study, which seems unlikely). This led to a conclusion that "any diagnostic process that lends itself too readily to massive errors of this sort cannot be a very reliable one". Studies by others found similarly problematic diagnostic results.


Related experiments

Maurice K. Temerlin split 25 psychiatrists into two groups and had them listen to an actor portraying a character of normal mental health. One group was told that the actor "was a very interesting man because he looked neurotic, but actually was quite psychotic" while the other was told nothing. Sixty percent of the former group diagnosed psychoses, most often schizophrenia, while none of the control group did so. Maurice K. Temerlin, Ph. ...


Loring and Powell gave 290 psychiatrists a transcript of a patient interview and told half of them that the patients were black and the other half white; they concluded of the results that "Clinicians appear to ascribe violence, suspiciousness, and dangerousness to black clients even though the case studies are the same as the case studies for the white clients".


Impact

Rosenhan published his findings in Science, criticising the validity of psychiatric diagnosis and the disempowering and demeaning nature of patient care experienced by the associates in the study. His article generated an explosion of controversy. Science is the journal of the American Association for the Advancement of Science (AAAS). ...


Many defended psychiatry, arguing that psychiatric diagnosis must rely heavily on the patient's own report of their experiences. Hence, mis-diagnosis in the presence of fake symptoms no more demonstrates problems with psychiatric diagnosis than would lying about other medical symptoms. As an example, psychiatrist Robert Spitzer wrote in a 1975 criticism of Rosenhan's study: Dr. Robert L. Spitzer is a Professor of Psychiatry at Columbia University. ...

If I were to drink a quart of blood and, concealing what I had done, come to the emergency room of any hospital vomiting blood, the behaviour of the staff would be quite predictable. If they labelled and treated me as having a peptic ulcer, I doubt I could argue convincingly that medical science does not know how to diagnose that condition.

However, despite the perceived shortcomings of Rosenhan's study, Spitzer felt that there was still a laxness in the field. He played an important role in updating psychiatric diagnosis, eventually resulting in the Diagnostic and Statistical Manual of Mental Disorders, in an attempt to introduce more rigor and reliablity. The Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, is the handbook used most often in diagnosing mental disorders in the United States and other countries. ...


Lauren Slater says in her 2004 book Opening Skinner's Box that she repeated Rosenhan's study, by presenting at the emergency rooms of different hospitals with a single auditory hallucination. She writes that she was not admitted to any of them but was instead given prescriptions for antipsychotics and antidepressants. Her claims were questioned by Robert Spitzer and others[1]; she replied (through her attorney) that she considered her work to be "anecdote, not systematic research, and certainly not a 'replication' of Rosenhan's study."[2] Dr. Lauren Slater Lauren Slater (born March 21, 1963) is an American psychologist and writer. ... Year 2004 (MMIV) was a leap year starting on Thursday of the Gregorian calendar. ... The term antipsychotic is applied to a group of drugs used to treat psychosis. ... A recent form of antidepressant medication - Prozac Serotonin-norepinephrine reuptake inhibitor, Venlafaxine An antidepressant, in the most common usage, is a psychiatric medication taken to alleviate clinical depression or dysthymia (milder depression). ...


References

  • Rosenhan, D. (1973) On being sane in insane places. Science, 179, 250-8. Full text as PDF
  • Slater, L. (2004) Opening Skinner's Box: Great Psychological Experiments of the Twentieth Century. ISBN 0-393-05095-5.
  • Spitzer, R.L. (1975) 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, 84 (5), 442-52.

See also


  Results from FactBites:
 
Rosenhan (1073 words)
Rosenhan claims that the study demonstrates that psychiatrists cannot reliably tell the difference between people who are sane and those who are insane.
Rosenhan explains that psychiatric labels tend to stick in a way that medical labels do not and that everything a patient does is interpreted in accordance with the diagnostic label once it has been applied.
Rosenhan noted that experience of hospitalisation for the pseudo patients was one of depersonalisation and powerlessness.
Rosenhan experiment « Peoples Health and Fitness (1605 words)
The Rosenhan experiment was a famous experiment into the validity of psychiatric diagnosis conducted by David Rosenhan in 1972.
For this experiment, Rosenhan used a well-known research and teaching hospital, whose staff had heard of the results of the initial study but claimed that similar errors could not be made at their institution.
Rosenhan arranged with them that during a three month period, one or more pseudopatients would attempt to gain admission and the staff would rate every incoming patient as to the likelihood they were an impostor.
  More results at FactBites »


 

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