Question: Do you think Rosenhan was exaggerating how bad DSM is , given how psychologists like Slater (2004) couldn't replicate his results?

Jack barton answered on 17 Jun 2017:

David Rosenhan was influenced by R.D. Laing who was a prominent antipsychiatric and celebrity in the mid 20th century. They both argued that psychiatric diagnoses had limited validity and Rosenhan felt that he could test this claim scientifically with a series of experiments. As far as I’m aware, Lauren Slater did broadly manage to replicate Rosenhan’s study in that she was prescribed antipsychotics and was given a diagnosis of psychotic depression. She wasn’t hospitalised but her ‘experiment’ supported the broad problem with psychiatric diagnoses. However, a study by Spitzer and colleagues in 2005 failed to replicate Rosenhan’s and Slater’s work in that only 3 out of 74 emergency room psychiatrists would give an example like Slater’s a diagnosis of psychotic depression. This suggests that perhaps we should be cautious of Rosenhan’s conclusions following their study in 1974.

My own view is that the DSM is far from perfect but it is an attempt to make sense out of the messy range of symptoms which those with mental illness, and schizophrenia in particular, might present with. Rosenhan illustrated that it is difficult to accurately diagnose mental illnesses without reliable biological markers of the illness in question. We are getting closer to identifying these but we are not at a point where we can diagnose say schizophrenia or depression with a blood test or brain scan.