1.39: Deprescribing in palliative care- applying knowledge translation strategies
Introduction
Palliative care aims to reduce the suffering of individuals faced with chronic or life-limiting illness by improving quality of life (QoL) for both patients and their care providers. 1,2 The purpose of palliative care is to manage pain, provide psychological, spiritual, social, and emotional support as well as support family members with the coping and bereavement process. 2,3 Studies have shown that palliative care not only enhances QoL for the patient but also positively influences the course of disease or illness. 2 Palliative care also encompasses the management of major medical emergencies such as hypercalcemia, spinal cord compression, pain crisis, significant breathing difficulties and bone fractures. 4,5 Hospice is a subdomain of palliative care that is intended to support the dying person in achieving peace, comfort and death with dignity. 2
The term “palliative care” was first defined by a Canadian physician, Dr. Balfour Mount in 1975. 6 Palliative care, at an international stage, began to be recognized for cancer patients in the 1980s with increasing awareness for need in other chronic diseases such as HIV/AIDS, heart failure and neurodegenerative diseases over time. 2 Thereafter, the World Health Organization (WHO) published guidance on cancer pain therapies in 1986 which was later revised in 1996 to include a guide on opioid availability. 6 In 2014, the World Health Assembly comprehensive palliative care resolution was created that informed the writings in the Global Atlas of Palliative Care at the End of Life. 6 Palliative care is still considered an underdeveloped area of practice around the world, particularly outside of North America, Europe and Australia. 2
According to the WHO, approximately 40 million people require palliative care every year worldwide with almost 80% of those individuals residing in low to middle-income countries. 7 However, due to a variety of barriers, there remains an unmet need for palliative care implementation in many parts of the world. 2 Some of the barriers to the provision of palliative care include: (1) uncertainty or poor experience with palliative care or end of life discussions in the past, (2) lack of recognition of the impact of pain and ineffective symptom management on quality of life, and (3) cultural considerations around the topic of death and dying. 5,8
Knowledge translation, which encompasses knowledge transfer and exchange, refers to the processes and frameworks applied to create a synthesis of evidence and information from research to be translated into a format that is usable for the stakeholder of interest, 9 be it clinicians, public health or patients and their caregivers. A very commonly applied knowledge translation framework developed by Graham et al . known as the knowledge-to-action framework applies an iterative and dynamic process to move information from research into action. 9,10 Knowledge translation faces a very unique challenge in palliative care environments due to the negative perception of palliation and end-of-life. 8 Some of the barriers that palliative care researchers often face in the process of knowledge translation in the setting of palliative care are communication gaps, skepticism about the value and strength of evidence for palliative care frameworks, and competing priorities in the health services. 8 Resources created through knowledge translation can include guidelines, toolkits and education sessions. The process of knowledge translation can help to improve uptake and utilization of palliative care practices around the world.
Polypharmacy, defined as taking five or more medications on a regular basis, whether prescribed or non-prescribed, is common in the palliative setting. 11,12 Polypharmacy has been associated with higher symptom burden and lower quality of life for individuals with advanced illness 13 with the number of drugs taken being the important predictor of harm. 14,15 Therefore deprescribing can help to optimize medication use, reduce overall medication burden, and avoid drug-related adverse effects and harm. Deprescribing is a systematic approach to identify and discontinue medications where harm outweighs benefit within the context of an individual’s care goals, level of functioning, life expectancy, and values. 15 There have been many approaches to address deprescribing but facets include: (1) obtaining an accurate medication list that includes prescribed and non-prescribed agents, (2) evaluating the risk of drug-induced harm for each agent, (3) determining indication and efficacy of each agent, (4) taking into consideration patient goals, estimated life expectancy and expected lag time for intervention benefit, creating a list of medications to be considered for discontinuation, (5) creating and implementing a deprescribing plan and clear goals for monitoring. 13,15 Further research into the barriers and facilitators to deprescribing in the palliative care setting is needed to support global, local and organizational change, interdisciplinary communication and collaboration with patients and caregivers. 16
Case
You are a pharmacist at an outpatient memory clinic, accompanied by the team physician, registered nurse, occupational therapist, and social worker.
CC: “I need help remembering to take my medications, I never know when I’ve taken them and when I’ve forgotten.”
Patient: FR is a 94-year-old male (69 in, 70kg) with advanced Alzheimer’s disease that has been coming to this clinic annually for the past five years. He is accompanied by his 60-year-old son on today’s visit. FR is being seen by your outpatient memory clinic team today after recent discharge from hospital post treatment for E. coli bacteremia and sepsis, with the primary source of sepsis uncertain but urosepsis suspected.  The medication list that accompanies these prescribed and non-prescribed agents was written 7 years ago by FR’s late wife.
HPI: FR uses a walker as a mobility aid and has a shuffling gait. You note what appears to be a new tremor in his hands bilaterally and increased unsteadiness in his gait. FR is dizzy when moving from sitting to standing and notes that he is dizzy when he gets up from bed in the morning, which has been occurring for the last few months. When asked about his diet, FR notes that he eats food served by the retirement home, at which he resides but is unable to recall examples of meals. FR comes dressed for the Canadian weather, which is currently bitter cold, with a winter coat, scarf, hat, and gloves. FR can recall his name and that he is in a clinic but notes that the year is 1965 and that he is still in Greece, where he was born. He has been residing in Canada for the last 40 years.
FR’s son started to notice a change in how his father was taking medications due to the number of vials, bottles and medicine cups that have been piling up on the kitchen table and on different counters around FR’s residence over the last six months. FR also explained to his son that there were days when he would forget his medications entirely or would be uncertain whether he took them, so would take them again. FR’s son was concerned, particularly after recent illness and hospitalization, so he called you, the memory clinic pharmacist to see if an appointment could be scheduled with the team.
PMH:
- T2DM (diagnosed 20 years ago)
- HTN (diagnosed 15 years ago)
- Dyslipidemia (diagnosed 15 years ago)
- Alzheimer’s disease (diagnosed seven years ago)
- Dysphagia associated with Alzheimer’s disease
- Frequent falls history (three falls in the last year)
- Recurrent colorectal cancer (diagnosed stage IV six weeks ago)
- Insomnia (diagnosed 20 years ago)
Immunizations:
- Tetanus, diphtheria & pertussis booster two years go
- Pneumococcal vaccine four years
- Shingles vaccine three years ago
- Influenza vaccine annually
FH:
- Mother: (deceased 30 years ago; MI)
- Father: (deceased 40 years ago; stage IV lung cancer)
- Siblings: none
SH:
- Social alcohol intake with 1-2 beers per day on weekends
Medications:
Prescription (oral unless noted otherwise):
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Insulin glargine 15 units subcutaneous at night
- Occasionally checks blood glucose when he feels shaky
- Home blood glucose readings in 54-72 mg/dL range over the last six months and is not able to help describe how he corrects hypoglycemia
- Atorvastatin 20 mg at night
- Metoprolol tartrate 25mg BID
- Perindopril 4 mg daily
- Amlodipine 5 mg daily
- Donepezil 10 mg daily
- Sitagliptin 50 mg BID
- Pantoprazole 40 mg BID
- Docusate 100 mg TID with food
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Lorazepam 0.5 to 1 mg sublingually at night as needed for sleep
- This medication was added during a recent admission
OTC:
- Acetaminophen 500 mg QID PRN
- Cetirizine 10 mg daily PRN
Supplements and natural health products:
- Vitalux 1 tablet daily
- CoQ 10 enzyme 1 capsule daily
- Multivitamin 1 tablet daily
- Melatonin 10 mg at night
- Calcium/Magnesium 1 tablet daily
- Vitamin D 2000 IU (2 tabs) daily
Oncology regimen:
- FR’s son explains that his father is on a palliative chemotherapy regimen for his colorectal cancer called FOLFIRI where he goes to an outpatient cancer center every two weeks for IV medications. He sees the oncologist every six months at least and more frequently if there are any concerns.
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FR has a list of his antiemetic regimen, which keep him relatively symptom free for nausea and vomiting and includes:
- Ondansetron 8 mg BID for three days, start on day of chemotherapy
- Dexamethasone 8 mg once daily for three days, start on day of chemotherapy (patient educated to take the dexamethasone first thing in the morning with breakfast to avoid affecting sleep)
- Olanzapine 2.5 mg BID as needed for breakthrough nausea and vomiting (taken very infrequently)
Allergies: NKDA
Vitals:
- BP 114/60 mmHg (seated); 90/65 mmHg (one minute after standing)
- HR 80 bpm and regular (seated); 85 bpm and regular (one minute after standing)
- RR 15/min (seated)
Labs Last checked 72 hours ago:
| Parameter | Value | Parameter | Value |
|---|---|---|---|
| Hgb | 10 g/dL | Albumin, serum | 3.2 g/dL |
| Hct | 31.1% | Total bilirubin, serum | 0.5 mg/dL |
| LKC | 7000 /uL | AST | 30 units/L |
| Iron, serum | 60 ug/dL | CRP | 1.4 mg/L |
| HgbA1c | 7.8% | Total cholesterol | 248 mg/dL |
| FBG (before supper) | 70 mg/dL | HDL | 58 mg/dL |
| Na, serum | 147 mEq/L | LDL | 158 mg/dL |
| K, serum | 4.5 mEq/L | SCr | 1.5 mg/dL |
| Ca, serum | 9 mg/dL | ACR, urine | 25mg/g |
ROS:
- Integument: N/A
- HEENT: N/A
- Neurologic: See HPI
-
Respiratory:
- Lungs clear to auscultation bilaterally
- No wheezing, cough, or SOB
-
CV:
- S1 is normal and S2 is normal but faint with a mild diastolic murmur appreciated
- Peripheral edema, ++ pitting bilaterally
- Gastrointestinal: N/A
- Hepatic/renal: N/A, see labs
- MSK: N/A
- Endocrine: N/A, see labs
Surgical history:
- Cholecystectomy (30 years ago)
- Right knee replacement (20 years ago)
SDH: FR is a retired university professor who speaks English, French and Greek but his fluency of speech has degraded over last year. He previously enjoyed water painting and hiking but has been uninterested in these as of late. He was widowed nine years ago and is not currently in a relationship. He lives in a retirement home and has weekly visits from his only son and daughter-in-law; they have four children (his grandchildren).
Additional context: As the clinic pharmacist, you suggest the following: (1) a home medication review be performed in consultation with FR’s primary care provider, (2) removal of all old medications from the residence, and (3) discussion around starting a blister pack to reduce the number of loose vials and other containers around the residence.
Case Questions
- Provide a patient-centered explanation of palliative care to FR and his son.
- Why is it important to address polypharmacy in the palliative care setting?
- How is deprescribing defined?
- FR is interested in the involvement of a palliative focused plan to his care while continuing to receive chemotherapy and treatment for Alzheimer’s Disease. Provide a framework for deprescribing FR’s medication list with patient goals in mind.
- Discuss some of the barriers and facilitators to knowledge translation in the palliative care setting.
- List the three most important medications in FR’s regimen to consider for deprescribing and provide the reasoning for each of your choices. Based on FR’s goals, he wishes to discontinue medications that have risk of causing harm and side effects.
- List some of the other agents that you would consider discontinuing in the future with appropriate references to support deprescribing.
Author Commentary
Studies have shown that palliative care can enhance quality of life for the patient and may also positively influence the course of disease or illness. 2 For example, a study of patients with metastatic non-small-cell lung cancer found that early palliative care was associated with better quality of life and mood, such as lower rates of depressive symptoms, as compared to patients who received standard care alone. 17 Authors noted that 33% of the palliative patients in comparison to 54% received aggressive end of life therapies and mean survival was longer amongst patients who received early palliative care. 17 The ultimate goal is to integrate palliative care into mainstream healthcare systems around the world in order to ensure that patients who are in need of palliative care receive it. As healthcare providers, pharmacists are in a unique position to optimize medication regimens and reduce the medication burden for patients. 2
Patient Approaches and Opportunities
Pharmacists can improve patient quality of life and caregiver burden by deprescribing unnecessary medications, ultimately lessening drug-drug interactions and reducing drug-related adverse effects. A patient-centered approach to deprescribing should be applied and should include the patient and involved family and caregivers. 13 In order to integrate evidence-based palliative care practices into clinical settings, utilize effective communication and engagement strategies with key stakeholders during the research process to overcome barriers and improve potential buy-in. 8
Related chapters of interest:
- Medication safety: to ‘error’ is human
- Interprofessional collaboration: transforming public health through teamwork
- Ethical decision-making in global health: when cultures clash
- Safe opioid use in the community setting: reverse the curse?
- Saying what you mean doesn’t always mean what you say: cross-cultural communication
- Communicating health information: hidden barriers and practical approaches
- Bridging the gap between oncology and primary care: a multidisciplinary approach
External resources:
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Websites
- World Palliative Care Alliance. Global atlas of palliative care at the end of life. http://www.who.int/cancer/publications/palliative-care-atlas/en/
- Bruyère Research Institute. Deprescribing tools. https://deprescribing.org/
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Journal articles
- Connor SR. Global aspects of palliative care. In: Textbook of palliative care . MacLeod RD, Van den Block L, eds. Springer International Publishing; 2019:29-36.
- Thompson J. Deprescribing in palliative care. Clin Med J R Coll Physicians London 2019;19(4):311-31.
- Scott IA, Hilmer SN, Reeve E, et al. Reducing inappropriate polypharmacy: The process of deprescribing. JAMA Intern Med 2015;175(5):827-34.
- Narayan SW, Nishtala PS. Discontinuation of preventive medicines in older people with limited life expectancy: a systematic review. Drugs Aging 2017;34(10):767-76.
- Kernohan WG, Brown MJ, Payne C, Guerin S. Barriers and facilitators to knowledge transfer and exchange in palliative care research. BMJ Evid Based Med 2018;23(4):131-6.
- Paque K, Vander Stichele R, Elseviers M, Pardon K, Dilles T, Deliens L, Christiaens T. Barriers and enablers to deprescribing in people with a life-limiting disease: a systematic review. Palliat Med 2019;33(1):37-48.
References
- Oliver D. Improving patient outcomes through palliative care integration in other specialised health services: what we have learned so far and how can we improve? Ann Cardiothorac Surg 2018;7(3):S219-30.
- World Palliative Care Alliance. Global atlas of palliative care at the end of life. 2014. http://www.who.int/cancer/publications/palliative-care-atlas/en/ . Accessed December 15, 2020.
- Wilkie DJ, Ezenwa MO. Pain and symptom management in palliative care and at end of life. Nurs Outlook 2012;60(6):357-64.
- Falk S, Fallon M. ABC of palliative care: emergencies. BMJ 1997;315(7121):1525-1528.
- Mounsey L, Ferres M, Eastman P. Palliative care for the patient without cancer. Aust J Gen Pract 2018;47(11):765-9.
- Connor SR. Global aspects of palliative care. In: Textbook of palliative care . MacLeod RD, Van den Block L, eds. Springer International Publishing; 2019:29-36.
- World Health Organization. Palliative Care. World Health Organization News Room. 2020. http://www.ninr.nih.gov/sites/www.ninr.nih.gov/files/palliative-care-brochure.pdf . Accessed December 15, 2020.
- Kernohan WG, Brown MJ, Payne C, Guerin S. Barriers and facilitators to knowledge transfer and exchange in palliative care research. BMJ Evid Based Med 2018;23(4):131-6.
- Straus SE, Tetroe J, Graham I. Defining knowledge translation. CMAJ 2009;181(3-4):165-8.
- Graham ID, Logan J, Harrison MB, et al. Lost in knowledge translation: time for a map? J Contin Educ Health Prof 2006;26(1):13-24.
- Thompson J. Deprescribing in palliative care. Clin Med J R Coll Physicians London 2019;19(4):311-4.
- World Health Organization. Medication safety in polypharmacy: technical report. 2019. https://apps.who.int/iris/handle/10665/325454 . Accessed February 25, 2021.
- Bemben NM, McPherson ML. Palliative Care. In: Pharmacotherapy: a pathophysiologic approach, 10e . DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. McGraw-Hill Education; 2017.
- Stinson MJ, Gurevitz S, Carrigan A. Deprescribing at the end of life in older patients. J Am Acad Physician Assist 2019;32(7):20-4.
- Scott IA, Hilmer SN, Reeve E, et al. Reducing inappropriate polypharmacy: The process of deprescribing. JAMA Intern Med 2015;175(5):827-834.
- Paque K, Vander Stichele R, Elseviers M, et al. Barriers and enablers to deprescribing in people with a life-limiting disease: A systematic review. Palliat Med 2019;33(1):37-48.
- Gaertner J, Wolf J, Voltz R. Early palliative care for patients with metastatic cancer. Curr Opin Oncol 2012;24(4):357-62.


7.5: Nuclear Reactions
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Learning Objectives
By the end of this section, you will be able to:
- Describe and compare three types of nuclear radiation
- Use nuclear symbols to describe changes that occur during nuclear reactions
- Describe processes involved in the decay series of heavy elements
Early experiments revealed three types of nuclear “rays” or radiation: alpha \((\alpha)\) rays , beta \((\beta)\) rays , and gamma \((\gamma)\) rays . These three types of radiation are differentiated by their ability to penetrate matter. Alpha radiation is barely able to pass through a thin sheet of paper. Beta radiation can penetrate aluminum to a depth of about 3 mm, and gamma radiation can penetrate lead to a depth of 2 or more centimeters (Figure \(\PageIndex{1}\)).
The electrical properties of these three types of radiation are investigated by passing them through a uniform magnetic field, as shown in Figure \(\PageIndex{2}\). According to the magnetic force equation for a moving charge in a magnetic field
\[\vec{F} = q\vec{v} \times \vec{B} \nonumber \]
where positively charged particles are deflected upward, negatively charged particles are deflected downward, and particles with no charge pass through the magnetic field undeflected. Eventually, \(\alpha\) rays were identified with helium nuclei \((^4He)\), \(\beta\) rays with electrons and positrons (positively charged electrons or antielectrons ), and \(\gamma\) rays with high-energy photons. We discuss alpha, beta, and gamma radiation in detail in the remainder of this section.
Alpha Decay
Heavy unstable nuclei emit \(\alpha\) radiation. In \(\alpha\)-particle decay (or alpha decay ), the nucleus loses two protons and two neutrons, so the atomic number decreases by two, whereas its mass number decreases by four. Before the decay, the nucleus is called the parent nucleus . The nucleus or nuclei produced in the decay are referred to as the daughter nucleus or daughter nuclei. We represent an \(\alpha\) decay symbolically by
\[\ce{_Z^AX \rightarrow _{Z-2}^{A-4}X + _2^4He} \label{alpha} \]
where \(_Z^AX\) is the parent nucleus, \(_{Z-2}^{A-4}X\) is the daughter nucleus, and \(_2^4He\) is the \(\alpha\) particle. In \(\alpha\) decay, a nucleus of atomic number Z decays into a nucleus of atomic number \(Z - 2\) and atomic mass \(A - 4\). Interestingly, the dream of the ancient alchemists to turn other metals into gold is scientifically feasible through the alpha-decay process. The efforts of the alchemists failed because they relied on chemical interactions rather than nuclear interactions.
Watch alpha particles escape from a polonium nucleus, causing radioactive alpha decay. See how random decay times relate to the half-life. To try a simulation of alpha decay, visit alpha particles
An example of alpha decay is uranium-238:
\[\ce{_{92}^{238}U \rightarrow _{90}^{234}X + _2^4He} \nonumber \]
The atomic number has dropped from 92 to 90. The chemical element with \(Z = 90\) is thorium. Hence, Uranium-238 has decayed to Thorium-234 by the emission of an \(\alpha\) particle, written
\[\ce{_{92}^{238}U \rightarrow _{90}^{234}Th + _2^4He} \nonumber \]
Subsequently, \(_{90}^{234}Th\) decays by \(\beta\) emission with a half-life of 24 days. The energy released in this alpha decay takes the form of kinetic energies of the thorium and helium nuclei, although the kinetic energy of thorium is smaller than helium due to its heavier mass and smaller velocity.
Example \(\PageIndex{1}\): Plutonium Alpha Decay
Find the energy emitted in the \(\alpha\) decay of \(^{230}Pu\) can be found using the equation \(E = (\Delta m)c^2\). We must first find \(\Delta m\), the difference in mass between the parent nucleus and the products of the decay.
Solution
The decay equation is
\[\ce{^{230}Pu \rightarrow ^{235}U + ^4He}. \nonumber \]
Thus, the pertinent masses are those of \(^{230}Pu\), \(^{235}U\), and the \(\alpha\) particle or \(^4He\), all of which are known. The initial mass was \(m(^{230}Pu) = 230.052157 \, u\). The final mass is the sum
\[\ce{m(^{235}U) + m(^4He) = 235.043924 \, u + 4.002602 \, u} \nonumber \]
Thus,
\[ \ce{\Delta m = m(^{230}Pu) - [m(^{235}U) + m(^4He)]} \nonumber \]
\[= 239.052157 \, u - 239.046526 \, u \nonumber \]
\[= 0.0005631 \, u. \nonumber \]
Now we can find E by entering \(\Delta m\) into the equation:
\[E = (\Delta m) c^2 = (0.005631 \, u)c^2. \nonumber \]
We know \(1 \, u = 931.5 \, MeV/c^2\), so we have
\[\begin{align} E & = (0.005631)(931.5 \, MeV/c^2)(c^2) \nonumber \\[4pt] &= 5.25 \, MeV. \nonumber \end{align} \nonumber \]
Significance
The energy released in this \(\alpha\) decay is in the MeV range, many times greater than chemical reaction energies. Most of this energy becomes kinetic energy of the \(\alpha\) particle (or \(^4He\) nucleus), which moves away at high speed. The energy carried away by the recoil of the \(^{235}U\) nucleus is much smaller due to its relatively large mass. The \(^{235}U\) nucleus can be left in an excited state to later emit photons (\(\gamma\) rays). 239 Pu → 235 U + 4 He .
Beta Decay
In most \(\beta\) particle decays (or beta decay ), either an electron (\(\beta^-\)) or positron (\(\beta^+\)) is emitted by a nucleus. A positron has the same mass as the electron, but its charge is \(+e\). For this reason, a positron is sometimes called an antielectron. How does \(\beta\) decay occur? A possible explanation is the electron (positron) is confined to the nucleus prior to the decay and somehow escapes. To obtain a rough estimate of the escape energy, consider a simplified model of an electron trapped in a box (or in the terminology of quantum mechanics, a one-dimensional square well) that has the width of a typical nucleus (\(10^{-14}\)). According to the Heisenberg uncertainty principle in Quantum Mechanics, the uncertainty of the momentum of the electron is:
\[\begin{align} \Delta p &\ge \dfrac{h}{\Delta x} \nonumber \\[4pt] &= \dfrac{6.6 \times 10^{-34} m^2 \cdot kg/s}{10^{-14}m} \nonumber \\[4pt] &= 6.6 \times 10^{-20} kg \cdot m/s. \end{align} \nonumber \]
Taking this momentum value (an underestimate) to be the “true value,” the kinetic energy of the electron on escape is approximately
\[\begin{align} \dfrac{(\Delta p)^2}{2m_e} &= \dfrac{6.6 \times 10^{-20} m^2 \cdot kg/s)^2}{2(9.1 \times 10^{-31}kg)} \nonumber \\[4pt] &= 2.0 \times 10^{-9} J \nonumber \\[4pt] &= 12,400 \, MeV. \end{align} \nonumber \]
Experimentally, the electrons emitted in \(\beta^-\) decay are found to have kinetic energies of the order of only a few MeV. We therefore conclude that the electron is somehow produced in the decay rather than escaping the nucleus. Particle production (annihilation) is described by theories that combine quantum mechanics and relativity, a subject of a more advanced course in physics.
Nuclear beta decay involves the conversion of one nucleon into another. For example, a neutron can decay to a proton by the emission of an electron (\(\beta^-\)) and a nearly massless particle called an antineutrino (\(\overline{\nu}\)):
\[\ce{_0^1n \rightarrow _1^1p + _1^0e + \overline{\nu}. } \nonumber \]
The notation \(_{-1}^0e\) is used to designate the electron. Its mass number is 0 because it is not a nucleon, and its atomic number is \(-1\) to signify that it has a charge of \(-e\). The proton is represented by \(_1^1p\) because its mass number and atomic number are 1. When this occurs within an atomic nucleus, we have the following equation for beta decay:
\[\ce{_z^AX \rightarrow _{Z+1} ^AX + _1^0e + \overline{\nu}.} \label{beta} \]
This process occurs due to the weak nuclear force.
Watch beta decay occur for a collection of nuclei or for an individual nucleus.
As an example, the isotope \(_{90}^{234}Th\) is unstable and decays by \(\beta^-\) emission with a half-life of 24 days. Its decay can be represented as
\[\ce{_{90}^{234}Th \rightarrow _{91}^{234}X + _1^0e^+ + \overline{\nu}.} \nonumber \]
Since the chemical element with atomic number 91 is protactinium (Pa), we can write the \(\beta^-\) decay of thorium as
\[\ce{_{90}^{234}Th \rightarrow _{91}^{234}Pa + _1^0e^+ + \overline{\nu}.} \nonumber \]
The reverse process is also possible: A proton can decay to a neutron by the emission of a positron (\(e^+\) and a nearly massless particle called a neutrin o (\(v\)). This reaction is written as
\[\ce{_1^1p \rightarrow _0^1n + _{+1}^0e + \nu.} \nonumber \]
The positron \(_1^0e\) is emitted with the neutrino \(\nu\), and the neutron remains in the nucleus. (Like \(\beta^-\) decay, the positron does not precede the decay but is produced in the decay.) For an isolated proton, this process is impossible because the neutron is heavier than the proton. However, this process is possible within the nucleus because the proton can receive energy from other nucleons for the transition. As an example, the isotope of aluminum \(_{13}^{26}Al\) decays by \(\beta^+\) emission with a half-life of \(7.40 \times 10^5 y\). The decay is written as
\[\ce{_{13}^{26}Al \rightarrow _{12}^{26}X + _1^0e + \nu.} \nonumber \]
The atomic number 12 corresponds to magnesium. Hence,
\[\ce{_{13}^{26}Al \rightarrow _{12}^{26}Mg + _1^0 e + \nu.} \nonumber \]
As a nuclear reaction, positron emission can be written as
\[\ce{_Z^AX \rightarrow _{Z-1} ^AX + _1^{0} e + \nu.} \nonumber \]
The neutrino was not detected in the early experiments on \(β\) decay. However, the laws of energy and momentum seemed to require such a particle. Later, neutrinos were detected through their interactions with nuclei.
Example \(\PageIndex{2}\): Bismuth Alpha and Beta Decay
The \(_{83}^{211}Bi\) nucleus undergoes both \(\alpha\) and \(\beta^-\) decay. For each case, what is the daughter nucleus?
Strategy
We can use the processes described by Equation \ref{alpha} and Equation \ref{beta}, as well as the Periodic Table, to identify the resulting elements.
Solution
The atomic number and the mass number for the \(\alpha\) particle are 2 and 4, respectively. Thus, when a bismuth-211 nucleus emits an \(\alpha\) particle, the daughter nucleus has an atomic number of 81 and a mass number of 207. The element with an atomic number of 81 is thallium, so the decay is given by
\[\ce{_{83}^{211}Bi \rightarrow _{81}^{207} Ti + _2^4He.} \nonumber \]
In \(\beta^-\) decay, the atomic number increases by 1, while the mass number stays the same. The element with an atomic number of 84 is polonium, so the decay is given by
\[\ce{_{83}^{211}Bi \rightarrow _{84}^{211}Po + _{-1}^0e + \overline{\nu}.} \nonumber \]
Exercise \(\PageIndex{1}\)
In radioactive beta decay, does the atomic mass number, A , increase or decrease?
Solution
Neither; it stays the same.
Gamma Decay
A nucleus in an excited state can decay to a lower-level state by the emission of a “gamma-ray” photon, and this is known as gamma decay . This is analogous to de-excitation of an atomic electron. Gamma decay is represented symbolically by
\[\ce{_{Z}^{A}X}^{*} \ce{\rightarrow _{Z}^{A}X + \gamma} \label{gamma} \]
where the asterisk (*) on the nucleus indicates an excited state. In \(\gamma\) decay, neither the atomic number nor the mass number changes, so the type of nucleus does not change.
Radioactive Decay Series
Nuclei with \(Z > 82\) are unstable and decay naturally. Many of these nuclei have very short lifetimes, so they are not found in nature. Notable exceptions include \(_{90}^{232}Th\) (or Th-232) with a half-life of \(1.39 \times 10^{10}\) years, and \(_{92}^{238}U\) (or U-238) with a half-life of \(7.04 \times 10^8\) years. When a heavy nucleus decays to a lighter one, the lighter daughter nucleus can become the parent nucleus for the next decay, and so on. This process can produce a long series of nuclear decays called a decay series . The series ends with a stable nucleus.
To illustrate the concept of a decay series, consider the decay of Th-232 series (Figure \(\PageIndex{3}\)). The neutron number, N , is plotted on the vertical y -axis, and the atomic number, Z , is plotted on the horizontal x -axis, so Th-232 is found at the coordinates \((N, Z) = (142.90)\). Th-232 decays by \(\alpha\) emission with a half-life of \(1.39 \times 10^{10}\) years. Alpha decay decreases the atomic number by 2 and the mass number by 4, so we have
\[\ce{_{90}^{232}Th \rightarrow _{88}^{228}Ra + _2^4He.} \nonumber \]
The neutron number for Radium-228 is 140, so it is found in the diagram at the coordinates \((N,Z) = (140, \, 90)\). Radium-228 is also unstable and decays by \(\alpha\) emission with a half-life of 5.76 years to Actinum-228. The atomic number increases by 1, the mass number remains the same, and the neutron number decreases by 1. Notice that in the graph, \(α\) emission appears as a line sloping downward to the left, with both N and Z decreasing by 2. Beta emission, on the other hand, appears as a line sloping downward to the right with N decreasing by 1, and Z increasing by 1. After several additional alpha and beta decays, the series ends with the stable nucleus Pb-208.
The relative frequency of different types of radioactive decays (alpha, beta, and gamma) depends on many factors, including the strength of the forces involved and the number of ways a given reaction can occur without violating the conservation of energy and momentum. How often a radioactive decay occurs often depends on a sensitive balance of the strong and electromagnetic forces .
As another example, consider the U-238 decay series shown in Figure \(\PageIndex{4}\). After numerous alpha and beta decays, the series ends with the stable nucleus Pb-206.
An example of a decay whose parent nucleus no longer exists naturally is shown in Figure \(\PageIndex{5}\). It starts with Neptunium-237 and ends in the stable nucleus Bismuth-209. Neptunium is called a transuranic element because it lies beyond uranium in the periodic table. Uranium has the highest atomic number \((Z + 92)\) of any element found in nature. Elements with \(Z > 92\) can be produced only in the laboratory. They most probably also existed in nature at the time of the formation of Earth, but because of their relatively short lifetimes, they have completely decayed. There is nothing fundamentally different between naturally occurring and artificial elements.
Notice that for Bi (21), the decay may proceed through either alpha or beta decay.
Radioactivity in the Earth
According to geologists, if there were no heat source, Earth should have cooled to its present temperature in no more than 1 billion years. Yet, Earth is more than 4 billion years old. Why is Earth cooling so slowly? The answer is nuclear radioactivity, that is, high-energy particles produced in radioactive decays heat Earth from the inside (Figure \(\PageIndex{6}\)).
Candidate nuclei for this heating model are \(^{238}U\) and \(^{40}K\), which possess half-lives similar to or longer than the age of Earth. The energy produced by these decays (per second per cubic meter) is small, but the energy cannot escape easily, so Earth’s core is very hot. Thermal energy in Earth’s core is transferred to Earth’s surface and away from it through the processes of convection , conduction , and radiation .


8.2.1: The Many Varieties of Conformity
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Learning Objectives
- Describe some of the active and passive ways that conformity occurs in our everyday lives.
- Compare and contrast informational conformity and normative conformity.
- Summarize the variables that create majority and minority social influence.
- Outline the situational variables that influence the extent to which we conform.
The typical outcome of social influence is that our beliefs and behaviors become more similar to those of others around us. At times this change occurs in a spontaneous and automatic sense, without any obvious intent of one person to change the other. Perhaps you learned to like jazz or rap music because your roommate was playing a lot of it. You didn’t really want to like the music, and your roommate didn’t force it on you—your preferences changed in passive way. Robert Cialdini and his colleagues (Cialdini, Reno, & Kallgren, 1990) found that college students were more likely to throw litter on the ground when they had just seen another person throw some paper on the ground and were least likely to litter when they had just seen another person pick up and throw paper into a trash can. The researchers interpreted this as a kind of spontaneous conformity—a tendency to follow the behavior of others, often entirely out of our awareness. Even our emotional states become more similar to those we spend more time with (Anderson, Keltner, & John, 2003).
Research Focus
Imitation as Subtle Conformity
Perhaps you have noticed in your own behavior a type of very subtle conformity—the tendency to imitate other people who are around you. Have you ever found yourself talking, smiling, or frowning in the same way that a friend does? Tanya Chartrand and John Bargh (1999) investigated whether the tendency to imitate others would occur even for strangers, and even in very short periods of time.
In their first experiment, students worked on a task with another student, who was actually an experimental confederate. The two worked together to discuss photographs taken from current magazines. While they were working together, the confederate engaged in some unusual behaviors to see if the research participant would mimic them. Specifically, the confederate either rubbed his or her face or shook his or her foot. It turned out that the students did mimic the behavior of the confederate, by themselves either rubbing their own faces or shaking their own feet. And when the experimenters asked the participants if they had noticed anything unusual about the behavior of the other person during the experiment, none of them indicated awareness of any face rubbing or foot shaking.
It is said that imitation is a form of flattery, and we might therefore expect that we would like people who imitate us. Indeed, in a second experiment, Chartrand and Bargh found exactly this. Rather than creating the behavior to be mimicked, in this study the confederate imitated the behaviors of the participant. While the participant and the confederate discussed the magazine photos, the confederate mirrored the posture, movements, and mannerisms displayed by the participant.
As you can see in the following figure, the participants who had been mimicked liked the other person more and indicated that they thought the interaction had gone more smoothly, in comparison with the participants who had not been imitated.
Participants who had been mimicked indicated that they liked the person who had imitated them more and that the interaction with that person had gone more smoothly, in comparison with participants who had not been mimicked. Data are from Chartrand and Bargh (1999).
Imitation is an important part of social interaction. We easily and frequently mimic others without being aware that we are doing so. We may communicate to others that we agree with their viewpoints by mimicking their behaviors, and we tend to get along better with people with whom we are well “coordinated.” We even expect people to mimic us in social interactions, and we become distressed when they do not (Dalton, Chartrand, & Finkel, 2010). This unconscious conformity may help explain why we hit it off immediately with some people and never get it together with others (Chartrand & Dalton, 2009; Tickle-Degnen & Rosenthal, 1990, 1992).
Informational Conformity: Conforming to Be Accurate
Although mimicry represents the more subtle side, conformity also occurs in a more active and thoughtful sense, for instance, when we actively look to our friends’ opinions to determine appropriate behavior, when a car salesperson attempts to make a sale, or even when a powerful dictator uses physical aggression to force the people in his country to engage in the behaviors that he desires. In these cases, the influence is obvious. We know we are being influenced and we may attempt—sometimes successfully, and sometimes less so—to counteract the pressure.
Influence sometimes occurs because we believe that other people have valid knowledge about an opinion or issue, and we use that information to help us make good decisions. When we take our winter coat to school because the weatherman says it’s going to be cold, this is because we think that the weatherman has some good information that we can use. Informational conformity is the change in opinions or behavior that occurs when we conform to people whom we believe have accurate information . We base our beliefs on those presented to us by reporters, scientists, doctors, and lawyers because we believe they have more expertise in certain fields than we have. But we also use our friends and colleagues for information; when we choose a prom gown on the basis of our friends’ advice about what looks good on us, we are using informational conformity—we believe that our friends have good judgment about the things that matter to us.
Informational conformity is often the end result of social comparison , the process of comparing our opinions with those of others to gain an accurate appraisal of the validity of an opinion or behavior (Festinger, Schachter, & Back, 1950; Hardin & Higgins, 1996; Turner, 1991). Informational conformity lead to real, long-lasting, changes in beliefs. The result of informational influence is normally private acceptance : real change in opinions on the part of the individual . We believe that taking the winter coat was the right thing to do and that the prom gown really looks good on us.
Normative Conformity: Conforming to Be Liked and to Avoid Rejection
In other cases we conform not because we want to have valid knowledge but rather to meet the goal of belonging to and being accepted by a group that we care about (Deutsch & Gerard, 1955). When we start smoking cigarettes or buy shoes that we cannot really afford in order to impress others, we do these things not so much because we think they are the right things to do but rather because we want to be liked.
Normative conformity occurs when we express opinions or behave in ways that help us to be accepted or that keep us from being isolated or rejected by others . When we engage in normative conformity we conform to social norms —socially accepted beliefs about what we do or should do in particular social contexts (Cialdini, 1993; Sherif, 1936; Sumner, 1906).
In contrast to informational conformity, in which the attitudes or opinions of the individual change to match that of the influencers, the outcome of normative conformity often represents public conformity rather than private acceptance. Public conformity is a superficial change in behavior (including the public expression of opinions) that is not accompanied by an actual change in one’s private opinion . Conformity may appear in our public behavior even though we may believe something completely different in private. We may obey the speed limit or wear a uniform to our job (behavior) to conform to social norms and requirements, even though we may not necessarily believe that it is appropriate to do so (opinion). We may use drugs with our friends without really wanting to, and without believing it is really right, because our friends are all using drugs. However, behaviors that are originally performed out of a desire to be accepted (normative conformity) may frequently produce changes in beliefs to match them, and the result becomes private acceptance. Perhaps you know someone who started smoking to please his friends but soon convinced himself that it was an acceptable thing to do.
Although in some cases conformity may be purely informational or purely normative, in most cases the goals of being accurate and being accepted go hand-in-hand, and therefore informational and normative conformity often occur at the same time. When soldiers obey their commanding officers, they probably do it both because others are doing it (normative conformity) and because they think it is the right thing to do (informational conformity). It has been argued that the distinction between informational and normative conformity is more apparent than real and that it may not be possible to fully differentiate them (Turner, 1991).
Majority Influence: Conforming to the Group
Although conformity occurs whenever group members change their opinions or behaviors as a result of their perceptions of others, we can divide such influence into two types. Majority influence occurs when the beliefs held by the larger number of individuals in the current social group prevail . In contrast, minority influence occurs when the beliefs held by the smaller number of individuals in the current social group prevail . Not surprisingly, majority influence is more common, and we will consider it first.
In a series of important studies on conformity, Muzafer Sherif (1936) used a perceptual phenomenon known as the autokinetic effect to study the outcomes of conformity on the development of group norms. The autokinetic effect is caused by the rapid, small movements of our eyes that occur as we view objects and that allow us to focus on stimuli in our environment. However, when individuals are placed in a dark room that contains only a single, small, stationary pinpoint of light, these eye movements produce an unusual effect for the perceiver—they make the point of light appear to move.
Sherif took advantage of this effect to study how group norms develop in ambiguous situations. In his studies, college students were placed in a dark room with the point of light and were asked to indicate, each time the light was turned on, how much it appeared to move. Some participants first made their judgments alone. Sherif found that although each participant who was tested alone made estimates that were within a relatively narrow range (as if they had their own “individual” norm), there were wide variations in the size of these judgments among the different participants he studied.
Sherif also found that when individuals who initially had made very different estimates were then placed in groups along with one or two other individuals, and in which all the group members gave their responses on each trial aloud (each time in a different random order), the initial differences in judgments among the participants began to disappear, such that the group members eventually made very similar judgments. You can see that this pattern of change, which is shown in Figure 7.2, illustrates the fundamental principle of social influence—over time, people come more and more to share their beliefs with each other. Sherif’s study is thus a powerful example of the development of group norms.
The participants in the studies by Muzafer Sherif (1936) initially had different beliefs about the degree to which a point of light appeared to be moving. (You can see these differences as expressed on Day 1.) However, as they shared their beliefs with other group members over several days, a common group norm developed. Shown here are the estimates made by a group of three participants who met together on four different days.
Furthermore, and indicating that Sherif had created private acceptance, the new group norms continued to influence judgments when the individuals were again tested alone. The participants did not revert back to their initial opinions, even though they were quite free to do so; rather, they stayed with the new group norms. And these conformity effects appear to have occurred entirely out of the awareness of most participants. Sherif (1936, p. 108) reported that the majority of the participants indicated after the experiment was over that their judgments had not been influenced by the judgments made by the other group members.
Sherif also found that the norms that were developed in groups could continue over time. When the original research participants were moved into groups with new people, their opinions subsequently influenced the judgments of the new group members (Jacobs & Campbell, 1961). The norms persisted through several “generations” (MacNeil & Sherif, 1976) and could influence individual judgments up to a year after the individual was last tested (Rohrer, Baron, Hoffman, & Swander, 1954).
When Solomon Asch (Asch, 1952, 1955) heard about Sherif’s studies, he responded in perhaps the same way that you might have: “Well of course people conformed in this situation, because after all the right answer was very unclear,” you might have thought. Since the study participants didn’t know the right answer (or indeed the “right” answer was no movement at all), it is perhaps not that surprising that people conformed to the beliefs of others.
Asch conducted studies in which, in complete contrast to the autokinetic effect experiments of Sherif, the correct answers to the judgments were entirely unambiguous. In these studies, the research participants were male college students who were told that they were to be participating in a test of visual abilities. The men were seated in a small semicircle in front of a board that displayed the visual stimuli that they were going to judge. The men were told that there would be 18 trials during the experiment, and on each trial they would see two cards. The standard card had a single line that was to be judged. And the test card had three lines that varied in length between about 2 and 10 inches:
The men’s task was simply to indicate which line on the test card was the same length as the line on the standard card. As you can see from the Asch card sample above, there is no question that correct answer is line 1. In fact, Asch found that people made virtually no errors on the task when they made their judgments alone.
On each trial, the each person answered out loud, beginning with one end of the semicircle and moving to the other end. Although the participant did not know it, the other group members were not true participants but experimental confederates who gave predetermined answers on each trial. Because the participant was seated next to last in the row, he always made his judgment after most of the other group members made theirs. Although on the first two trials the confederates each gave the correct answer, on the third trial, and on 11 of the subsequent trials, they all had been instructed to give the same incorrect answer. For instance, even though the correct answer was Line 1, they would all say it was Line 2. Thus when it became the participant’s turn to answer, he could either give the clearly correct answer or conform to the incorrect responses of the confederates.
Asch found that about 76% of the 123 men who were tested gave at least one incorrect response when it was their turn, and 37% of the responses, overall, were conforming. This is indeed evidence for the power of conformity because the research participants were giving clearly incorrect answers out loud. However, conformity was not absolute—in addition to the 24% of the men who never conformed, only 5% of the men conformed on all 12 of the critical trials.
You might think that Asch’s study shows primarily normative conformity, in the sense that the participants gave the wrong answer not because they thought it was correct but because they wanted to avoid being seen as different. But is it not possible that the participants were also a bit unsure of the correct answer? When I look at the picture of one of the participants in Asch’s studies (see Figure 7.3), it looks to me like he is really unsure about what he is seeing. Perhaps, then, even in Asch’s study some informational influence is occurring. Maybe the participants became unsure of their responses and used the opinions of others to help them determine what was correct. Normative and informational conformity often operate together.
Minority Influence: Resisting Group Pressure
The research that we have discussed to this point involves conformity in which the opinions and behaviors of individuals become more similar to the opinions and behaviors of the majority of the people in the group—majority influence. But we do not always blindly conform to the beliefs of the majority. Although more unusual, there are nevertheless cases in which a smaller number of individuals are able to influence the opinions or behaviors of the group—this is minority influence .
It is a good thing that minorities can be influential; otherwise, the world would be pretty boring. When we look back on history we find that it is the unusual, divergent, innovative minority groups or individuals, who—although frequently ridiculed at the time for their unusual ideas—end up being respected for producing positive changes. The work of scientists, religious leaders, philosophers, writers, musicians, and artists who go against group norms by expressing new and unusual ideas frequently is not liked at first. These novel thinkers may be punished—in some cases even killed—for their beliefs. In the end, however, if the ideas are interesting and important, the majority may conform to these new ideas, producing social change. In short, although conformity to majority opinions is essential to provide a smoothly working society, if individuals only conformed to others there would be few new ideas and little social change.
The French social psychologist Serge Moscovici was particularly interested in the situations under which minority influence might occur. In fact, he argued that all members of all groups are able, at least in some degree, to influence others, regardless of whether they are in the majority or the minority. To test whether minority group members could indeed produce influence, he and his colleagues (Moscovici, Lage, & Naffrechoux, 1969) created the opposite of Asch’s line perception study, such that there was now a minority of confederates in the group (two) and a majority of experimental participants (four). All six individuals viewed a series of slides depicting colors, supposedly as a study of color perception, and as in Asch’s research, each voiced out loud an opinion about the color of the slide.
Although the color of the slides varied in brightness, they were all clearly blue. Moreover, demonstrating that the slides were unambiguous, just as the line judgments of Asch had been, participants who were asked to make their judgments alone called the slides a different color than blue less than 1% of the time. (When it happened, they called the slides green.)
In the experiment, the two confederates had been instructed to give one of two patterns of answers that were different from the normal responses. In the consistent-minority condition, the two confederates gave the unusual response (green) on every trial. In the inconsistent-minority condition the confederates called the slides “green” on two thirds of their responses and called them blue on the other third.
The minority of two was able to change the beliefs of the majority of four, but only when they were unanimous in their judgments. As shown in Figure 7.4, Moscovici found that the presence of a minority who gave consistently unusual responses influenced the judgments made by the experimental participants. When the minority was consistent, 32% of the majority group participants said green at least once and 18% of the responses of the majority group were green. However, as you can see in Figure 7.4, the inconsistent minority had virtually no influence on the judgments of the majority.
In the studies of minority influence by Serge Moscovici, only a consistent minority (in which each individual gave the same incorrect response) was able to produce conformity in the majority participants. Data are from Moscovici, Lage, and Naffrechoux (1969).
On the basis of this research, Moscovici argued that minorities could have influence over majorities, provided they gave consistent, unanimous responses. Subsequent research has found that minorities are most effective when they express consistent opinions over time and with each other, when they show that they are invested in their position by making significant personal and material sacrifices, and when they seem to be acting out of principle rather than from ulterior motives (Hogg, 2010). Although they may want to adopt a relatively open-minded and reasonable negotiating style on issues that are less critical to the attitudes they are trying to change, successful minorities must be absolutely consistent with regard to their core arguments (Mugny & Papastamou, 1981).
When minorities are successful at producing influence, they are able to produce strong and lasting attitude change—true private acceptance—rather than simply public conformity. People conform to minorities because they think that they are right, and not because they think it is socially acceptable. Minorities have another, potentially even more important, outcome on the opinions of majority group members—the presence of minority groups can lead majorities to engage in fuller, as well as more divergent, innovative and creative thinking about the topics being discussed (Martin & Hewstone, 2003; Martin, Martin, Smith, & Hewstone, 2007).
Nemeth and Kwan (1987) had participants work in groups of four on a creativity task in which they were presented with letter strings such as tdogto and asked to indicate which word came to their mind first as they looked at the letters. The judgments were made privately, which allowed the experimenters to provide false feedback about the responses of the other group members. All participants indicated the most obvious word (in this case, dog ) as their response on each of the initial trials. However, the participants were told (according to experimental condition) either that three of the other group members had also reported seeing dog and that one had reported seeing god or that three out of the four had reported seeing god whereas only one had reported dog . Participants then completed other similar word strings on their own, and their responses were studied.
Results showed that when the participants thought that the unusual response (for instance, god rather than dog ) was given by a minority of one individual in the group rather than by a majority of three individuals, they subsequently answered more of the new word strings using novel solutions, such as finding words made backward or using a random order of the letters. On the other hand, the individuals who thought that the majority of the group had given the novel response did not develop more creative ideas. The idea is when the participants thought that the novel response came from a group minority (one person), they thought about the responses more carefully, in comparison with the same behaviors performed by majority group members, and this led them to adopt new and creative ways to think about the problems. This result, along with other research showing similar findings, suggests that messages that come from minority groups lead us to think more fully about the decision, which can produce innovative, creative thinking in majority group members (Crano & Chen, 1998).
In summary, we can conclude that minority influence, although not as likely as majority influence, does sometimes occur. The few are able to influence the many when they are consistent and confident in their judgments but are less able to have influence when they are inconsistent or act in a less confident manner. Furthermore, although minority influence is difficult to achieve, if it does occur it is powerful. When majorities are influenced by minorities they really change their beliefs—the outcome is deeper thinking about the message, private acceptance of the message, and in some cases even more creative thinking.
Situational Determinants of Conformity
The studies of Asch, Sherif, and Moscovici demonstrate the extent to which individuals—both majorities and minorities—can create conformity in others. Furthermore, these studies provide information about the characteristics of the social situation that are important in determining the extent to which we conform to others. Let’s consider some of those variables.
The Size of the Majority
As the number of people in the majority increases, relative to the number of persons in the minority, pressure on the minority to conform also increases (Latané, 1981; Mullen, 1983). Asch conducted replications of his original line-judging study in which he varied the number of confederates (the majority subgroup members) who gave initial incorrect responses from 1 to 16 people, while holding the number in the minority subgroup constant at 1 (the single research participant). You may not be surprised to hear the results of this research: When the size of the majorities got bigger, the lone participant was more likely to give the incorrect answer.
Increases in the size of the majority increase conformity, regardless of whether the conformity is informational or normative. In terms of informational conformity, if more people express an opinion, their opinions seem more valid. Thus bigger majorities should result in more informational conformity. But larger majorities will also produce more normative conformity because being different will be harder when the majority is bigger. As the majority gets bigger, the individual giving the different opinion becomes more aware of being different, and this produces a greater need to conform to the prevailing norm.
Although increasing the size of the majority does increase conformity, this is only true up to a point. The increase in the amount of conformity that is produced by adding new members to the majority group (known as the social impact of each group member) is greater for initial majority members than it is for later members (Latané, 1981). This pattern is shown in Figure 7.5, which presents data from a well-known experiment by Stanley Milgram and his colleagues (Milgram, Bickman, & Berkowitz, 1969) that studied how people are influenced by the behavior of others on the streets of New York City.
Milgram had confederates gather in groups on 42nd street in New York City, in front of the Graduate Center of the City University of New York, each looking up at a window on the sixth floor of the building. The confederates were formed into groups ranging from one to 15 people. A video camera in a room on the sixth floor above recorded the behavior of 1,424 pedestrians who passed along the sidewalk next to the groups.
As you can see in Figure 7.5, larger groups of confederates increased the number of people who also stopped and looked up, but the influence of each additional confederate was generally weaker as size increased. Groups of three confederates produced more conformity than did a single person, and groups of five produced more conformity than groups of three. But after the group reached about six people, it didn’t really matter very much. Just as turning on the first light in an initially dark room makes more difference in the brightness of the room than turning on the second, third, and fourth lights does, adding more people to the majority tends to produce diminishing returns—less effect on conformity.
This figure shows the percentage of participants who looked up as a function of the size of the crowd on the street in Milgram’s (1969) study on the streets of New York. You can see that the amount of conformity increases dramatically until there are five participants, after which it levels off. Similar patterns have been found in many other studies of conformity.
Group size is an important variable that influences a wide variety of behaviors of the individuals in groups. People leave proportionally smaller tips in restaurants as the number in their party increases, and people are less likely to help as the number of bystanders to an incident increases (Latané, 1981). The number of group members also has an important influence on group performance: As the size of a working group gets larger, the contributions of each individual member to the group effort become smaller. In each case, the influence of group size on behavior is found to be similar to that shown in Figure 7.5.
As you can see in Figure 7.5, the effect of adding new individuals to the group eventually levels off entirely, such that adding more people to the majority after that point makes no meaningful difference in the amount of conformity. This peak usually occurs when the majority has about four or five persons. One reason that the impact of new group members decreases so rapidly is because as the number in the group increases, the individuals in the majority are soon seen more as a group rather than as separate individuals. When there are only a couple of individuals expressing opinions, each person is likely to be seen as an individual, holding his or her own unique opinions, and each new individual adds to the impact. As a result, two people are more influential than one, and three more influential than two. However, as the number of individuals grows, and particularly when those individuals are perceived as being able to communicate with each other, the individuals are more likely to be seen as a group rather than as individuals. At this point, adding new members does not change the perception; regardless of whether there are four, five, six, or more members, the group is still just a group. As a result, the expressed opinions or behaviors of the group members no longer seem to reflect their own characteristics, so much as they do that of the group as a whole, and thus increasing the number of group members is less effective in increasing influence (Wilder, 1977).
The Unanimity of the Majority
Although the number of people in the group is an important determinant of conformity, it cannot be the only thing—if it were, minority influence would be impossible. It turns out that the consistency or unanimity of the group members is even more important. In Asch’s study, as an example, conformity occurred not so much because many confederates gave a wrong answer but rather because each of the confederates gave the same wrong answer. In one follow-up study that he conducted, Asch increased the number of confederates to 16 but had just one of those confederates give the correct answer. He found that in this case, even though there were 15 incorrect and only one correct answer given by the confederates, conformity was nevertheless sharply reduced—to only about 5% of the participants’ responses. And you will recall that in the minority influence research of Moscovici, the same thing occurred; conformity was only observed when the minority group members were completely consistent in their expressed opinions.
Although you might not be surprised to hear that conformity decreases when one of the group members gives the right answer, you may be more surprised to hear that conformity is reduced even when the dissenting confederate gives a different wrong answer. For example, conformity is reduced dramatically in Asch’s line-judging situation, such that virtually all participants give the correct answer (assume it is line 3 in this case) even when the majority of the confederates have indicated that line 2 is the correct answer and a single confederate indicates that line 1 is correct. In short, conformity is reduced when there is any inconsistency among the members of the majority group—even when one member of the majority gives an answer that is even more incorrect than that given by the other majority group members (Allen & Levine, 1968).
Why should unanimity be such an important determinant of conformity? For one, when there is complete agreement among the majority members, the individual who is the target of influence stands completely alone and must be the first to break ranks by giving a different opinion. Being the only person who is different is potentially embarrassing, and people who wish to make a good impression on, or be liked by, others may naturally want to avoid this. If you can convince your friend to wear blue jeans rather than a coat and tie to a wedding, then you’re naturally going to feel a lot less conspicuous when you wear jeans too.
Second, when there is complete agreement—remember the consistent minority in the studies by Moscovici—the participant may become less sure of his or her own perceptions. Because everyone else is holding the exact same opinion, it seems that they must be correctly responding to the external reality. When such doubt occurs, the individual may be likely to conform due to informational conformity. Finally, when one or more of the other group members gives a different answer than the rest of the group (so that the unanimity of the majority group is broken), that person is no longer part of the group that is doing the influencing and becomes (along with the participant) part of the group being influenced. You can see that another way of describing the effect of unanimity is to say that as soon as the individual has someone who agrees with him or her that the others may not be correct (a supporter or ally), then the pressure to conform is reduced. Having one or more supporters who challenge the status quo validates one’s own opinion and makes disagreeing with the majority more likely (Allen, 1975; Boyanowsky & Allen, 1973).
The Importance of the Task
Still another determinant of conformity is the perceived importance of the decision. The studies of Sherif, Asch, and Moscovici may be criticized because the decisions that the participants made—for instance, judging the length of lines or the colors of objects—seem rather trivial. But what would happen when people were asked to make an important decision? Although you might think that conformity would be less when the task becomes more important (perhaps because people would feel uncomfortable relying on the judgments of others and want to take more responsibility for their own decisions), the influence of task importance actually turns out to be more complicated than that.
Research Focus
How Task Importance and Confidence Influence Conformity
The joint influence of an individual’s confidence in his or her beliefs and the importance of the task was demonstrated in an experiment conducted by Baron, Vandello, and Brunsman (1996) that used a slight modification of the Asch procedure to assess conformity. Participants completed the experiment along with two other students, who were actually experimental confederates. The participants worked on several different types of trials, but there were 26 that were relevant to the conformity predictions. On these trials a photo of a single individual was presented first, followed immediately by a “lineup” photo of four individuals, one of whom had been viewed in the initial slide (but who might have been dressed differently):
The participants’ task was to call out which person in the lineup was the same as the original individual using a number between 1 (the person on the left) and 4 (the person on the right). In each of the critical trials the two confederates went before the participant and they each gave the same wrong response.
Two experimental manipulations were used. First, the researchers manipulated task importance by telling some participants (the high importance condition ) that their performance on the task was an important measure of eyewitness ability and that the participants who performed most accurately would receive $20 at the end of the data collection. (A lottery using all the participants was actually held at the end of the semester, and some participants were paid the $20.) Participants in the low-importance condition , on the other hand, were told that the test procedure was part of a pilot study and that the decisions were not that important. Second, task difficulty was varied by showing the test and the lineup photos for 5 and 10 seconds, respectively ( easy condition ) or for only ½ and 1 second, respectively ( difficult condition ). The conformity score was defined as the number of trials in which the participant offered the same (incorrect) response as the confederates.
On easy tasks, participants conformed less when they thought that the decision was of high (versus low) importance, whereas on difficult tasks, participants conformed more when they thought the decision was of high importance. Data are from Baron et al. (1996).
As you can see in the preceding figure, an interaction between task difficulty and task importance was observed. On easy tasks, participants conformed less to the incorrect judgments of others when the decision had more important consequences for them. In these cases, they seemed to rely more on their own opinions (which they were convinced were correct) when it really mattered, but were more likely to go along with the opinions of the others when things were not that critical (probably normative conformity).
On the difficult tasks, however, results were the opposite. In this case participants conformed more when they thought the decision was of high, rather than low, importance. In these cases in which they were more unsure of their opinions and yet they really wanted to be correct, they used the judgments of others to inform their own views (informational conformity).
Key Takeaways
- Social influence creates conformity.
- Influence may occur in more passive or more active ways.
- We conform both to gain accurate knowledge (informational conformity) and to avoid being rejected by others (normative conformity).
- Both majorities and minorities may create social influence, but they do so in different ways.
- The characteristics of the social situation, including the number of people in the majority and the unanimity of the majority, have a strong influence on conformity.
Exercises and Critical Thinking
- Describe a time when you conformed to the opinions or behaviors of others. Interpret the conformity in terms of the concepts discussed in this section.
- Imagine you were serving on a jury trial in which you found yourself the only person who believed that the defendant was innocent. What strategies might you use to convince the majority?
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