Rosenhan experiment

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The Rosenhan experiment was a study of the reliability of psychiatric diagnoses carried out by psychologist David Rosenhan between 1968 and 1972 and published in Science magazine in 1973 under the title On Being Sane in Insane Places (title of the German translation: Gesund in Kranker Environment ). Since 2019, however, it has been doubted whether Rosenhan actually carried out the experiment as described.

In 1965, the psychologist Robert Rosenthal carried out comparable experiments in US elementary schools ( Pygmalion effect ).

Trial design and results

The study consisted of two parts. In the first, sane people secretly allowed themselves to be admitted to psychiatric institutions under the pretense of hallucinations in order to check the reactions of the hospitals. The second part went exactly the other way round: Rosenhan announced that he would smuggle “pseudo-patients” into some psychiatric hospitals, but without doing so. Nevertheless, the employees there believed that they had recognized pseudo-patients.

The experiment with pseudopatients

Eight different people (a psychology student, three psychologists, a psychiatrist, a pediatrician, a painter and a housewife; three of them were women, five men) registered at a total of twelve psychiatric institutions and claimed during the admission examination that they had heard voices who, as far as one could understand them, said the words "empty", "hollow" and "thud" ("empty" means "empty", "hollow" means "hollow", and "thud" has many meanings: bang, Thud, thudding, bouncing, hitting, booming, thudding. "Heart thudding" means "with a beating heart"). After they were admitted to the respective clinic, they behaved completely normal again. When registering, they gave a false name and false details about their employment, but otherwise stuck to the truth.

Each of the test subjects was accepted, eleven registrations were diagnosed with schizophrenia , one with manic-depressive psychosis . During the test, no test person was recognized as healthy by the staff. However, since the test subjects no longer showed any symptoms during their stay in the clinic, they were finally discharged after an average of 19 days (in one case even 52 days), although not as cured, but as symptom-free. The test persons were given a total of 2100 tablets of very different drugs, which they did not take secretly. They carefully recorded all events - first in secret and later in public because no one paid any attention. (In the protocols of the institutions, this activity was usually listed as pathological writing behavior.)

The other patients, on the other hand, saw through the deception relatively quickly and mistook the test subjects for journalists or professors. Correct discussions with the hospital staff did not take place and most questions from the pseudo-patients were ignored. An example for:

Pseudo patient: “ Pardon me, Dr. X. Could you tell me when I am eligible for grounds privileges? ”(German:“ Excuse me, Dr. X. Can you tell me when I will get the exit rights? ”) Doctor in passing without paying attention to the question:“ Good morning, Dave. How are you today? "(German:" Good morning, Dave. How are you today? ")

The experiment without pseudopatients

An institute which, after announcing the results of the first experiment, claimed that nothing like this would happen to them, was told that Rosenhan would send some pseudo-patients to them within three months and that they would therefore rate all patients according to their probability of being pseudo-patients should. During these 3 months, 193 patients were admitted, 41 of whom were mistaken for test subjects and a further 42 were classified as suspicious without Rosenhan actually sending pseudo-patients.

reception

The Rosenhan experiment and Rosenhan's conclusions have been criticized from various quarters, particularly because of their methodological weaknesses. Since a psychiatric diagnosis is usually based mainly on reports from the patients concerned or from people in their environment relating to the behavior and perception of the patients, the critics believe that a false diagnosis based on false claims does not indicate problems with the Precision of diagnosis.

Robert L. Spitzer , professor of psychiatry at Columbia University , pointed out this problem in the study in a review published in 1975. In other medical disciplines, too, consciously presenting false symptoms would lead to incorrect diagnoses. Despite this criticism of the Rosenhan experiment, Spitzer subsequently endeavored to improve diagnostic standards in psychiatry, for example by revising the Diagnostic and Statistical Manual of Mental Disorders ( Diagnostic and Statistical Manual of Mental Disorders ).

In 2019 the author and journalist Susannah Cahalan published her research in book form. This research raises considerable doubts about Rosenhan's presentation of the study. Rosenhan is said to have participated in the study himself as a patient and described much more serious symptoms (e.g. suicidal thoughts ) than he later reported. Despite intensive research, only one other participant in the study could be found, but his experiences did not coincide with the descriptions of Rosenhan.

literature

Web links

credentials

  1. ↑ Klaus Koch. The lost look into the soul. at sueddeutsche.de; Retrieved December 28, 2010.
  2. ↑ David L. Rosenhan : On Being Sane in Insane Places . In: Science . Vol. 179, No. 4070 , 1973, pp. 250–258 , doi : 10.1126 / science.179.4070.250 (English, web archive, PDF; 100 kB ).
  3. ↑ a b Susannah Cahalan: Stanford professor who changed America with just one study was also a liar. In: New York Post. November 2, 2019, accessed November 4, 2019 .
  4. ^ A b Johann Grolle: Journey into the realm of madness . In: Der Spiegel . No. 50 , 2019, pp. 112 f . ( online ).
  5. ^ Robert L. Spitzer: On pseudoscience in science, logic in remission, and psychiatric diagnosis: A critique of Rosenhan's "On being sane in insane places" . In: Journal of Abnormal Psychology . Vol. 84, No. 5 , 1975, p. 442–452 , doi : 10.1037 / h0077124 (English).
  6. ↑ Peter Bauer: US Psychiatry: The Study That Never Was. In: orf.at. January 6, 2020, accessed January 11, 2020 .