30-Second Psychology: The 50 Most Thought-provoking Psychology Theories, Each Explained in Half a Minute - Christian Jarrett 2011
Rosenhan’s insane places
In the early 1970s David Rosenhan believed that the medical definitions of mental illness were hopelessly vague and subject to the whims of the individual doctor. He decided to test how well psychiatrists could distinguish between ’sane’ and ’insane’ people by sending eight friends to hospital emergency rooms, each pretending to hear a voice saying ’empty’, ’hollow’, and ’thud’. All eight were diagnosed with schizophrenia and admitted to psychiatric hospitals, at which point, following Rosenhan’s earlier instructions, they began to act normally and report that their ’voices’ had gone. The ’pseudopatients’ were kept in hospital, often for weeks, while staff consistently interpreted normal behaviour as part of their non-existent illness. When news of the study spread, a local university hospital doubted that it would make such errors so Rosenhan promised to send more fake patients. In reality, he sent none, but in the meantime the hospital had branded more than forty real patients as fakers and another twenty-three were regarded as suspect. The shockwaves from the study, provocatively entitled ’On Being Sane in Insane Places’, battered the confidence of the medical profession and led to a new system of diagnosis that depends on checklists and scientific studies that test how reliably psychiatrists can use them.
’If sanity and insanity exist, how shall we know them?’ asked David Rosenhan’s 1973 study, in which fake patients with unlikely symptoms were diagnosed with schizophrenia.
Psychiatrist Robert Spitzer replied that if he drank blood and vomited in an emergency room to fake a peptic ulcer, the staff should not be blamed for being misled and nor should they change the definition of internal bleeding. Despite making this criticism, Spitzer led a reform of how mental illnesses are defined and modern diagnoses are now much less vague or subject to individual interpretation.
WASON’S CONFIRMATION BIAS
Is it fair to tell doctors about fake symptoms and then complain when the result is an inappropriate diagnosis? Rosenhan’s shock study led to a more rigorous system of diagnosis for mental illness.