It's unclear if this experiment actually happened the way Rosenhan claimed. A journalist went through Rosenhan's archives and tried to verify his story. She managed to track down one of the pseudopatients, who disputed some of Rosenhan's claims such as the amount of preparation, and whether Rosenhan had worked out a legal backup plan in case the institution refused to release the patient.[1] She also noted large discrepancies in various numbers. Apparently she wrote a book about the whole thing, but I haven't had the chance to read it.[2][3]
If you've ever taken a depression screener at a wellness visit, that's a consequence of this work. This paper describes how unreliable psychiatric diagnosis used to be. There were standards, but they ultimately came down to physician judgment. This created demand for more objective standards, which resulted in the "checklist" approach that we have now.
It's true. You wouldn't believe how many people I've SIGECAPS'd during my medical training. I didn't realize this article was the beginning of this approach, but it certainly helped get care to people who previously wouldn't have received it. Though I'm sure there are also many who may require intervention that aren't captured by a SIGECAPS exam. The double edged sword of the checklist manifesto, though I overall think it has been beneficial.
SIGECAPS is an acronym taught in US medicine for the diagnosis of major depressive disorder: Sleep disturbance, Interest loss, Guilt, Energy loss, Concentration loss, Appetite changes, Psychomotor agitation, Suicidality. And must have Depressed mood or Anhedonia (inability to enjoy things previously enjoyable).
The history of the SIG E CAPS acronym is also interesting, I've heard it was short for SIG (old shorthand for "to be prescribed") Energy CAPsules.
The awful thing is that with at least some of those screeners you can still get people on the other side who make whatever you're self-reporting worse. When my spouse answered honestly on a postpartum survey about how she was feeling the social worker they sent in picked at my infant son's mismatching socks and suggested that she was so old she was "set in her ways" and that having a child might be too big of an adjustment for her. It set her back in a huge way and knowing what I know now I'd go to all of those appointments with her and never answer any of that stuff honestly.
It doesn't really matter how "objective" your standard is if you're still relying on individuals to try to "address" whatever the patient is reporting. People still form a negative opinion and label you really quickly no matter how hard the profession fights that perception.
I have heard that, however there is truth in the assertions. I know two people currently in psychiatric hospital, with one seeming to be relatively sane just now but trapped in there, and another whose mental health is being affected detrimentally by the hospital environment. I've no doubt the latter could have recovered last year but for the fact she is being kept in an environment where her only contact with the outside world or nature is at the behest of hospital staff (who vary a lot in terms of attitude and even fluency in English).
We are trained to be scared of lone individuals and rural environments, when in fact most abuses occur within a hierarchy and urban settings. I feel the fatal flaw in human nature is so many are obedient to power without question, especially when power has some kind of uniform, but also within gangs etc.
In the hospital environment, power is partly conveyed by the clothes people where and if you do not conform or obey, then you are punished. It is a pattern we are conditioned into from nursery/kindergarten onwards.
I think it comes down to a fear of uncertainty. It's comfortable to believe in authority.
Authority provides the illusion of a sense of control, predictability, certainty and orderliness, and it's like we gravitate toward that even when it leads to bad outcomes for us.
For most of us the fear of being out of control seems to be greater than the fear of being controlled.
Nowadays there's a lot of FUTON bias in research. There's so much power in just hitting the streets or reaching out to your circle.
For the most part, you care the most about your circle, so if that isn't representative of the whole of society, it sounds like somebody else's problem. Who said all research needed to be perfect.
I remember reading an essay explaining that patients not sharing the political beliefs of the physician running the asylum are more likely to be classified as mentally ill. A mental asylum paid by state money is usually going to be in the hand of physicians who never see anything wrong with the state (not biting the hand that feeds you and all that): so when for example a libertarian arrives, he's much more likely to be classified as mentally ill than if a socialist arrives.
So it's all arbitrary and, moreover, you better put the odds on your side by trying to determine what are the physicians' political beliefs and pretend you have the same ; )
I wonder the same. Have been reading up on literature related to ADD/ADHD diagnosis and prescription stimulants. It seems like there is little to no friction in getting a legit positive diagnosis. One can pretend to have issues securing a medication that is only meant for strong ADHD patients. I know someone who was able to get their hand on a lot of such stimulants, got addicted, went over the typical dosage, and is now suffering from psychosis.
I'd say yes. I have a book by Lauren Slater, called 'Opening Skinners Box' in which she researched many psychological experiments of the past, and subjected herself to similar conditions where she could, in an effort to understand better.
The chapter on 'Thud' ended with her visiting a psychiatric hospital of good reputation with an emergency room, she basically said the same things as the researchers in the paper. She was given some anti-psychotics and sent away.
Like I say elsewhere I have visited two people in our local psychiatric unit. I haven't encountered any of the shrinks but the nurses vary a lot in attitude. The whole place is underfunded and I believe most people would become more mentally ill by being kept in this environment, which has little more than a TV to keep people motivated. The only view of the outdoors is through windows and almost no one is allowed to smoke even though this causes immense tension.
Could you please stop posting unsubstantive comments and flamebait? You've unfortunately been doing it repeatedly. It's not what this site is for, and destroys what it is for. Please don't create accounts to do this with.
ggreer|27 days ago
1. https://sci-hub.red/10.1038/d41586-019-03268-y
2. https://www.npr.org/2019/11/13/777172316/the-great-pretender...
3. https://www.susannahcahalan.com/the-great-pretender
dbgrman|27 days ago
dang|27 days ago
The Rosenhan Experiment: On Being Sane in Insane Places - https://news.ycombinator.com/item?id=45785783 - Nov 2025 (1 comment)
On Being Sane in Insane Places (1973) - https://news.ycombinator.com/item?id=32686098 - Sept 2022 (2 comments)
David Rosenhan’s fraudulent Thud experiment set back psychiatry for decades - https://news.ycombinator.com/item?id=22155529 - Jan 2020 (119 comments)
Troubling discrepancies in Rosenhan's “On Being Sane in Insane Places”? - https://news.ycombinator.com/item?id=21437852 - Nov 2019 (16 comments)
On being sane in insane places - https://news.ycombinator.com/item?id=10885181 - Jan 2016 (1 comment)
On being sane in insane places - https://news.ycombinator.com/item?id=4371212 - Aug 2012 (2 comments)
Rosenhan experiment (1973) - https://news.ycombinator.com/item?id=1469370 - June 2010 (2 comments)
ossicones|27 days ago
dillydogg|27 days ago
SIGECAPS is an acronym taught in US medicine for the diagnosis of major depressive disorder: Sleep disturbance, Interest loss, Guilt, Energy loss, Concentration loss, Appetite changes, Psychomotor agitation, Suicidality. And must have Depressed mood or Anhedonia (inability to enjoy things previously enjoyable).
The history of the SIG E CAPS acronym is also interesting, I've heard it was short for SIG (old shorthand for "to be prescribed") Energy CAPsules.
throwway120385|27 days ago
It doesn't really matter how "objective" your standard is if you're still relying on individuals to try to "address" whatever the patient is reporting. People still form a negative opinion and label you really quickly no matter how hard the profession fights that perception.
dbgrman|27 days ago
ameliaquining|27 days ago
nephihaha|27 days ago
dbgrman|27 days ago
lostlogin|27 days ago
nephihaha|27 days ago
In the hospital environment, power is partly conveyed by the clothes people where and if you do not conform or obey, then you are punished. It is a pattern we are conditioned into from nursery/kindergarten onwards.
jordwest|26 days ago
Authority provides the illusion of a sense of control, predictability, certainty and orderliness, and it's like we gravitate toward that even when it leads to bad outcomes for us.
For most of us the fear of being out of control seems to be greater than the fear of being controlled.
unknown|27 days ago
[deleted]
12_throw_away|27 days ago
TZubiri|27 days ago
For the most part, you care the most about your circle, so if that isn't representative of the whole of society, it sounds like somebody else's problem. Who said all research needed to be perfect.
cm2012|27 days ago
wumms|27 days ago
nephihaha|27 days ago
TacticalCoder|26 days ago
I remember reading an essay explaining that patients not sharing the political beliefs of the physician running the asylum are more likely to be classified as mentally ill. A mental asylum paid by state money is usually going to be in the hand of physicians who never see anything wrong with the state (not biting the hand that feeds you and all that): so when for example a libertarian arrives, he's much more likely to be classified as mentally ill than if a socialist arrives.
So it's all arbitrary and, moreover, you better put the odds on your side by trying to determine what are the physicians' political beliefs and pretend you have the same ; )
nibles_and_bits|27 days ago
dbgrman|27 days ago
tines|27 days ago
dbgrman|27 days ago
clort|27 days ago
The chapter on 'Thud' ended with her visiting a psychiatric hospital of good reputation with an emergency room, she basically said the same things as the researchers in the paper. She was given some anti-psychotics and sent away.
https://en.wikipedia.org/wiki/Opening_Skinner%27s_Box
nephihaha|27 days ago
EtienneDeLyon|27 days ago
https://archive.is/tH0il
lalith_c|25 days ago
readthenotes1|26 days ago
https://spectator.com/article/how-a-fraudulent-experiment-se...
sddfgvdsvsdfas|27 days ago
dang|27 days ago
If you wouldn't mind reviewing https://news.ycombinator.com/newsguidelines.html and taking the intended spirit of the site more to heart, we'd be grateful.
(We detached this subthread from https://news.ycombinator.com/item?id=46860103.)
unknown|27 days ago
[deleted]
sddfgvdsvsdfas|27 days ago
[deleted]