Reading: Hock 29 - Who’s Cray Here, Anyway?
Reading: Hock 29 - Who’s Cray Here, Anyway? APSY.UE.0002
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This 4 page Class Notes was uploaded by Brianda Hickey on Tuesday May 3, 2016. The Class Notes belongs to APSY.UE.0002 at NYU School of Medicine taught by Adina Schick, in Spring 2016. Since its upload, it has received 21 views. For similar materials see INTRODUCTION TO PSYCHOLOGY AND ITS PRINCIPLES in Psychlogy at NYU School of Medicine.
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Date Created: 05/03/16
Reading: Hock 29 - Who’s Cray Here, Anyway? normal = eﬀective psychological functioning abnormal = psychological disorder To determine if someone is normal or abnormal, professionals use the following criteria: Context of the Behavior Persistence of Behavior Social Deviance Subjective Distress Psychological Handicap Eﬀect on Functioning Researcher: David Rosenhan Theoretical Propositions Rosenhan questioned whether the characteristics that lead to psychological diagnoses reside int he patients themselves or in the situations and contexts in which the observers for the patients Rosenhan tested his question by have normal patients seek admittance to psychiatric facilities to see if those charges with diagnosing them would see that, in reality, they were psychologically healthy. If pseudo patients behaved normally and the doctors/staﬀ railed to recognize this, this would provide evidence that diagnoses of the mentally ill are ties more to the situation than to the patient Method 8 participants (including Rosenhan) served as pseudo patients 3 men and 5 women one graduate student, three psychologists, one pediatrician, one psychiatrist, one painter, and one homemaker Participants were to present themselves for admission to 12 psychological hospitals, in 5 states on both the East and West coasts of the US Followed same instructions: called hospital & made appointment complained of hearing voices that said “empty” “hollow” and “thud" After this single symptom, participants acted completely normal and gave truthful information to the interviewer Upon completing of the intake interview - all participants were admitted to the hospital and all but one was admitted with a diagnosis of schizophrenia Once inside the hospital, the pseudo patients dropped their pretend symptoms and behaved normally Up to them to convince staﬀ they were normal and be released Behaved as model patients, cooperating with staﬀ and accepting all medication (that they ﬂushed down the toilet) All participants took notes of their experience Results Length of hospital stay ranged from 7 - 52 days with an average of 19 days not one of the pseudo patients was detected by anyone on the hospital staﬀ When released - mental health status was recorded as “schizophrenia in remission" in 3 of the pseudo patients hospitalizations, 35 out of 118 real patients voiced suspicions that the participants were not actually mentally ill Contact among the patients and the staﬀ were minimal and often bizarre Ex. Pseudo patient would ask a common question ( “when will I be allowed groups privileges”) and the staﬀ would respond with a “Good Morning, Dave. How are you today?” then they moved on without waiting for a response Medication was free ﬂowing the 8 pseudo patients were given a total of 2,100 pills Discussion the study demonstrated that even trained professionals often cannot distinguish the normal from the mentally ill in a hospital setting According to Rosenhan, this is because of the overwhelming inﬂuence of the psychiatric hospital setting on the staﬀ’s judgement of an individual’s behavior the doctors and staﬀ tend to view them in ways that ignore them as individual people When diagnosed with a disorder, it becomes the patient’s central characteristic or personality trait staﬀ members perceive all of the patient’s behavior as stemming from the diagnosis The patient’s history was interpreted in ways that were consistent with their diagnosis Signiﬁcant Findings The study’s results pointed to two crucial factors it appended that the “sane” could not be distinguished from the “insane” in mental hospital settings It demonstrated the danger of diagnostic labels once a person is laced as having a certain psychological condition, that label eclipses any and all of his or her other characteristics All behavior and personality characteristics are then seen as stemming from the disorder If a person is treated in a certain way consistently over time, he or she may begin to behave that way Out of Rosenhan’s work grew greater care in diagnostic procedures and increased awareness of the dangers of applying labels to patients Questions and Criticisms One hospital doubted that such mistakes in diagnosis could be made in their hospital Rosenhan informed them that during the nest 3 months, one or more pseudo patients would try ti be admitted ti their psychiatric unit Each staﬀ member was asked to rate each presenting patient on a 10-point scale as to the likelihood that he or she was a pseudo patient 193 patients were admitted 41 were considered with high conﬁdence to be pseudo patients by at least one staﬀ member At the end, Rosenhan revealed that he had not sent any pseudo patients to the hospital during the 3-month period Rosenhan replicated his study several times in 12 hospitals between 1973 and 1975, each time ﬁnding similar results Spitzer argued that although the methods used by Rosenhan appeared to invalidate psychological diagnosis systems, in reality it did not It should not be diﬃcult for pseudo patients to lie their way into a mental hospital because may such admissions are based on verbal reports Even though the doctor was tricked, the diagnosis methods were not invalid the pseudo patients behaved normally once admitted to the hospital - such symptom variation in psychiatric disorders is common and does not meant that the staﬀ was incompetent in failing to detect the deception Recent Applications Thomas Szaz used Rosenhan’s research in challenging the validity of diagnoses made by mental health professionals his contention is that mental illnesses are not diseases and cannot be properly understood as such but rather must be seen as “problems in living: that have social and environmental causes One study examined how, in real life situations, people may indeed purposely fabricate symptoms of mental illness the case study discussed in the article involved a man accused of sexually assaulting a teenage boy perpetrator displayed various psychotic behaviors upon further examination, clinicians found that he had faked all his symptoms We have to be careful that criminals are not able to fake mental illness as a “get- out-of-jail-free card" In a survey of more than 1,300 mental health consumers, Wahl asked participants about their experiences of being discriminated against and stigmatized majority of respondents reported feeling the eﬀects of the stigma surrounding mental illness for carious sources “the majority of respondents tended to try to conceal their disorders and worried a great deal that others would ﬁns out about their psychiatric status and treat them unfairly" The authors of a study entitles “Listen to My Madness” Suggested that one possible approach to help us understand the experience of those with mental illness is to interpret their impairment in society similar to our perception of those with other types of deﬁned disabilities the authors proposed that seriously mentally ill individuals interaction with society is often very similar to people with other disabilities in terms of receiving care By applying a disability model to the mentally ill, they will have an easier time gaining access to and receiving the services and help they need
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