Transcript Rosenhan - PsychologyA2atbusheyacademy

The Individual
Differences
Approach
What is Abnormal
Behaviour?
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
One Flew Over The
Cuckoo’s Nest Clip
Categorising Mental Illness
Diagnostic and Statistical Manual of
Mental Disorders (DSM-IV)
 International Statistical Classification
of Diseases and Related Health
Problems (ICD)

Diagnoses or
Labelling?
Social Stigma?


Many people misunderstand and may even
fear those with a mental illness.
Frank Bruno, one of the nations favourite
Boxers who won the ABA Heavyweight
Championship at just 18 had to be
sectioned in 2003 for Depression. This
shows how anyone can be affected by
mental illness, whether famous, successful
or otherwise.
What is Schizophrenia?

A serious mental disorder

Positive Symptoms (additional to normal
behaviour) include: hallucinations, delusions
and thought disorder

Negative Symptoms (reduction in normal
experiences or behaviour) include unusual
emotional responses and lack of motivation.
How did it feel?

If you had a mental illness how would
you like to be treated?
The Question
If sanity and insanity exist
How shall we recognise them?
D.L. Rosenhan (1973)

The ground breaking study :
“On being sane in insane places”
The volunteers

EIGHT sane people
one graduate student
 three psychologists
 a paediatrician
 a painter
 housewives

What did they do?
The procedure:
telephoned 12 psychiatric hospitals for
urgent appointments
 gave false name and address
 complained of hearing unclear voices …
saying “empty, hollow, thud”

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

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 label

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.

Discuss: How would YOU convince
someone you are sane?
Were they treated in the
same way as normal
patients?

Given total of 2100 medication tablets

they flushed them down the toilets

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”
Rosenhan:
The 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 will 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
SUSPECTS
were pseudo-patients?
NONE
 No pseudo-patients were sent – the
staff were rating their regular intake

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
Questions YOU should be
able to answer

Methodology: This was a field
experiment

Who were the participants?

Was this study ethical? If not why not?
Questions YOU should be
able to answer

Why might the reports of the pseudopatients have been unreliable?
Rosenhan …..
YOU must read this study

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...
DL
Rosenhan
(1973)
Study 3! (last but certainly not least!)
Aim: to investigate patient-staff contact.
Method: In 4 of the hospitals pseudopatients approached a member of
staff and asked~
“Pardon me, Mr/Mrs/Dr X, could you tell
me when I will be eligible for ground
privileges?”
Method continued:

The pseudopatient did this as
normally as possible and avoided
asking the same person more than
once a day.
Results

A brief reply as the member of staff
continued walking and did not make
eye contact.
4% psychiatrists stop to talk
 0.5% nurses stopped
 Overall 2% in each group paused and
chatted.

Results continued:
The Control
Young female participant
 Stanford University Campus
 Asked 6 questions
 All staff stopped and answered all
questions and made eye contact.

Conclusion:

The lack of eye contact between staff
and patients depersonalises the
patients.
Summary and conclusion
We cannot distinguish the sane from
the insane all of the time.
 Hospitalisation for the mentally ill isn’t
the solution as it results in
powerlessness, depersonalisation,
segregation, mortification and selflabelling- all counter-therapeutic.

Powerlessness and
Depersonalisation



Staff treated patients will little respect:
Beating them and swearing at them for
minor incidents- this is depersonalising and
leads to patients feeling powerless.
This is added to by; patients being unable to
initiate contact with staff, lack of privacy
(physical examinations are conducted in
semi-private rooms)
The general activity around the patient is
conducted as if they are invisible.
And don’t forget….
ETHICS!!!