--- module: 100-01 language: en chapter: 100 title: "Social Psychology, Communication, Culture, and the Behaviour of Health" module_title: "Social cognition, identity, influence, and groups" source_sha256: 8e9d3d50acf85a530cab785697038822ce9857fb8d16e81078444a117ee24ca1 --- # Social cognition, identity, influence, and groups ## Social psychology in medicine ### Behaviour shaped by actual, imagined, implied others ### Families, teams, institutions shape decisions ### Coordinates care and provides belonging #### Can also create bias and silence disagreement ### Social information is evidence, not irrationality ## Perception and attribution ### Rapid categorisation guides attention #### Reduces load but hides within-group variation ### Stereotype, prejudice, discrimination #### Can occur separately ### Observers overweight traits, underweight situations #### Missed appointments: transport, cost, childcare ### Test person and environment explanations ### Hindsight bias exaggerates predictability ### Just-world tendency blames illness on behaviour ### Self-serving attributions #### Reversed by depression, shame, marginalisation ## Attitudes and persuasion ### Beliefs, emotions, action tendencies ### Predict best when specific, accessible, stable ### Cognitive dissonance after inconsistent action #### Change beliefs, justify, or avoid information #### Coercive commitment entrenches resistance ### Careful versus heuristic processing ### Credibility needs competence and trustworthiness ### Fear without a feasible response #### Defensive avoidance when efficacy is low ## Norms, conformity, and compliance ### Descriptive versus injunctive norms ### Advertised misconduct can normalise it #### Pair with a clear valued standard ### Trusted peers outweigh society ### Informational versus normative influence ### Uncertainty, unanimity, public response strengthen #### One dissenter breaks unanimity ### Independent assessments before discussion ### Commitment, reciprocity, scarcity techniques #### Consent needs more than a pressured yes ## Authority and speaking up ### Coordinates expertise and accountability ### Harm easier when responsibility shifts upward #### Fragmented tasks, dissent seen as disloyal ### Professional status gives no immunity ### Escalation, graded assertiveness, closed loop ### Leaders thank people for concerns ### Formal permission with social punishment fails ## Identity and group behaviour ### In-group favouritism even when arbitrary ### Threat, competition, unequal status harden boundaries ### Contact helps with cooperation and equality #### Hostile proximity reinforces stereotypes ### Intersecting identities limit prediction ### Deindividuation follows salient local norms ### Diffusion of responsibility among bystanders #### Name a person to call for help ## Group decisions and teamwork ### Polarisation toward the initial tendency ### Groupthink from directive, insulated, homogeneous groups #### Structured dissent and independent review ### Collective intelligence from sharing and safety ### Shared-information bias hides unique facts #### Ask what evidence would change the plan ### Social loafing versus coordination loss ### Competition suppresses learning and candour ### Redundancy preserves resilience ## Power, prosocial behaviour, and conflict ### Power from expertise, position, rewards, information ### Low-power people monitor and bear conflict risk #### Patient agreement may reflect dependence #### Private questions and safe refusal ### Empathic concern versus self-focused distress ### Exhaustion and moral distress are distinct ### Organisational support over resilience exhortation ### Positions versus underlying interests ### Scarcity limits win-win solutions #### Fair procedure, transparency, review ## Designing better environments ### Education rarely abolishes bias ### Slow high-risk decisions, expose base rates ### Invite independent views, document reasons ### Audit outcomes across groups ### Make influence visible and accountable