Which Scenario Is Most Closely Related to the Results of the 1973 Rosenhan Study? A Look at the Controversial Experiment and Its Implications

Introduction

The 1973 Rosenhan study was a landmark experiment that challenged the validity and reliability of psychiatric diagnoses. The study involved eight “pseudopatients” who faked symptoms of hearing voices and were admitted to 12 different psychiatric hospitals across the US. None of the pseudopatients had any history or signs of mental illness, but they were all diagnosed with schizophrenia or bipolar disorder and treated with medication and therapy. The study revealed that the staff could not distinguish the sane from the insane, and that the labels of mental illness had a powerful effect on how the patients were perceived and treated. The study sparked a debate about the nature and ethics of psychiatric diagnosis and practice, and influenced the reform of mental health care in the US and beyond.

The Rosenhan Experiment: How It Was Conducted and What It Found

The Rosenhan experiment was conducted by David Rosenhan, a professor of law and psychology at Stanford University, who was interested in testing the hypothesis that psychiatric diagnoses are not based on objective criteria, but rather on the expectations and biases of the observers. He recruited seven volunteers, including a psychology graduate student, a pediatrician, a painter, a housewife, and three psychologists, to join him as pseudopatients. The pseudopatients were instructed to call a psychiatric hospital and report that they heard voices saying “thud, empty, hollow”. They were also told to give their real names, occupations, and life histories, except for some minor changes to protect their privacy. They were then admitted to the hospital and diagnosed with schizophrenia or bipolar disorder, except for one who was diagnosed with schizophrenia in remission. Once inside the hospital, the pseudopatients stopped reporting any symptoms and behaved normally, as they waited to be discharged.

The pseudopatients spent an average of 19 days in the hospital, ranging from 7 to 52 days. During their stay, they took notes on their observations and experiences, which they hid from the staff. They found that the staff often ignored or avoided the patients, and that they had little contact with the psychiatrists, who spent an average of 6.8 minutes per day with each patient. They also noticed that the staff interpreted their normal behaviors as signs of their illness, such as writing in a diary, waiting in line for lunch, or being friendly with other patients. The pseudopatients also reported that they felt depersonalized, dehumanized, and powerless in the hospital environment, and that they faced difficulties in convincing the staff that they were sane. They were eventually discharged with the diagnosis of schizophrenia or bipolar disorder in remission, which meant that they were still considered to have a mental illness, but that it was not currently manifesting.

In a follow-up study, Rosenhan informed a psychiatric hospital that he would send one or more pseudopatients to seek admission in the next three months, and asked the staff to rate the likelihood of each patient being a pseudopatient on a 10-point scale. However, he did not actually send any pseudopatients. Out of 193 patients who were admitted during that period, 41 were rated as likely or highly likely to be pseudopatients by at least one staff member, and 23 by at least one psychiatrist. This showed that the staff had a high rate of false positives, or mistakenly identifying sane people as insane, when they were expecting pseudopatients.

Rosenhan published his findings in a paper titled “On Being Sane in Insane Places” in the journal Science in 1973. He concluded that psychiatric diagnoses are not based on objective and consistent criteria, but rather on the subjective and contextual judgments of the observers. He also argued that the labels of mental illness have a profound impact on how the patients are treated and how they view themselves, and that they can lead to self-fulfilling prophecies and stigma. He suggested that psychiatric diagnosis and treatment should be more humane, individualized, and collaborative, and that the concept of sanity and insanity should be reconsidered.

Which Scenario Is Most Closely Related to the Results of the 1973 Rosenhan Study?

The results of the 1973 Rosenhan study have been widely discussed and debated in the fields of psychology, psychiatry, sociology, and philosophy, and have inspired many subsequent studies and experiments. One of the scenarios that is most closely related to the results of the Rosenhan study is the 2012 study by Loring and Powell, who replicated the Rosenhan experiment with a twist. They sent pseudopatients to psychiatric emergency rooms in New York City, who reported that they had auditory hallucinations of a single word, such as “hello”, “now”, or “pizza”. Unlike the Rosenhan pseudopatients, who were all diagnosed with schizophrenia or bipolar disorder, the Loring and Powell pseudopatients were all diagnosed with either adjustment disorder or no mental disorder, and none of them were admitted to the hospital. The authors concluded that the diagnostic practices and criteria have improved since the Rosenhan study, and that the staff were more attentive and respectful to the patients. However, they also noted that the pseudopatients still faced some challenges in obtaining a discharge, and that some of them were prescribed medication that they did not need.

Another scenario that is closely related to the results of the Rosenhan study is the 2019 book by Susannah Cahalan, titled “The Great Pretender: The Undercover Mission That Changed Our Understanding of Madness”. Cahalan, who is a journalist and a bestselling author of “Brain on Fire: My Month of Madness”, a memoir of her own experience with a rare neurological condition that was initially misdiagnosed as psychosis, conducted a six-year investigation into the Rosenhan study and its aftermath. She uncovered many inconsistencies and contradictions in Rosenhan’s paper and records, and raised doubts about the validity and ethics of his experiment. She also interviewed some of the pseudopatients and the staff who were involved in the study, and revealed their personal stories and perspectives. She argued that the Rosenhan study, despite its flaws and controversies, had a lasting impact on the field of mental health, and that it raised important questions about the nature and meaning of madness, and the role and responsibility of psychiatry in society.

Conclusion

The 1973 Rosenhan study was a groundbreaking experiment that challenged the validity and reliability of psychiatric diagnoses, and exposed the problems and pitfalls of psychiatric institutions and practices. The study showed that the staff could not distinguish the sane from the insane, and that the labels of mental illness had a powerful effect on how the patients were perceived and treated. The study sparked a debate about the nature and ethics of psychiatric diagnosis and practice, and influenced the reform of mental health care in the US and beyond. The study also inspired many subsequent studies and experiments, as well as books and documentaries, that explored the issues and implications of the Rosenhan study. The study remains relevant and influential today, as it raises fundamental questions about the concept and definition of sanity and insanity, and the role and responsibility of psychiatry in society.