Some features of the site may not work correctly. DOI: Just as his pseudopatients were diagnosed at discharge as "schizophrenia in remission," so a careful examination of this study's methods, results, and conclusion leads to a diagnosis of "logic in remission. This rather unremarkable finding is not relevant to the real problems of the… Expand. View on PubMed. Save to Library Save. Create Alert Alert. Share This Paper.
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In eleven instances, participants were admitted on a diagnosis of schizophrenia, and discharged with a diagnosis of schizophrenia in remission. In one instance, a participant was admitted on a diagnosis of manic-depressive psychosis; their discharge diagnosis was not reported. Stays ranged from 7 to 52 days, with a mean of 19 days.
Standard deviation was not disclosed. The errant diagnosis on admission, Prof. As he put it:. Errant diagnoses after admission, once participants had dropped all pretence of psychiatric disturbance, were more surprising and troubling to Prof. It seemed that once diagnosed with an aberrant psychiatric trait, participants were unable to escape the diagnosis, despite their having dropped the farce immediately upon admission.
It was presumed that a competent practitioner, upon being well-acquainted with participants, would eventually identify the initial diagnosis as a type II error , and subsequently correct it.
No such correction took place in any of the 12 hospital stays. The admission diagnoses seemed, in Prof. Rosenhan offered the following explanation for this surprising result. In the absence of a psychopathic diagnosis, these behaviours are attributed to something other than psychopathy, like being bored or being a writer.
But in the presence of such a diagnosis, these behaviours are more often attributed to psychopathy, as they were in two instances in the study, than not. This attribution, in turn, only reinforces the diagnosis, thereby fixing any type II errors in place. The fact that such behaviours are often attributed to psychopathies in diagnosed patients, Prof.
On initiating contact with staff members, participants were overwhelmingly not paid any attention by psychiatrists, nurses, nor attendants at four of the hospitals.
Inter-hospital differences were not deemed significant, and were not reported. Statistical differences and significance were not reported. Six participants, totalling days of hospitalisation, measured their daily contact with staff.
Daily contact with psychiatrists, psychologists, residents and physicians ranged from 3. Dis-aggregated data, contact time with other staff, statistical differences, statistical significance and standard deviation were not reported.
Contact, Prof. Table 1. Self-initiated contact by participants with psychiatrists, nurses and attendants. Adapted from Table 1 of Rosenhan study, p. Copyright c AAAS. The import of this practice, and the powerlessness it elicited, Prof. Rosenhan argued, could be readily inferred. Of the scores obtained, 41 patients were judged highly likely to have been a pseudo-patient by at least one staff member, 23 by at least one psychiatrist, and 19 by one psychiatrist and at least one other staff member.
No pseudo-patients were sent by Prof. Rosenhan or affiliated researchers. In either case, Prof. It is clear that we cannot distinguish the sane from the insane in psychiatric hospitals.
The hospital itself imposes a special environment in which the meanings of behaviour can easily be misunderstood. Both practitioners and patients, the study reveals, seem caught in Catchs.
Out of an excess of caution, psychiatrists and psychologists strongly tend towards type II errors on admission. On the other hand, should practitioners try to avoid type II errors from sticking to patients, they run the risk of equally damaging type I errors. On the other hand, patients, once admitted, are likely to develop psychopathies, whether they truly had any on admission or not, given the bizarre setting they are thrust into on admittance.
But should they seek to avoid the setting — the psychiatric hospital — they run the risk of an untreated mental illness getting worse, in the case they truly suffered one to begin with. A way out for practitioners and patients is not immediately clear to Prof. Two promising directions he noted were —. Sampling, randomisation, control, blinding, and statistical analyses methods were largely unreported, and so likely to not have been up to present-day standards.
Participant training was not reported, and so likely not undertaken before the study. Study flaws aside, the observed effects were large enough to likely be clinically, and easily statistically, significant —. The findings pointed to an unacceptable preponderance and persistence of type II errors by competent psychiatric staff, and to the danger of psychiatric harm to patients posed by then current psychiatric practices.
Field experiments have the major advantage of being conducted in a real environment and this gives the research high ecological validity. However it is not possible to have as many controls in place as would be possible in a laboratory experiment. Participant observation allows the collection of highly detailed data without the problem of demand characteristics.
As the hospitals did not know of the existence of the pseudopatients, there is no possibility that the staff could have changed their behaviour because they knew they were being observed. However this does raise serious ethical issues see below and there is also the possibility that the presence of the pseudopatient would change the environment in which they are observing.
Strictly speaking, the sample is the twelve hospitals that were studied. Rosenhan ensured that this included a range of old and new institutions as well as those with different sources of funding. The results revealed little differences between the hospitals it this suggests that it is probably reasonable to generalise from this sample and suggest that the same results would be found in other hospitals.
There is a huge variety of data reported in this study, ranging from the quantitative data detailing how many days each pseudopatient spent in the hospital and how many times pseudopatients were ignored by staff through to qualitative descriptions of the experiences of the pseudopatients. One of the strengths of this study could be seen as the wealth of data that is reported and there is no doubt that the conclusions reached by Rosenhan are well illustrated by the qualitative data that he has included.
Strictly speaking, no. The staff were deceived as they did not know that they were being observed and you need to consider how they might have felt when they discovered the research had taken place.
Was the study justified?
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