classic study for clinical psychology : Rosenhan (1973)
Thorough summary of Aims, Procedures, Results & Conclusions (APRC)
Full evaluation (SCOUT)
key psychological terminology highlighted for better recall and to score more marks in an exam question
Accurate diagnosis helps reduce adult mental health problems preceded by symptoms
of CD
1) CLINICIAN FACTORS
a. Interpersonal exchange btw patient - clinician in diagnostic interview : clinician
affected by implicit bias (+ve / -ve mental attitude towards person at unconscious
level) in interpretation of info given
mL see same symptoms as being consistent with depression in females
lL give same diagnosis to male as it’s less prevalent in M
b. Subjective interpretation of symptoms + diagnosis by clinician: their training +
perception of presenting symptoms with more focus on acute symptoms &
overlooking other symptoms
2) PATIENT FACTORS
a. Current state during diagnosis : mood, memory + shame associated with other
symptoms = inaccurate info provided
b. COMORBIDITY: 2+ conditions co-occur at same time
CLASSIC STUDY
ROSENHAN (1973): on being sane in insane places
Aim: to see if medical professionals could tell + detect sane from insane
- To find out what life like in psychiatric hospital + raise awareness abt conditions
- to investigate the effect of labeling on medical diagnosis
Procedure:
Pps: staff in psychiatric hospitals
8 pseudopatients in 12 psychiatric hospitals in 5 USA states (3 F + 5 M) with no history
of mental illness
, 22
● Clinical interview at initial admission meeting: reported symptom of hearing
voices (“empty, “thud” & “hollow”) but have healthy lifestyles + relationships at
work (fake ID + jobs to cover those psychology related)
● When admitted, pps behaved normally + stopped reporting hearing voices
● Notepad + pen for recording what heard + saw (covert, unstructured observation)
● Secretly disposed of medication given
● Friendly + polite, did everything that was asked of them
2 structured observations :
- Record how many patients voiced suspicions abt pseudopatients & how much
time staff spent on ward interacting with patients
- Pseudopatients approached staff with scripted Qs, record their answer + body
language
Results: all hospitals diagnosed pseudopatients as mentally ill on minimal symptoms
- 7 SZ
- 1 manic depression with psychosis (bipolar disorder)
● Daily visitors indicated they behaving normally
● Mean length / stay in hospital= 19 days
Range: 7-52 days for pseudopatients discharged with diagnoses of SZ in
remission (incurable)
● Staff not suspicious of pseudopatients + never detected their sanity
patients accused them of not being genuinely ill.
● Staff most of time in secure area with glass windows (cage) and behaved as if
mental illness was contagious
Only 11.3 % time outside of it doing mostly chores
● Treated pseudopatients in way consistent with their diagnosis + pathologised
normal bhv
E.g. note taking = “writing bhv”
Pacing corridors due to boredom = nervousness
Waiting outside lunch hall early = “oral-inquisitive syndrome
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