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Issues in Mental Health

Rosenhan (1973) on being sane in insane places: results, conclusions and evaluation

  • 3 things to know
  • Component 03

Overview

Recall questions on Rosenhan's findings on reinterpreted behaviour, depersonalisation and staff responses, the follow-up study at a teaching hospital, conclusions about diagnostic labels and hospital environments, and the study's strengths, ethics, critics and relevance to categorising disorders.

What you need to know

Answer each one before you reveal it.

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Study

What was the outcome of the follow-up study?

Key term

Give an example of ordinary behaviour being reinterpreted in the light of the diagnosis.

Key term

What do the two studies together show about diagnostic error?

Questions from this subtopic

Each one with the model answer underneath.

  1. 1

    Give an example of ordinary behaviour being reinterpreted in the light of the diagnosis.

    Model answer

    Note-taking by a pseudopatient was recorded in the nursing notes as engaging in writing behaviour, and queuing outside the dining hall before it opened was read as evidence of the oral-acquisitive nature of the syndrome.

  2. 2

    What evidence did Rosenhan gather about depersonalisation on the wards?

    Model answer

    Staff spent most of their time inside a glassed-in office away from patients, contact with psychiatrists averaged only a few minutes a day, patients had almost no privacy, and medication was handed out in large quantities but frequently flushed away.

  3. 3

    Describe the test in which pseudopatients approached staff with a polite question.

    Model answer

    They asked staff a reasonable question about grounds privileges; psychiatrists made eye contact about a quarter of the time and stopped to talk in only a handful of cases, while nurses and attendants usually walked straight past.

  4. 4

    What did the follow-up study at the teaching hospital involve?

    Model answer

    Staff who doubted such errors could happen at their hospital were warned that one or more pseudopatients would try to gain admission over the following three months, and were asked to rate every new patient.

  5. 5

    What was the outcome of the follow-up study?

    Model answer

    Of 193 genuine patients, 41 were confidently judged to be pseudopatients by at least one member of staff, even though Rosenhan had sent nobody at all.

  6. 6

    What do the two studies together show about diagnostic error?

    Model answer

    Together they show that psychiatric judgement can fail in both directions, since the sane were called ill in the first study and the genuinely ill were called sane in the second.

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