Transcript And don`t forget….

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

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Diagnostic and Statistical Manual of
Mental Disorders (DSM-IV)
International Statistical Classification
of Diseases and Related Health
Problems (ICD)
Diagnoses or Labelling?
Social Stigma?
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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.
What do you think it would be like
to have Schizophrenia?
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
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EIGHT sane people
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one graduate student
three psychologists
a paediatrician
a painter
housewives
What did they do?
The procedure:
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telephoned 12 psychiatric hospitals for
urgent appointments
gave false name and address
complained of hearing unclear voices
… saying “empty, hollow, thud”
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Simulated ‘existential crisis’
“Who am I, what’s it all for?”
What happened?
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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?
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Normal behaviour was misinterpreted
Writing notes was described as 
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“The patient engaged in writing
behaviour”
Arriving early for lunch described as
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“oral acquisitive syndrome”
Behaviour distorted to ‘fit in’ with label
How long did they stay in
hospital?
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The shortest stay was 7 days
The longest stay was 52 days
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The average stay was 19 days
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They had agreed to stay until they convinced
the staff they were sane.
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Discuss: How would YOU convince someone
you are sane?
Were they treated in the same
way as normal patients?
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Given total of 2100 medication tablets
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they flushed them down the loos
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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?
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Nurses stayed in ward offices 90% of
time
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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
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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
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What happened?
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Staff members rated ‘new patients’ on
scale 1 - 10 as ‘how likely to be a
fraud’
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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)
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How many of these
SUSPECTS
were pseudo-patients?
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NONE
No pseudo-patients were sent –
the staff were rating their regular
intake
Rosenhan’s conclusion
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“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
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The depersonalisation and
powerlessness of patients in
psychiatric hospitals
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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
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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
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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
Method continued:
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The pseudopatient did this as
normally as possible and avoided
asking the same person more than
once a day.
Results
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A brief reply as the member of staff
continued walking and did not
make eye contact.
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4% psychiatrists stop to talk
0.5% nurses stopped
Overall 2% in each group paused
and chatted.
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Results continued:
The Control
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Young female participant
Stanford University Campus
Asked 6 questions
All staff stopped and answered all
questions and made eye contact.
Conclusion:
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The lack of eye contact between staff
and patients depersonalises the
patients.
Summary and conclusion
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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
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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!!!