A / AS Psychology.. Key Studies

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A / AS Psychology.. Key Studies

• Abnormal Psychology
• Key study
• D L Rosenhan (1973)

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D L Rosenhan (1973)

• On being sane in insane places!

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The Question.

• If sanity and insanity exist
• How shall we recognise them?

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Specifically.

• Do the characteristics of abnormality reside in
  the patients?
• or
• In the environments in which they are observed?
• Does madness lie in the eye of the observer?

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Before we begin.

• 1 List two behaviours that YOU consider to be
  a sign of psychological abnormality
• 2 Write down why you think each of these
  behaviours is abnormal

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Some definitions of abnormality

• Stratton Hayes (1993) .. Abnormality IS
• Behaviour which deviates from the norm
• most people dont behave that way
• Behaviour which does not conform to social
  demands
• most people dont like that behaviour
• Behaviour which is maladaptive or painful to the
  individual
• its not normal to harm yourself

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Look at your examples

• Did your examples fall into those three
  categories?
• Can you think of any other useful definitions of
  abnormality?

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What was Rosenhans interest?

• How reliable are diagnoses of abnormality?

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The astonishing study.. On being sane in
insane places...

• D L Rosenhan (1973)
• What did he do?
• Who were involved?

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The brave volunteers .

• EIGHT sane people!
• one graduate student
• three psychologists
• a paediatrician
• a painter
• Housewive
• Psychiatrist

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What did they DO?The procedure..

• telephoned 12 psychiatric hospitals for urgent
  appointment (in five USA states)
• arrived at admissions
• gave false name and address
• gave other life details correctly

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What else did they do?

• complained of hearing unclear voices saying
  empty, hollow, thud
• Said the voice was unfamiliar, but was same sex
  as themselves
• Simulated existential crisis
• Who am I, whats it all for?

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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

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What happened on the wards?

• The pseudo-patients were never detected
• All pseudo-patients wished to be discharged
  immediately
• BUT - they waited until they were diagnosed as
  fit to be discharged

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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 theory

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The pseudo-patients observations

• If they approached staff with simple request
• (NURSES ATTENDANTS)
• 88 ignored them
• (walked away with head averted)
• 10 made eye contact
• 2 stopped for a chat
• (1283 attempts)

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The pseudo-patients observations

• If they approached staff with simple request
• (PSYCHIATRISTS)
• 71 ignored them
• (walked away with head averted)
• 23 made eye contact
• 2 stopped for a chat
• (185 attempts)

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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!!

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Were they treated in the same way as normal
patients...

• Given total of 2100 medication tablets
• they flushed them down the loos
• Noted that other patients did the same and that
  this was ignored as long as patients behaved
  themselves !!

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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

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Perhaps they behaved abnormally

• Pseudo-patients visitors detected No
  serious behavioural consequences
• DID ANYONE SUSPECT?

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What about the REAL patients?

• 35 out of 118 patients voiced their suspicions

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On release ...

• The pseudo-patients were diagnosed as
• Schizophrenia IN REMISSION

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RosenhanThe 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 would attempt to be admitted

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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)

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How many of these SUSPECTSwere
pseudo-patients?...

• NONE
• No pseudo-patients were sent
• Staff were rating their regular intake

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What did Rosenhan conclude?

• Remember .. His question was
• Do the characteristics of abnormality reside in
  the patients?
• or
• In the environments in which they are observed?
• Does madness lie in the eye of the observer

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Rosenhans 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

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Rosenhans 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

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Another Rosenhan note..

• The pseudo-patients described their stay in the
  hospitals as a negative experience
• This is not to say that REAL patients have
  similar experiences
• Real patients do not know the diagnosis is false
  are NOT pretending
• (Remember Zimbardo)

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Questions YOU should be able to answer...

• Methodology -
• This was a participant observation
• Who were the OTHER participants?
• Was this study ethical? If not why not?

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Questions YOU should be able to answer.

• Why might the reports of the pseudo-patients have
  been unreliable?

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Look back at your list of abnormal behaviour
...

• How can we devise some general rules
• to describe
• NORMAL and ABNORMAL behaviour

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Rosenhan .. YOU must read this study up

• 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?

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On being sane in insane places...

• D L Rosenhan (1973)
• THE END