Peter Grayson

Who’s Crazy

Here

Anyway?

•How does one distinguish between the psychological diagnoses of normal and abnormal behavior?

•Dividing line is not at all clear:

•Where does a person’s behavior lie on the line?

•Context of behavior, persistence of behavior, social deviance, subjective distress, psychological handicap, effect on functioning.

Background

NORMAL ABNORMAL(EFFECTIVE

FUNCTIONING) (MENTAL ILLNESS)

•David Rosenhan - Very provocative study.

•Do the characteristics that lead to psychological diagnoses stem from the patients themselves or from the situations in which the observers discovered their patients?

•Trained professionals should be able to distinguish.

•8 pseudopatients (including Rosenhan) were to gain admittance to a mental hospital and pose as having a mental illness. In the hospital, pseudopatients acted normally; cooperated with staff, took medications. 1973 - 1975.

Experiment

•Pseudopatients’ stays: 7 to 52 days. Avg: 19 days.

•Not one pseudopatient was discovered as sane by doctors/nurses.

•Other “real” patients could tell.

•Bizarre confrontations between pseudopatients and doctors:

During the experiment...

Response Psychiatrists Nurses/AttendantsMoves on/head

averted 71% 88%

Makes eye contact 23% 10%Pauses, chats 2% 2%Stops, talks 4% 0.5%

•In hospital, normal people cannot be distinguished from mentally ill.

•Diagnostic labels.

•If “labeled” with a condition, that label eclipses all other characteristics of the patient.

•If labeled with schizophrenia, doctors will view patient as “the schizophrenic”.

•Due to Rosenhan, psychiatric labels are used carefully. Treated with the respect their power demands.

Significance

•Some hospitals doubted that diagnostic mistakes could be made.

•Rosenhan informed hospitals: Over next three months, one or more pseudopatient would enter hospital. Doctors should rate which patients they suspected. 41 out of 193 were suspected by doctors.

•In reality, Rosenhan hadn’t sent a single pseudopatient.

•Are psychological diagnoses really valid?

Controversy/Criticisms

•Broughton and Chesterman - 2001

•Man sexually assaults teenage boy, questioned and displayed various psychotic behaviors. All were faked.

•As with Rosenhan’s pseudopatients, mental health professionals assumed the accuracy of the patient’s statements.

•Broughton and Chesterman: “We have to be careful that criminals are not able to fake mental illness as a get-out-of-jail-free card”.

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