Abstract:

Competitive victimhood is a psychological phenomenon pervasive on both sides of an intergroup conflict; it implies that one person believes their group suffers more than the other does. As one of the most prominent and growing barriers to positive intergroup relations globally, competitive victimhood has gradually attracted the attention of researchers. However, little research has been conducted on competitive victimhood in Chinese hospitals, where the doctor-patient relationship is increasingly tense. The common ingroup identity model holds that by reconstructing social identity and breaking the boundaries of conflict groups, members can develop a common ingroup identity. This identity improves attitudes toward outer groups, which may help reduce competitive victimhood. The need-based model argues that power and morality are ingroups and outgroups’ basic needs. Members of both sides are threatened by power or morality and are motivated to restore their identities, affecting competitive victimhood. Therefore, it is worth studying whether common ingroup identity can effectively reduce competition victimization between doctors and patients and what roles power and moral needs play.

In Study 1, 90 doctors and nurses and 86 patients and their families from three hospitals in Shanghai and Sichuan were selected in a 2 (group: doctors vs. patients) × 2 (common identity: control group vs. common ingroup identity) design. A brief story about doctors and patients fighting disease together was used to improve common ingroup identity. Then we used a questionnaire about competitive victimhood to investigate whether common ingroup identity affected competitive victimhood between doctors and patients. In Study 2A, another group of participants was selected, including 71 doctors and nurses along with 73 patients and their families from three hospitals in Shanghai and Sichuan. Participants underwent the same procedure as in Study 1, then completing the power and moral needs questionnaires. Study 2A aimed to investigate the influence of common ingroup identity on victimhood between doctors and patients, as well as the roles of power and moral needs. To further test the hypothesized model, we selected 54 medical students with hospital internship experience and 54 non-medical students with recent treatment experience in Study 2B, where we activated common ingroup identities using a re-categorization strategy.

The main results were as follows. In Study 1, ANOVA results showed that compared with control group (M = 5.15, SD = 0.96), group with common ingroup identity (M = 4.58, SD = 0.93) reported lower competitive victimhood, F(1, 172) = 16.58, p < 0.001, η_p² = 0.088. And there was no interaction between group identity and common ingroup identity, F(1, 172) = 2.66, p = 0.105.

Study 2A showed that power need mediated the relationship between common ingroup identity and competitive victimhood. ANOVA results showed that main effect of common ingroup identity was significant, F(1, 140) = 13.54, p < 0.001, η_p² = 0.088, group with common ingroup identity(M = 4.60, SD = 0.92) reported lower competitive victimhood than control group (M = 5.19, SD = 1.06). The indirect effect of power need was significant and the indirect effect of moral need was not significant (see Figure 1).

Study 2B reconfirmed the model for doctors but not for the patients group. ANOVA results showed that main effect of common ingroup identity was not significant, F(1, 104) = 1.58, p= 0.212, and main effect of group identity was significant, F(1, 104) = 26.52, p < 0.001, η_p² = 0.203, the competitive victimhood of doctors (M = 4.99, SD = 1.00) was higher than patients (M = 4.11, SD = 0.83), p < 0.001, 95% CI = [0.87, 1.83]. And there was significant interaction between group identity and common ingroup identity, F(1, 104) = 7.43, p = 0.008, η_p² = 0.067. For doctors, group with common ingroup identity (M = 4.65, SD = 1.05) reported lower competitive victimhood than control group (M = 5.33, SD = 0.83), p = 0.006, and the indirect effect of power need was also significant, but for patients there was no difference, p = 0.301 (see Figure 2).

Based on the common ingroup identity model, this study proposed and confirmed the applicability of this model in the doctor-patient field in China. Additionally, the study proposed new methods and perspectives on the doctor-patient relationship. In the future, researchers should focus on other mediators, such as empathy and trust in different groups.

Key words: doctor-patient relationship, competitive victimhood, common ingroup identity, power need, moral need