CLP 4143 discussion post


CLP 4433

The University of South Florida

Question Description

Read the article On being sane in insane places.

1) Write a 200 to 250 word summary of this article in your own words. Follow these instructions from the Purdue Online Writing Lab (Links to an external site.) to write an APA style abstract :

"write a concise summary of the key points of [the] research. Your abstract should contain at least [the] research topic, research questions, participants, methods, results, data analysis, and conclusions. You may also include possible implications of [the] research and future work you see connected with [the] findings."

2) Write a 150 to 250 word response to the article that includes 1) your personal reaction to this article, 2) what are the implications of the article regarding diagnosis and treatment of mental health disorders, and 3) do you think the findings would be the same if this study were conducted today? (explain why)

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On Being Sane in Insane Places Author(s): D. L. Rosenhan Source: Science , Jan. 19, 1973, New Series, Vol. 179, No. 4070 (Jan. 19, 1973), pp. 250258 Published by: American Association for the Advancement of Science Stable URL: REFERENCES Linked references are available on JSTOR for this article: You may need to log in to JSTOR to access the linked references. JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact Your use of the JSTOR archive indicates your acceptance of the Terms & Conditions of Use, available at American Association for the Advancement of Science is collaborating with JSTOR to digitize, preserve and extend access to Science This content downloaded from on Fri, 22 Jan 2021 17:35:25 UTC All use subject to The Geographical Distribution of Animals (Wiley, New York, 1957); B. Rensch, Evolution Above the Species Level (Methuen, London, 1959); V. Grant, The Origin of Adaptations (Columbia Univ. Press, New York, 1963). 5. S. Wright, Genetics 16, 97 (1931). tion 22, 699 (1968); 0. Halkka and E. the effects of gene flow. This is because the effective gene selection on males in sex-linked 1968), p. 351; B. C. Clarke and J. J. Murray, in Ecological Genetics and Evolution, R. (Univ. of Chicago Press, Chicago, 1955) for a good discussion of sex-linkage and selection. A. P. Platt and L. P. Brower, Evolu- Mikkola, Hereditas 54, 140 (1965); B. C. Clarke, in Evolution and Environment, E. T. Drake, Ed. (Yale Univ. Press, New Haven, Greed, Ed. (Blackwells, Oxford, 1971), p. 6. , ibid. 28, 114 (1943); ibid. 31, 39 51; J. A. Bishop and P. S. Harper, Heredity (1946); Evolution and the Genetics of Popu25, 449 (1969); J. A. Bishop, J. Anim. Ecol. lations, vol. 2, The Theory of Gene Fre- quencies (Univ. of Chicago Press, Chicago, 1969); F. J. Rohlf and G. D. Schnell, Amer. 41, 209 (1972); G. Hewitt and F. M. Brown, Heredity 25, 365 (1970); G. Hewitt and C. Ruscoe, J. Anim. Ecol. 40, 753 (1971); H. Wolda, ibid. 38, 623 (1969); F. B. Livingstone, Amer. J. Phys. Anthropol. 31, 1 (1969). 22. C. P. Haskins, E. F. Haskins, J. J. A. McLaughlan, R. E. Hewitt, in Vertebrate Mishima-City, Japan 9, 84 (1958). Speciation, W. F. Blair, Ed. (Univ. of Texas 9. M. Kimura and G. H. Weiss, Genetics 49, Press, Austin, 1961), p. 320. 561 (1964); M. Kimura and T. Maruyama, 23. A. J. Bateman, Heredity 1, 234, 303 (1947); Genet. Res. 18, 125 (1971). ibid. 4, 353 (1950); R. N. Colwell, Amer. J. 10. P. R. Ehrlich and P. H. Raven, Science 165, Bot. 38, 511 (1951); M. R. Roberts and H. 1228 (1969). Lewis, Evolution 9, 445 (1955); C. P. Haskins, 11. For example, J. Maynard-Smith, Amer. Natur. personal communication; K. P. Lamb, E. 100, 637 (1966). Hassan, D. P. Scoter, Ecology 52, 178 (1971). 12. J. M. Thoday, Nature 181, 1124 (1958); -For localized distribution and problem of and T. B. Boam, Heredity 13, 204 (1959); E. establishment see also: W. F. Blair, Ann. Millicent and J. M. Thoday, Ibid. 16, 219 N.Y. Acad. Sci. 44, 179 (1943); Evolution 4, (1961); J. M. Thoday and J. B. Gibson, Amer. 253 (1950); L. R. Dice, Amer. Natur. 74, 289 Natur. 105, 86 (1971). (1940); P. Labine, Evolution 20, 580 (1966); 13. F. A. Streams and D. Pimentel, ibid. 95, 201 H. Lewis, ibid. 7, 1 (1953); W. Z. Lidicker, (1961); Th. Dobzhansky and B. Spassky, Proc. personal communication; J. T. Marshall, Jr., Roy. Soc. London Ser. B. 168, 27 (1967); Natur. 105, 295 (1971). 7. J. B. S. Haldane, J. Genet. 48, 277 (1948). 8. R. A. Fisher, Biometrics 6, 353 (1950); M. Kimura, Annu. Rep. Nat. Inst. Genet. , J. Sved, ibid. 173, 191 (1969); Th. Dobzhansky, H. Levene, B. Spassky, ibid. 180, 21 (1972). 14. M. Slatkin, thesis, Harvard University (1971). 15. S. K. Jain and A. D. Bradshaw, Heredity 21, 407 (1966). 16. Parapatric divergence is divergence between adjacent but genetically continuous popula- tions. See H. M. Smith, Syst. Zool. 14, 57 (1965); ibid. 18, 254 (1969); M. J. D. White, R. E. Blackith, R. M. Blackith, J. Cheney, Aust. J. Zool. 15, 263 (1967); M. J. D. White, Science 159, 1065 (1968); K. H. L. Key, Syst. Zool. 17, 14 (1968). 17. J. S. Huxley, Nature 142, 219 (1938); Bijdr. Dierk. Leiden 27, 491 (1939). 18. F. B. Sumner, Bibliogr. Genet. 9, 1 (1932). 19. F. Salomonsen, Dan. Biol. Medd. 22, 1 (1955). 20. E. B. Ford, Biol. Rev. Cambridge Phil. Soc. 20, 73 (1945). 21. Examples of morph-ratio clines include: H. B. D. Kettlewell and R. J. Berry, Heredity 16, 403 (1961); ibid. 24, 1 (1969); H. B. D. Kettlewell, R. J. Berry, C. J. Cadbury, G. C. Phillips, Ibid., p. 15; H. N. Southern, J. Zool. London Ser. A 138, 455 (1966); A. J. Cain and J. D. Currey, Phil. Trans. Roy. Soc. London Ser. B. 246, 1 (1962); loci makes the net selection stronger, compared to autosomal loci, for the population as a whole. See C. C. Li, Population Genetics 30. The equilibrium configurations are not significantly altered if the emigrants from the end demes do not return, unless the number of demes (d) is very small (J. A. Endler, unpublished data). 31. See, for example, the models of B. C. Clarke [Amer. Natur. 100, 389 (1966)] and those in (14). 32. This model incorporates Clarke's model of frequency-dependence; see B. C. Clarke, Evolution 18, 364 (1964). 33. R. A. Fisher and F. Yates, Statistical Tables for Biological, Agricultural, and Medical Research (Oliver & Boyd, Edinburgh, 1948); R. R. Sokal and F. J. Rohlf, Biometry (Freeman, San Francisco, 1969). 34. See, for example, C. G. Johnson, Migration and Dispersal of Insects by Flight (Methuen, London, 1969); J. Antonovics, Amer. Sci. 59, 593 (1971). 35. E. C. Pielou, An Introduction to Mathematical Ecology (Wiley-Interscience, New York, 1969). 36. W. F. Blair, Contrib. Lab. Vertebrate Biol. Univ. Mich. No. 36, 1 (1947). 37. P. A. Parsons, Genetica 33, 184 (1963). 38. G. Hewitt and B. John, Chromosoma 21, 140 (1967); Evolution 24, 169 (1970); G. Amer. Zool. 10, 53 (1970); P. Voipio, Ann. Zool. Fenn. 15, 1 (1952); P. K. Anderson, Hewitt, personal communication; H. Wolda, J. Anim. Ecol. 38, 305, 623 (1969). Science 145, 177 (1964). 24. N. W. Timofeeff-Ressovsky, in The New 39. L. R. Dice, Contrib. Lab. Vertebrate Genet. Systematics, J. S. Huxley, Ed. (Oxford Univ. Univ. Mich. No. 8 (1939), p. 1; ibid. No. 15 (1941), p. 1. Press, Oxford, 1940), p. 73. 40. I. C. J. Galbraith, Bull. Brit. Mus. Natur. 25. The null point is the position at which Hist. Zool. 4, 133 (1956). selection changes over from favoring one 41. I am grateful to the National Science Foundatype to favoring another. 26. J. A. Endler, in preparation. tion for a graduate fellowship in support 27. L. M. Cook, Coefficients of Natural Selection of this study. I thank Prof. Alan Robertson (Hutchinson Univ. Library, Biological Sciand the Institute of Animal Genetics, Uniences No. 153, London, 1971); F. B. Livingversity of Edinburgh, for the Drosophila, and stone, Amer. J. Phys. Anthropol. 31, 1 (1969). for kindly providing me with fresh medium throughout the study. Criticism of the manu28. W. C. Allee, A. E. Emerson, 0. Park, T. script by Professors John Bonner and Jane Park, K. P. Schmidt, Principles of Animal Ecology (Saunders, Philadelphia, 1949); H. C. Potter, Dr. Philip Ashmole, Peter Tuft, Dr. Andrewartha and L. C. Birch, The DistribuDavid Noakes, Dr. John Godfrey, Dr. Caryl tion and Abundance of Animals (Univ. of P. Haskins, and M. C. Bathgate was very welcome. In particular, I thank my supervisor, Chicago Press, Chicago, 1954); G. L. Clarke, Professor Bryan C. Clarke, for help and critiElements of Ecology (Wiley, New York, 1954); R. Geiger, The Climate Near the cism throughout this study. Any errors or omissions are entirely my own. I thank the Ground (translation, Harvard Univ. Press, Edinburgh Regional Computing Center and Cambridge, 1966). 29. Results for autosomal and sex-linked systems the Edinburgh University Zoology Department Condor 50, 193, 233 (1948); R. K. Sealander, do not differ for the models to be discussed, except that, for a given amount of selection, the sex-linked system is loss sensitive to for generous computer time allowances. I will supply the specially written IMiP language program upon request. What is viewed as normal in one cul- ture may be seen as quite aberrant in On On Being Being Sane Sanein inInsane InsanePlaces Places another. Thus, notions of normality and abnormality may not be quite as accurate as people believe they are. To raise questions regarding normal- ity and abnormality is in no way to question the fact that some behaviors D. L. Rosenhan are deviant or odd. Murder is deviant. So, too, are hallucinations. Nor does raising such questions deny the existence of the personal anguish that is often associated with "mental illness." tradictedby byequally equally eminent eminent psychiapsychia-Anxiety and depression exist. PsychoIf If sanity sanityand and insanity insanity exist, exist, how shall how tradicted shall we know them? trists trists for forthe theprosecution prosecution on on thethe matter matter logical suffering exists. But normality of of the the defendant's defendant'ssanity. sanity. More More gengenand abnormality, sanity and insanity, The question is neither capricious nor erally, erally, there thereare area agreat great deal deal of of conflictconflictitself insane. However much we may and the diagnoses that flow from them ing ing data dataon onthe thereliability, reliability, utility, utility, andand be personally convinced that we can tell the normal from the abnormal, the meaning meaningof ofsuch suchterms terms as as "sanity," "sanity," "in-"in-The author is professor of psychology and law at Stanford University, Stanford, California 94305. sanity,""mental "mentalillness," illness," and and "schizo"schizoevidence is simply not compelling. It is sanity," Portions of these data were presented to collo- phrenia" phrenia"(1). (1).Finally, Finally, as as early early as 1934, as 1934, quiums of the psychology departments at the University of California at Berkeley and at Santa Benedict Benedictsuggested suggested that that normality normality andand Barbara; University of Arizona, Tucson; and Harvard University, Cambridge, Massachusetts. abnormality are not universal (2). psychiatrists for the defense are con- commonplace, for example, to read about murder trials wherein eminent SCIENCE, VOL. 179 250 This content downloaded from on Fri, 22 Jan 2021 17:35:25 UTC All use subject to may be less substantive than many believe them to be. This article describes such an experiold and shabby, some were quite new. ment. Eight sane people gainedSome secret were research-oriented, others At its heart, the question of whetheradmission to 12 different hospitals not. (6). Some had good staff-patient ratios, the sane can be distinguished from theTheir diagnostic experiences constitute others were quite understaffed. Only article; insane (and whether degrees of insanitythe data of the first part of this one was a strictly private hospital. All can be distinguished from each other) the remainder is devoted to a descripof the others were supported by state is a simple matter: do the salient char-tion of their experiences in psychiatric or federal funds or, in one instance, by acteristics that lead to diagnoses resideinstitutions. Too few psychiatrists and university funds. in the patients themselves or in the enpsychologists, even those who have After calling the hospital for an apvironments and contexts in which obworked in such hospitals, know whatpointment, the pseudopatient arrived at servers find them? From Bleuler, the experience is like. They rarely talkthe admissions office complaining that through Kretchmer, through the formuabout it with former patients, perhapshe had been hearing voices. Asked what lators of the recently revised Diagnostic because they distrust information com-the voices said, he replied that they and Statistical Manual of the American ing from the previously insane. Those were often unclear, but as far as he Psychiatric Association, the belief haswho have worked in psychiatric hospi- could tell they said "empty," "hollow," been strong that patients present symptals are likely to have adapted so thor- and "thud." The voices were unfamiliar toms, that those symptoms can be cateoughly to the settings that they areand were of the same sex as the pseudogorized, and, implicitly, that the saneinsensitive to the impact of that expe-patient. The choice of these symptoms are distinguishable from the insane.rience. And while there have been ocwas occasioned by their apparent simcasional reports of researchers who ilarity to existential symptoms. Such More recently, however, this belief has submitted themselves to psychiatric hos-symptoms are alleged to arise from been questioned. Based in part on theopitalization (7), these researchers have painful concerns about the perceived retical and anthropological considerations, but also on philosophical, legal, commonly remained in the hospitals formeaninglessness of one's life. It is as short periods of time, often with the if the hallucinating person were saying, and therapeutic ones, the view has grown that psychological categorization knowledge of the hospital staff. It is"My life is empty and hollow." The difficult to know the extent to which of mental illness is useless at best and choice of these symptoms was also dedownright harmful, misleading, andthey were treated like patients or liketermined by the absence of a single research colleagues. Nevertheless, theirreport of existential psychoses in the pejorative at worst. Psychiatric diagnoses, in this view, are in the minds of reports about the inside of the psychi-literature. the observers and are not valid sum- maries of characteristics displayed the observed (3-5). Gains can be made in deciding which of these is more nearly accurate by getting normal people (that is, people who do not have, and have never suffered, symptoms of serious psychiatric disorders) admitted to psychiatric hospitals and then determining whether they were discovered to be sane and, if so, how. If the sanity of such pseudopatients were always detected, there would be prima facie evidence that a sane individual can be distinguished from the insane context in which he is atric hospital have been valuable. This Beyond alleging the symptoms and falsifying name, vocation, and employ- article extends those efforts. by ment, no further alterations of person, Pseudopatients and Their Settings history, or circumstances were made. The significant events of the pseudopatient's life history were presented as The eight pseudopatients were a they had actually occurred. Relationvaried group. One was a psychologyships with parents and siblings, with graduate student in his 20's. The respouse and children, with people at maining seven were older and "estab- work and in school, consistent with the lished." Among them were three psy- aforementioned exceptions, were dechologists, a pediatrician, a psychiatrist, scribed as they were or had been. Frusa painter, and a housewife. Three trations and upsets were described pseudopatients were women, five were along with joys and satisfactions. These men. All of them employed pseudofacts are important to remember. If nyms, lest their alleged diagnoses emanything, they strongly biased the subfound. Normality (and presumably ab-barrass them later. Those who were insequent results in favor of detecting normality) is distinct enough that it mental health professions alleged ansanity, since none of their histories or can be recognized wherever it occurs, other occupation in order to avoid the current behaviors were seriously pathofor it is carried within the person. If,special attentions that might be aclogical in any way. on the other hand, the sanity of the corded by staff, as a matter of courtesyImmediately upon admission to the pseudopatients were never discovered,or caution, to ailing colleagues (8).psychiatric ward, the pseudopatient serious difficulties would arise for those With the exception of myself (I was the ceased simulating any symptoms of abwho support traditional modes of psy- first pseudopatient and my presence was normality. In some cases, there was a chiatric diagnosis. Given that the hospi-known to the hospital administrator and brief period of mild nervousness and tal staff was not incompetent, that thechief psychologist and, so far as I can anxiety, since none of the pseudopapseudopatient had been behaving as tell, to them alone), the presence tients of really believed that they would be sanely as he had been outside of the pseudopatients and the nature of the readmitted so easily. Indeed, their shared hospital, and that it had never been search program was not known to the fear was that they would be immedipreviously suggested that he belonged hospital staffs (9). ately exposed as frauds and greatly in a psychiatric hospital, such an un- The settings were similarly varied. embarrassed. In Moreover, many of them likely outcome would support the view order to generalize the findings, admishad never visited a psychiatric ward; that psychiatric diagnosis betrays little sion into a variety of hospitals was even those who had, nevertheless had about the patient but much about the sought. The 12 hospitals in the sample some genuine fears about what might environment in which an observer finds were located in five different states on happen to them. Their nervousness, him. the East and West coasts. Some were then, was quite appropriate to the nov19 JANUARY 1973 251 This content downloaded from on Fri, 22 Jan 2021 17:35:25 UTC All use subject to elty of the hospital setting, and it abated rapidly. Apart from that short-lived nervousness, the pseudopatient behaved on the ward as he "normally" behaved. The pseudopatient spoke to patients and labeled schizophrenic, the pseudopatient was stuck with that label. If the pseudopatient was to be discharged, he must naturally be "in remission"; but he was not sane, nor, in the institution's view, them personal, legal, and social stigmas (12). It was therefore important to see whether the tendency toward diagnosing the sane insane could be reversed. The following experiment was arranged at a research and teaching hospital whose The uniform failure to recognize sanstaff had heard these findings but doubted that such an error could occur ity cannot be attributed to the quality had he ever been sane. staff as he might ordinarily. Because there is uncommonly little to do on a psychiatric ward, he attempted to enof the hospitals, for, although there in their hospital. The staff was informed gage others in conversation. When were considerable variations amongthat at some time during the following asked by staff how he was feeling, hethem, several are considered excellent.3 months, one or more pseudopatients indicated that he was fine, that he no Nor can it be alleged that there was would attempt to be admitted into the longer experienced symptoms. He re- simply not enough time to observe the psychiatric hospital. Each staff member sponded to instructions from attendants, pseudopatients. Length of hospitaliza- was asked to rate each patient who preto calls for medication (which was not tion ranged from 7 to 52 days, with an sented himself at admissions or on the swallowed), and to dining-hall instruc-average of 19 days. The pseudopatients ward according to ...
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