This Changes Everything - assignment 2 really good, actually amazing lol PDF

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this is a psychology essay, on this canoes everything. its good, its snaps, I got an excellence hehehe. why do I need to write more....

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This Changes Everything Psychologist David Rosenhan conducted a psychological experiment in 1973 titled “being sane in insane places”. He aimed to investigate whether or not psychiatrists could tell the difference between individuals who are genuinely mentally ill and those who are considered “normal”.

Significance There are many reasons for what makes Rosenhan's experiment significant. Rosenhan’s study was able to illustrate the problems with the validity and reliability of diagnosis of mental disorders while DSM-II was in use. Rosenhan was able to provide evidence that diagnoses are flawed and expose DSM-II as an unreliable tool as it was unable to “tell the sane from the insane”. Rosenhan’s Study was able to provide an insight into how scientific research proceeds since he was criticizing and texting already established theories concerning mental illness. This study was able to show the power of the observational method, since the pseudo-patients were undercover they were able to observe the staff and patients in a naturalistic setting. This provided Rosenhan with an realistic idea of what it was like in the psychiatric hospital since the staff and patients were unaware they were being observed.

Impact on Society Rosenhan’s experiment has had a huge impact on mental health care worldwide. After a review of how patients were diagnosed and treated, staff were better educated and trained to interact with the patients. This came into action after the experiment when pseudopatients observed the psychiatric hospital staff, nurses and doctors not treating the patients as people. The pseudo-patients found that the staff ignored the patients when they needed help, staff abused patients and made the patients feel powerless. Staff began to treat the patients with a more hands-on approach rather than depending on heavily medicating them with drugs. This experiment also illustrated the problems with the impact labelling can have on people within our society. Rosenhan suggested that we should start to focus on patients' distinct problems they deal with and the behaviour that comes with it instead of labelling them as insane for their mental illnesses/disorder. Since these labels tend to follow the individual even after receiving the treatment they needed. Rosenhan's study proved the scientific procedures around mental illnesses were always accurate and led to an incorrect diagnosis.

Relevances Rosenhan's study is relevant still to this day. Reviews of diagnostic procedures have taken place because of the results of Rosenhan’s study. There has been a change in social policy meaning there has been a move away from “institution type treatments” due to the lack of interaction between the patients and staff. Several large asylums were closed so more patients were able to get treated within the community. Since 1973 and 2000, 200 new additional illnesses have been found, a large majority of there's illnesses are treated with medication. However, If the diagnosis is incorrect then the medication used to treat the illness may also be incorrect. Additionally, Rosenhan’s study continues to be cited for the impact it has made on the stigma effect of labelling and diagnostic criteria. Labelling mentally ill patients as crazy can lead to dehumanization with the consequence of creating further issues. Still to this day, it is important to take into consideration that these issues are still

relevant.

Psychological Theories G Langweiler & M Linden (1993) sent a trained pseudo-patient to four different physicians each with a different professional background. They found that even though the pseudopatient presented the same symptoms to each physician, the pseudo-patient was offered four different treatments. Marti Loring and Brian Powell (1988) Investigated whether using the DMS-III do psychiatrists provide different evaluations of clients based on race and sex. Previous studies found conflicting evidence on the effects of sex and race on a diagnosis. However, it has been suggested that with the institution of formalisation the DMS-III effects of race and gender on diagnosis have become minimal. They assessed the accuracy of the claim by using an analogue approach, where 290 psychiatrists evaluate two case studies. The Case studies were manipulated so approximately one-fifth of the clinicians were using DMS-III derived criteria to evaluate a black female, a black male, a white female and a white male. The results indicated that the race and sex of a client influenced diagnoses even when a clear-cut diagnostic criteria is presented. They concluded the study saying that is premature to close the question of the influence of race and sex on a diagnostic assessment. Lauren Slater (2004) attempted to test the hypothesis of Rosenhan's “Being Sane in Insane Places” experiment - are psychiatric diagnoses influenced by situational contexts rather than the patient's symptoms they show. Slater went into nine different psychiatric emergency rooms with one fake symptom, saying she hears a voice in her head say “thud”. Slater reported that almost in every case she received a diagnosis of psychotic depression as well as prescriptions 25 antipsychotics and 60 antidepressants tablets. Slater then concluded that psychiatric diagnoses are driven by a "zeal to prescribe" - a willingness to prescribe drugs and medication. Spitzer, Lilienfeld & Miller (2005) challenged Slater’s findings by giving 74 emergency room psychiatrists her case description - hearing a voice in her head say “thud”. They found that three psychiatrists diagnosed “psychotic depression” (3/72) and a third recommended medication to treat (25/74). The fact that other psychologists have found they had similar findings show that misdiagnosis from psychiatrists/staff and the inability to tell the different individuals who are genuinely mentally ill and those who aren't is still an issue.

Validity For validity purposes, before the experiment was conducted Rosenhan trained all the pseudo-patients to act a certain way. However, not all of them followed the same standardised procedures. Data from a ninth pseudo-patient wasn't included in Roshan's report because they didn't stick close enough to the brief Rosenhan gave them. Another pseudo-patient struck up a romantic relationship with a nurse. A pseudo-patient revealed that he was going to become a psychologist and one of his visitors was a college professor. Finally, another pseudo-patients asked his wife to bring in his college homework to do which revealed he was a psychology professor. Seymour, Ketty (1974) criticised Rosenhan experiment saying that the pseudo-patients who were admitted into the psychiatric hospital by faking a mental illness doesn't tell us anything about individuals who genuinely are in the psychiatric hospital with a medical condition they are diagnosed with. “If I were to drink a quart of blood and, concealing what I had done, had come to the emergency room of any hospital vomiting blood, the behaviour of the staff would be quite predictable.” Seymour's point was that psychiatrists don't expect someone to carry

out deception by faking a mental illness to be admitted into a psychiatric hospital - the study lacked mundane realism. Spitzer (1975) criticised Rosenhan's experiment, pointing out that the staff in his study were not required to distinguish between sane and insane. He found that the study told us nothing about the accuracy of a diagnosis in an actually insane or mentally ill patient since pretending to have and having a mental health condition is not the same thing. All Rosenhan's study was assessing was whether people pretending to have mental disorders could be detected. Spitzer (1976) pointed out that the diagnosis “schizophrenia - in remission” given to 7 of the discharged pseudo-patients was unusual. Spitzer examined the records of the discharged schizophrenia patients in his own hospital as well as twelve other American hospitals. He found that “schizophrenia - in remission” was only used for a few patients each year. Spitzer then claimed that the psychiatrist's discharged diagnosis was a recognition that the pseudopatients behaviour was unusual, he continued to claim that this isn't proof that the psychiatrists couldn't tell the difference between those who are sane and insane.

Strengths Rosenhan's study had a significant amount of strengths. The first strength is that the staff at the psychiatric hospitals were unaware of the experiment, which therefore proves that validity of the experiment. Rosenhan used a range of hospitals - private, public, old, new, different states, well staffed, poorly staffed etc. The varied hospitals helped allow for generalization. The pseudo-patients admitted themselves under a different name so their identities were protected. Ethically this is a strength, since they don't need to associate themselves with the label that was attached to them as a result of being admitted. The fact that the experiment was an participant observation by pseudo-patients meant that the pseudo-patients were able to experience the ward from the patients perspective while also maintaining some degree of objectivity.

Judgement From further research into Rosenhan's “Being Sane in Insane Places” experiment, I have made a judgement that his experiment has had a positive impact on society. The initial results of the experiment found that Psychiatrists could not reliably tell the difference between individuals who are sane and those that are insane. Rosenhan’s experiment was able to shed light on the issues within mental health care which created a change. This research led to many care institutions to improve the care of their patients as this experiment highlighted the appalling conditions of many psychiatric hospitals. Observations from the pseudo-patients found that the staff didn't care about the patients and only spent on average 6.8 minutes a day interacting with them. This not only brought awareness to the conditions but how the staff treated patients. Staff were better trained to interact with patients which overall created a positive impact on the way mentally ill patients are treated. Additionally, this experiment also had a positive impact on the labelling, patients were previously negatively associated with their mental illness which continued to follow then after treatment. Fortunately, Rosenhan was able to spread awareness of the negative effects labelling has on individuals. After discovering that psychiatrists could not tell the difference between individuals who are genuinely insane and sane new rules had to be put in order. Patients were better assessed and diagnosed with more accurate mental illnesses and treated with more of a hands-on treatment rather than being heavily medicated. Overall Rosenhan's “Being Sane in Insane Places” experiment was able to review and change the way mentally

ill patients were diagnosed and treated in psychiatric hospitals.

Bibliography http://www.holah.karoo.net/rosenhanstudy.htm http://www.intergratedsociopsychology.net/sane_insane-place.html http://www.psychologywizard.net/rosenhan-ao1-ao3.html...