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Who’s Crazy Here Anyway? Rosenhan, D.L. (1973) On being sane in insane places. Science, 179, 250-258

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Text of Who’s Crazy Here Anyway? Rosenhan, D.L. (1973) On being sane in insane places. Science, 179,...

  • Slide 1
  • Whos Crazy Here Anyway? Rosenhan, D.L. (1973) On being sane in insane places. Science, 179, 250-258
  • Slide 2
  • What is psychopathology? Difference between normal and abnormal behavior is imperative in field of psychology. Difference between normal and abnormal behavior is imperative in field of psychology. Psychopathology, or abnormal psychology, is the field concerned with the nature and development of abnormal behavior, thoughts, and feelings. Psychopathology, or abnormal psychology, is the field concerned with the nature and development of abnormal behavior, thoughts, and feelings. This definition is the key variable in determining whether or not someone may be diagnosed as mentally ill. This definition is the key variable in determining whether or not someone may be diagnosed as mentally ill.
  • Slide 3
  • What is psychopathology? (contd) Human behavior lies on a continuum; normal behavior on one end (AKA effective psychological functioning) and abnormal behavior on the other. Human behavior lies on a continuum; normal behavior on one end (AKA effective psychological functioning) and abnormal behavior on the other. Normal----------------------------------------Abnormal Normal----------------------------------------Abnormal (effective functioning) (mental illness) Mental health professionals (i.e. clinical psychologists, psychiatrists, psychotherapists) determine where an individuals behavior lies on this continuum according to one or more of the six following criteria. Mental health professionals (i.e. clinical psychologists, psychiatrists, psychotherapists) determine where an individuals behavior lies on this continuum according to one or more of the six following criteria.
  • Slide 4
  • Criteria 1) Bizarreness of the behavior: (odd or eccentric) a subjective judgment based on a situation, the context in which the behavioral pattern occurs 2) Persistence of the behavior: how often does the behavior occur 3) Social deviance: does the behavior violate societal norms, which are extreme and persistent
  • Slide 5
  • Criteria (contd) 4) Subjective distress: refers to an individual being aware of their psychological stress 5) Psychological handicap: individual finds it impossible to be satisfied with life due to psychological problems 6) Effect on functioning: the extent to which the behavior in question interfere with a persons ability to live the life that he or she desires and that society will accept
  • Slide 6
  • Criteria (contd) Criteria at hand are based on judgments of mental health professionals. Criteria at hand are based on judgments of mental health professionals. Questions at hand: Are mental health professionals capable of distinguishing between mentally ill and mentally healthy? What are the repercussions of a misdiagnosis? Questions at hand: Are mental health professionals capable of distinguishing between mentally ill and mentally healthy? What are the repercussions of a misdiagnosis? David Rosenhan studies these questions at hand. David Rosenhan studies these questions at hand.
  • Slide 7
  • Theoretical Propositions H 1 : The criteria leading to diagnoses reside in patients or in the contexts in which the mental health professionals find the patients. He believes the professionals should be able to distinguish between the insane and the sane. H 1 : The criteria leading to diagnoses reside in patients or in the contexts in which the mental health professionals find the patients. He believes the professionals should be able to distinguish between the insane and the sane. Proposed that in order to test professional ability, he has normal people seek admittance to psychiatric facilities to see whether or not they would be found to be mentally healthy. Proposed that in order to test professional ability, he has normal people seek admittance to psychiatric facilities to see whether or not they would be found to be mentally healthy.
  • Slide 8
  • Theoretical Propositions (contd) He referred to these subjects as pseudopatients. He referred to these subjects as pseudopatients. The subjects were to behave as they would outside of the facility. The subjects were to behave as they would outside of the facility. If these pseudopatients were not found to be normal, this would suggest that the diagnosis of the mentally ill are tied more to the situation than to the patient. If these pseudopatients were not found to be normal, this would suggest that the diagnosis of the mentally ill are tied more to the situation than to the patient.
  • Slide 9
  • Method Eight subjects, including himself. Three women and five men (1 graduate student, 3 psychologists, 1 pediatrician, 1 psychiatrist, 1 painter, 1 homemaker). Eight subjects, including himself. Three women and five men (1 graduate student, 3 psychologists, 1 pediatrician, 1 psychiatrist, 1 painter, 1 homemaker). Admission to 12 psychological hospitals in five states, on east coast and west coast. Admission to 12 psychological hospitals in five states, on east coast and west coast. All subjects were told to phone the hospital and set up an appointment. Once they arrived, they were told to state that they were hearing voices (empty, hollow, thud). All subjects were told to phone the hospital and set up an appointment. Once they arrived, they were told to state that they were hearing voices (empty, hollow, thud).
  • Slide 10
  • Method (contd) This was the only false information the pseudopatients provided. All other background information (excluding names and occupations) was truthful (i.e. families, social life). This was the only false information the pseudopatients provided. All other background information (excluding names and occupations) was truthful (i.e. families, social life). All subjects were admitted. Seven subjects were admitted with a diagnosis of schizophrenia. All subjects were admitted. Seven subjects were admitted with a diagnosis of schizophrenia. Once the subjects had been in the hospital, they displayed normal behavior. It was up to them to convince the staff they were well enough to leave. Once the subjects had been in the hospital, they displayed normal behavior. It was up to them to convince the staff they were well enough to leave.
  • Slide 11
  • Method (contd) During the subjects stay, they documented their experiences. At first, this was a discrete attempt, although this became useless seen as the note-taking behavior was considered a symptom of their diagnosis. During the subjects stay, they documented their experiences. At first, this was a discrete attempt, although this became useless seen as the note-taking behavior was considered a symptom of their diagnosis. They wished to be released as soon as possible, hence they cooperated completely with all requests of the staff and took medication as told (medication was not swallowed, rather flushed). They wished to be released as soon as possible, hence they cooperated completely with all requests of the staff and took medication as told (medication was not swallowed, rather flushed).
  • Slide 12
  • Results Duration of stay ranged from 7-52 days, with an average of 19 days. Duration of stay ranged from 7-52 days, with an average of 19 days. None of the subjects were detected as mentally healthy by the staff or mental health professionals. None of the subjects were detected as mentally healthy by the staff or mental health professionals. Upon release their files were noted as, schizophrenia in remission. Upon release their files were noted as, schizophrenia in remission. Interestingly enough, although the staff was fooled, other patients were not. In three of the subjects hospitalizations, 35 out of 118 actual patients voiced such opinions that the subjects were not mentally ill. Interestingly enough, although the staff was fooled, other patients were not. In three of the subjects hospitalizations, 35 out of 118 actual patients voiced such opinions that the subjects were not mentally ill.
  • Slide 13
  • Results (contd) A test made by pseudopatients was to approach staff members and make verbal contact by asking common questions, such as referring to their duration of stay or privileges. A test made by pseudopatients was to approach staff members and make verbal contact by asking common questions, such as referring to their duration of stay or privileges. Response Psychiatrists MHA Moves on, head averted 71% 88% Makes eye contact 23% 10% Pauses and chats 2% 2% Stops and talks 4% 0.5%
  • Slide 14
  • Results (contd) When a subject did in fact elicit a response from a mental health professional, it was based on the emotional state of the subject, and most continued on. When a subject did in fact elicit a response from a mental health professional, it was based on the emotional state of the subject, and most continued on. Although there was not much contact between the patients and the staff, there was never a lack of medication. Distributed to the subjects was a total of 2,100 pills (not swallowed). Although there was not much contact between the patients and the staff, there was never a lack of medication. Distributed to the subjects was a total of 2,100 pills (not swallowed). Many of the actual patients hardly ever took their medications. Many of the actual patients hardly ever took their medications.
  • Slide 15
  • Discussion Rosenhans study suggests that mentally healthy people cannot be distinguished from mentally ill. Rosenhans study suggests that mentally healthy people cannot be distinguished from mentally ill. He believed that the staffs judgmen

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