1. What is the overarching research question behind placing “pseudopatients” in psychiatric hospitals?
Do the salient characteristics that lead to diagnoses are to be found in the patients themselves or in the environments and contexts in which observers find them? (Rosenhan, p. 251)
2. How would you characterize this research methodology—experimental, survey, observation, case study, etc.?
The research methodology is experimental. (Rosenhan, p. 251)
3. Describe the method: the participants (pseudopatients), the location, how they sought admission.
Eight participants were selected. They represented a diverse group of three psychologists, a pediatrician, a psychiatrist, a painter, a housewife, and a psychology graduate student – the youngest participant. Three participants were females, the rest – men. Those, who worked in the field of mental health, alleged other occupations. Besides, the participants acted under pseudonyms. At the same time, they did not alter details of their biographies. The settings were diverse as well. Among 12 hospitals in the sample, some were old, some were new. These institutions were situated in 5 states. The majority of hospitals were financed by state or federal budget, one was a private institution, and one was funded by a university. The participants went to the admissions office by appointment and complained about hearing voices. (Rosenhan, p. 251)
4. Why were these particular words chosen in the pseudopatients’ reports of what the voices said?
The voices reportedly said, “empty, “hollow”, and “thud”. (Rosenhan, p. 251)
5. How did they behave upon admission?
Upon admissions they behaved normally, like completely sane people. In the beginning, they were nervous, otherwise, their behavior was ordinary. (Rosenhan, p. 252)
6. On what basis were they discharged?
They were discharged with the following diagnosis: schizophrenia in remission. Thus, they were not considered sane and never were suspected to be simulants. (Rosenhan, p. 252)
7. What type(s) of cognitive bias covered earlier in the course can you identify in the nurses’ interpretations of the writing behavior? Give examples.
The nurses viewed the writing as one of the aspects of the pathological behavior. This interpretation clearly points to the stereotyping, confirmation bias, and fundamental attribution bias. The nurses regarded the patients as mentally ill, therefore, the behavior they observed, should have justified their expectations. Based on their knowledge about the patients, the nurses assessed their behavior so, that it confirmed their beliefs. Besides, they attributed this behavior solely to the characteristics of the observed patients, and never to the surroundings. (Rosenhan, p. 253)
8. What are the main points from the discussion of “depersonalization: ” Identify examples of how it occurred and discuss the impact of it in the ward.
Rosenhan argues that attitudes towards mentally ill people and the structure of typical psychiatric hospital lead to depersonalization of patients. The participants of the experiment experienced the effects of hospitalization on the mentality and mind of the sane people. The medical staff avoids patients. They prefer not to interact with them. When a patient sought a conversation, the staff escaped eye contact or reacted with suspect or aggression. What is more, the participants felt that in the eyes of the staff they did not exist and their interests were not taken into consideration. Their privacy is disrupted now and then. They are powerless and exposed. Even though the superiors of hospitals are the ones with the biggest impact on patients’ fates, their contact with patients is insignificant. Such behavior of the senior staff encourages nurses and attendants to behave in the same way and deliberately avoid contact with patients. Even though the insufficient funding of the mental institutions can be blamed for the shortage of staff, the fact that the mental illness is viewed as a leprosy, play a much more significant role in depersonalization of patients than financial problems. (Rosenhan, p. 254-257)
9. Rosenhan expressed concern in the article about the effect of labeling individuals with disorders.
a) What does he mean by the diagnosed patient experiencing a “self-fulfilling prophecy?”
Label of psychiatric diagnosis influences the patient and, once he accepts it and symptoms associated with illness, the diagnosis becomes a “self-fulfilling prophecy”. When the patient is expected to behave in a deviant way or his behavior is interpreted as abnormal, often he begins to behave in the way, anticipated by others. (Rosenhan, p. 254)
b) What do you think are the reasons that the mental health professions emphasize diagnosis of disorders, and more specifically, labeling collections of thoughts, feelings and behaviors as a disorder? Are there benefits to this labeling system, and if so, are these benefits limited to the professionals or do they extend to the patient?
Labeling of patients is a convenient way for a doctor to treat them as a group. In this case, there is no need to treat them individually. Once the symptoms are recognized (often falsely), they are ascribed to a particular disorder and treated respectively. Thus, I think that the labeling system benefits the medical professionals, as it saves them a lot of time, while the patients suffer from it.
Work Cited:
Rosenhan, David L. “On being sane in insane places”. Science, New Series, 179 (1973): 250-258. Web. 5 Oct. 2012
