| TRUE | if the statement agrees with the information |
| FALSE | if the statement contradicts the information |
| NOT GIVEN | if there is no information on this |
Who’s Crazy?
A bizarre experiment in the United States has demonstrated that psychiatrists cannot distinguish effectively between people who are mentally disturbed and those who are sane.
According to its originators, the experiment demonstrates the fallibility of conventional psychiatric diagnosis. It also lends considerable support to the position taken by radical psychiatrists like RD Laing, who argue that diagnoses of mental disease are often no more than convenient labels designed to make life easier for doctors.
Eight perfectly normal people, by shamming symptoms of a mild kind, successfully gained admission to psychiatric wards where they remained undetected for as long as they could stand it Once admitted, their behaviour was normal in every way, but doctors and nurses continued to treat them as disturbed.
In every case but one the diagnosis was schizophrenia. Once they were labelled as mentally ill, everything the “pseudopatients” did tended to confirm the diagnosis in the eyes of the medical staff, though other patients in the hospital were much less easy to convince.
The eight pseudopatients included three psychologists, a pediatrician, a psychiatrist, a painter and a housewife. All eight assumed false names and those connected with the medical profession also invented false occupations, so as not to attract special attention from fellow-professionals. The hospitals chosen ranged from expensive private units to dingy publicly-run institutions.
To gain admission, the pseudopatients told the whole truth about their lives, their emotions and their personal relationships — all of which were within the normal range — and lied only about their names, symptoms, and in some cases their occupations. The symptoms they complained of were hearing disembodied voices saying the words “empty”, “hollow” and “thud”.
This was sufficient in every case for them to be classified as mentally ill. Once inside J they stopped pretending and behaved as normally as they could. Their stays inside varied from 7 to 52 days, with an average of 19 days.
As many as a third of the real patients inside detected that they were frauds. "You’re not crazy. You're a journalist or a professor. You’re checking up on the hospital,’’ was a typical comment from a fellow-patient.
The pseudopatients spent much of their time taking extensive notes, but even this did not apparently raise any suspicions in the doctors’ mind. "Patient engages in writing behaviour," was the daily nursing comment on one patient, but nobody troubled to ask him what he was writing.
The experiment was carried out under the supervision of Professor D. L. Rosenhan of Stanford University, himself one of the eight fake patients. Writing about the experiment in this week’s Science, he concludes: “We cannot distinguish the sane from the insane in mental hospitals ... how many people, one wonders, are sane but not recognized as such in our psychiatric institutions? ... How many have been stigmatized by well-intentioned, but nevertheless erroneous, diagnoses?”
In Professor Rosenhan’s view, the hospital itself is an environment that distorts judgment As evidence, he quotes what happened to patients who asked doctors perfectly sensible questions. They took the form: “Pardon me, Dr. X, could you tell me when I will be eligible for ground privileges?” — or some similar request, courteously presented. In almost three quarters of the cases, the psychiatrist’s response was to walk on, head averted and some were staying for more than 3 weeks. Only one doctor in 25 stopped and tried to answer the question.
But the clinching piece of evidence comes from another experiment in which a hospital was warned that pseudopatients would be presenting themselves. Faced with this threat to their professional reputation, the doctors admitting patients became much more conservative in their diagnosis. Of 193 patients presenting themselves, one doctor was firmly convinced that 41 were frauds, while another doctor suspected 23. In fact, no fake patient had arrived at all.
In the present state of knowledge, there seems little hope of more accurate diagnostics. Doctors should try to err on the side of caution, in Rosenhan’s opinion, and “refrain from sending the distressed to insane places”. That, and a more benign environment inside institutions, could help to sort out the insane from the merely confused.
AI explanationShows the answer. Tap to open.
Question Focus: Synonym match - 'convenient labels' and 'fallibility' match the idea that labels make life easier but may be wrong
Correct Answer: TRUE
Why this is correct: The passage clearly says that RD Laing believes psychiatric diagnoses are convenient labels and implies they are not reliable. If something is a convenient label, it may not truly describe reality, which matches the statement.
Passage Reference: It also lends considerable support to the position taken by radical psychiatrists like RD Laing, who argue that diagnoses of mental disease are often no more than convenient labels designed to make life easier for doctors.
Common Mistake: Some students choose NOT GIVEN because they focus only on 'convenient labels' and miss the implication that these labels are not accurate. This is a Paraphrase trap.
Paraphrasing: Passage: 'convenient labels designed to make life easier for doctors' = Statement: 'labelling patients makes doctors' work easier'
Tips: When a statement says 'may be wrong', look for words like 'fallible', 'convenient', or 'erroneous' in the passage.
Key Vocabulary:
- fallibility = possibility of being wrong
- label = name or category
Question Focus: Synonym match - both criticize the accuracy of psychiatric diagnosis
Correct Answer: TRUE
Passage Reference: According to its originators, the experiment demonstrates the fallibility of conventional psychiatric diagnosis. It also lends considerable support to the position taken by radical psychiatrists like RD Laing... Writing about the experiment... he concludes: "We cannot distinguish the sane from the insane in mental hospitals".
Why this is correct: Both Laing and Rosenhan believe psychiatric diagnosis is unreliable. Rosenhan's conclusion directly supports Laing's criticism, so their opinions are similar.
Common Mistake: Students sometimes answer NOT GIVEN because Laing and Rosenhan are mentioned in different parts of the text. This is a Wrong section trap.
Paraphrasing: Passage: 'fallibility of conventional psychiatric diagnosis' = Statement: 'holds a similar opinion'
Tips: If two people are both criticizing the same idea, their opinions are probably similar even if explained in different places.
Key Vocabulary:
- fallibility = weakness
- distinguish = tell the difference
Question Focus: Contradiction - the passage says most doctors ignored the patients
Correct Answer: FALSE
Passage Reference: In almost three quarters of the cases, the psychiatrist's response was to walk on, head averted... Only one doctor in 25 stopped and tried to answer the question.
Why this is correct: The statement says most doctors answered, but the passage says almost three quarters ignored the patients and only one in 25 answered. This is the opposite meaning.
Common Mistake: Some students choose NOT GIVEN because they remember doctors walking away but do not connect it to 'most doctors'. This is a Contradiction trap.
Paraphrasing: Passage: 'only one doctor in 25 stopped' = Statement: 'most doctors stopped and tried to answer'
Tips: Pay close attention to numbers and proportions like 'most', 'few', or 'only one'.
Key Vocabulary:
- head averted = looking away
- eligible = allowed
Question Focus: Not Given - public vs private hospitals are mentioned, but accuracy is not compared
Correct Answer: NOT GIVEN
Passage Reference: The hospitals chosen ranged from expensive private units to dingy publicly-run institutions.
Why this is correct: The passage mentions both private and public hospitals, but it never says that doctors in public institutions give more wrong diagnoses. The passage does not compare diagnostic accuracy between them.
Common Mistake: Students often answer TRUE because 'dingy publicly-run institutions' sounds negative. This is adding your own opinion, a Not Given trap.
Paraphrasing: Passage: 'publicly-run institutions' = Statement: 'public institutions'
Tips: Do not judge based on descriptive language. Ask: does the passage actually compare accuracy? If not, choose NOT GIVEN.
Key Vocabulary:
- dingy = dirty and unpleasant
- institution = organization
Question Focus: Contradiction trap - the second experiment actually supports the first
Correct Answer: FALSE
Passage Reference: Faced with this threat... the doctors admitting patients became much more conservative... In fact, no fake patient had arrived at all.
Why this is correct: The second experiment shows doctors wrongly suspected real patients, which again proves diagnoses are unreliable. This supports, not contradicts, Rosenhan's first experiment.
Common Mistake: Students choose TRUE because the outcomes are different. Different results do not mean opposite meaning. This is a Paraphrase trap.
Paraphrasing: Passage: 'no fake patient had arrived' = Statement: 'contradict the results'
Tips: Ask yourself: do both experiments point to the same problem? If yes, they do not contradict.
Key Vocabulary:
- contradict = prove the opposite
- conservative = cautious
Question Focus: Reverse meaning trap - they invented occupations to avoid attention
Correct Answer: FALSE
Passage Reference: All eight assumed false names and those connected with the medical profession also invented false occupations, so as not to attract special attention from fellow-professionals.
Why this is correct: The statement says they invented occupations to attract attention, but the passage clearly says the opposite, to avoid attention.
Common Mistake: Students miss the phrase 'not to attract special attention'. This is a Reverse meaning trap.
Paraphrasing: Passage: 'not to attract special attention' = Statement: 'in order to attract attention'
Tips: Always watch for negatives like 'not'. One small word can completely reverse the meaning.
Key Vocabulary:
- invented = made up
- fellow-professionals = people in the same job
General Tips:
- TFNG questions follow passage order. Use the location of the previous answer to find the next one faster.
- To decide between FALSE and NOT GIVEN, ask: does the passage clearly say the opposite? If not, choose NOT GIVEN.
- Be careful with numbers and quantity words like 'most', 'only', or 'many'. They are common traps.
- Do not add your own opinions or background knowledge. Use only what the passage states.
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