Studies

Clinical psychology

8.2.1 Rosenhan (1973) On being sane in insane places.

Aim: To see whether sane people could be distinguished from the insane using the DSM

Sample: A volunteer sample of eight sane people were used as confederate observers and contained
a total of three women and five men. The pseudo-patients included a psychology graduate student,
three psychologists, a paediatrician, a psychiatrist, a painter, and a 'housewife'.

Procedure: The study was conducted in 12 hospitals in several states of the USA, including state and
private care facilities. Rosenhan and seven volunteers arrived at a range of hospitals reporting a
single symptom, hearing voices saying ‘empty’, ‘hollow’ and ‘thud.’ They gave real information about
themselves such as details about their families and childhood. However, they gave false names and
those in the medical profession gave a false occupation. As soon as the eight pseudopatients were in
hospital, they started behaving normally.

Results: All the pseudopatients were admitted and none were detected as being sane. It was an
average of 19 days before any of them were released. Even when they were released all but one
were given the diagnosis of schizophrenia in remission. In no case did any of the doctors and nurses
notice that there was nothing wrong with them.

Conclusion: Rosenhan concluded that staff in psychiatric hospitals were unable to distinguish those
who were sane from those who were insane, and that DSM is not a valid measurement of mental
illness.

Strengths:

The study took place in a real-life context as the pseudo-patients were admitted to a range of
genuine psychiatric units in the USA, so the results have high ecological validity to the experiences of
mental health patients within institutions in the USA.

The study was conducted in a variety of hospitals, such as public and private, in several states of the
USA. Therefore, the findings are more generalisable to other psychiatric hospitals in the USA as it
represents psychiatric care in the USA at that time.

Detailed notes by the pseudo-patients gives validity to the data about experiences as they
documented how they were treated and how they felt.

Weaknesses:

Rosenhan (1973) can be considered unethical due to deception because the staff at the hospitals
were deceived about patient symptoms and were not told they were being studied. but this was
necessary to prevent demand characteristics so data is reliable and valid

There is a lack of generalisability to the experiences of the wider population of patients in psychiatric
institutions because the confederates did not represent those with mental health conditions.

There is a lack of objectivity in the observational data from the pseudo-patients in the ward as the
reports could have been affected by their emotions, so the data gathered about the experiences of
patients and behaviours of staff in the hospitals could have been subjective.
8.2.2 Suzuki et al. (2014) High prevalence of underweight and undernutrition in Japanese
inpatients with schizophrenia.

Aim: To investigate the prevalence of underweight and overweight/obesity in Japanese inpatients

Sample: 333 inpatients diagnosed with schizophrenia using the DSM-IV-TR (1) from different
psychiatric hospitals in Japan.

Conclusion: Overweight/obesity was similar between the inpatients with schizophrenia and the
healthy control group, and the risks related to overweight/obesity are alike for inpatients with
schizophrenia to the general population.

Evaluation

Strengths:

High credibility- Kitabayashi et al (2006) findings found that the percentage of underweight in
schizophrenic patients is higher than the percentage (8.1%) of underweight general population in
Japan. Supporting Suzuki's conclusion.

High validity- Suzuki controlled the extraneous variables by excluded patients that have extra
physical illnesses, recent changes in drug therapy etc. To ensure that the factor influencing the
weight and nutritional level is the mental disorder, not other variables. Increasing the validity of
results.

High generalizability- Suzuki used a participant sample of 333, age 16-80yr and from 9 different
mental hospitals. This is a large sample and include a variation of ages. Therefore it can be
generalized to the target population. However, it only included schizophrenic patients from Japan,
missing out other nationalities, therefore it cannot be generalized to the world schizophrenic
population.

Good ethics- Suzuki gathered informed consent from all the participants, making the study ethical.
However schizophrenic patients may not have logical conscious to judge the consent, therefore
presumptive consent should also be gathered.

Weakness:

8.2.5 Becker et al. (2002) Eating behaviours and attitudes following prolonged exposure to
television among ethnic Fijian adolescent girls.

Strengths:

The respondents completed a standardised 26-item eating attitudes test (EAT-26) about binge eating
and purging behaviour which gives retest-reliability as the questionnaire can be used and reused to
measure eating attitudes in all respondents.

An open ended, semi-structured interview with 30 respondents who showed disordered eating
behaviours gathered more in-depth data which increases the validity of the findings by allowing
respondents to explain their behaviours in a more personalised and detailed way.
An unstructured interview was used to gather qualitative data from the girls about their experiences
of television. This would increase the validity of the conclusions as it reflects how the television and
eating behaviours affect the participant as a whole

Weakness:

63 respondent participants in the 1995/first wave of the study a month after television was
introduced this is a low sample size and reduces the representativeness of the results, limiting
generalisation.

A standardised 26-item eating attitudes test was used to assess the eating behaviours of the girls,
however self-reported data can be subjective, especially with sensitive issues such as eating
behaviours, so the data may be unreliable.