• Cognitive Psychology
• Developmental Psychology
• Individual Differences
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You can also find all of the past exam questions on Rosenhan's study here. 

Here is  a quiz

Here you can read the original study

David Rosenhan

One of my favourite Simpsons episodes -Stark Raving Dad (from series 3) is worth watching in conjunction with this study.  It is a parody of the fantastic film - One Flew Over the Cuckoos Nest.  See how many other links to the core studies that you can find in the video.  If you haven't got the episode (shame on you) this link might work.

and this..
A guy is walking past an asylum, and can hear all the inmates inside screaming at the top of their lungs, “Thirteen! Thirteen! Thirteen!!!”. He peeks through a hole in the fence to see what all the commotion is about, and a finger suddenly pops out and jabs him in the eye. He yells in pain, and the inmates all start gleefully shouting, “Fourteen! Fourteen! Fourteen!!!”.

The aim of this study was to test the hypothesis that psychiatrists cannot reliably tell the difference between people who are sane and those who are insane.

The study actually consisted of two parts.

The main study is an example of a field experiment.  The study also involved participant observation, since, once admitted, the pseudo-patients kept written records of how the ward as a whole operated, as well as how they personally were treated.

The participants were hospital staff in 12 different hospitals.

The first part of the study involved eight sane people (pseudo-patients) attempting to gain admission to 12 different hospitals, in five different states in the USA.  There were three women and five men.

These pseudo-patients telephoned the hospital for an appointment, and arrived at the admissions office complaining that they had been hearing voices.  They said the voice, which was unfamiliar and the same sex as themselves, was often unclear but it said 'empty', 'hollow', 'thud'. 

The pseudo patients gave a false name and job, but all other details they gave were true including general ups and downs of life, relationships, events of life history and so on.

After they had been admitted to the psychiatric ward, the pseudo patients stopped simulating any symptoms of abnormality. The pseudo patients took part in ward activities, speaking to patients and staff as they might ordinarily.  When asked how they were feeling by staff they said they were fine and no longer experienced symptoms.  Each pseudo patient had been told they would have to get out by their own devices by convincing staff they were sane.

The pseudo patients spent time writing notes about their observations. Initially this was done secretly although as it became clear that no one was bothered the note taking was done more openly.

None of the pseudo patients was detected and all but one were admitted with a diagnosis of schizophrenia and were eventually discharged with a diagnosis of 'schizophrenia in remission'

The pseudo-patients remained in hospital for 7 to 52 days (average 19 days),

Although they were not detected by the staff, many of the other patients suspected their sanity (35 out of the 118 patients voiced their suspicions). 

The pseudo patients’ normal behaviours were often seen as aspects of their supposed illness.  For example, nursing records for three of the pseudo patients showed that their writing was seen as an aspect of their pathological behaviour.  'Patient engages in writing behaviour'. 

Another example of where behaviour was misinterpreted by staff as stemming from within the patient, rather than the environment, was when a psychiatrist pointed to a group of patients waiting outside the cafeteria half an hour before lunchtime.  To a group of registrars (trainee psychiatrists) he suggested that such behaviour was characteristic of an oral-acquisitive syndrome.  However, a more likely explanation would be that the patients had little to do, and one of the few things to anticipate in a psychiatric hospital is a meal.

In four of the hospitals the pseudo patients carried out an observation of behaviour of staff towards patients that illustrate the experience of being hospitalised on a psychiatric ward.  The results were compared with a university study.  In the university study, nearly all the requests were acknowledged and responded to unlike the psychiatric hospital where the pseudo patients were treated as if they were invisible.   See table 1.

Table 1: Responses of staff towards pseudo patients requests

In the secondary study, staff of a teaching and research hospital, which was aware of the first study, was falsely informed that during the next three months one or more pseudo patients would attempt to be admitted into their hospital.  Staff members were asked to rate on a 10-point scale each new patient as to the likelihood of them being a pseudo patient.

The table shows that many patients of the hospitals regular intake were judged to be pseudo patients.  For example, around ten per cent of their regular intake were judged by one psychiatrist and another staff member to be pseudo patients.

Table 2:  Judgement of all admissions patients as to the likelihood that they are pseudo patients

Rosenhan claims that the study demonstrates that psychiatrists cannot reliably tell the difference between people who are sane and those who are insane. 

The main experiment illustrated a failure to detect sanity, and the secondary study demonstrated a failure to detect insanity.

Rosenhan explains that psychiatric labels tend to stick in a way that medical labels do not and that everything a patient does is interpreted in accordance with the diagnostic label once it has been applied.

He suggested that instead of labelling a person as insane we should focus on the individual’s specific problems and behaviours.

Rosenhan noted that experience of hospitalisation for the pseudo patients was one of depersonalisation and powerlessness.

Powerlessness and depersonalisation were evident in the ways in which the patients were deprived of many human rights such as freedom of movement and privacy.  Medical records were open to all staff members regardless of status or therapeutic relationship with the patient and personal hygiene was monitored and many of the toilets did not have doors.  Some of the ward orderlies would be brutal to patients in full view of other patients but would stop as soon as another staff member approached.  This indicated that staff were credible witnesses but patients were not.