Manic patients exhibit more utilitarian moral judgments in comparison with euthymic bipolar and healthy persons

Both emotional and cognitive processes are involved in moral judgments. Ventromedial prefrontal lesions are related to impaired prosocial emotions and emotional dysregulation, and patients with these lesions exhibit increased utilitarian judgments of emotionally salient personal moral dilemmas. Bipolar patients experiencing manic episode also have impaired emotional regulation and behavioral control. We investigated the characteristics of moral judgment in manic and euthymic patients with bipolar disorder using the 50 hypothetical moral dilemma task (17 non-moral, 20 personal, and 13 impersonal). Our study included 27 manic bipolar patients, 26 euthymic bipolar patients, and 42 healthy controls. Subjects were instructed to determine whether or not each dilemma was morally acceptable, and their reaction times were recorded. Manic patients showed significantly greater utilitarian judgment than euthymic patients and normal controls for personal moral dilemmas. However, there were no significant between-group differences for the non-moral and impersonal moral dilemmas. Our results suggest that increased utilitarian judgments of personal moral dilemmas may be a state-related finding observed only in manic patients. This difference in moral judgment assessments may reflect the decision-making characteristics and underlying neurobiological mechanisms of bipolar disorder, especially during the manic state.     

Differential activation of the amygdala and the 'social brain' during fearful face-processing in Asperger Syndrome

Impaired social cognition is a core feature of autism. There is much evidence showing people with autism use a different cognitive style than controls for face-processing. We tested if people with autism would show differential activation of social brain areas during a face-processing task. Thirteen adults with high-functioning autism or Asperger Syndrome (HFA/AS) and 13 matched controls. We used fMRI to investigate 'social brain' activity during perception of fearful faces. We employed stimuli known to reliably activate the amygdala and other social brain areas, and ROI analyses to investigate brain areas responding to facial threat as well as those showing a linear response to varying threat intensities. We predicted: (1) the HFA/AS group would show differential activation (as opposed to merely deficits) of the social brain compared to controls and (2) that social brain areas would respond to varied intensity of fear in the control group, but not the HFA/AS group. Both predictions were confirmed. The controls showed greater activation in the left amygdala and left orbito-frontal cortex, while the HFA/AS group showed greater activation in the anterior cingulate gyrus and superior temporal cortex. The control group also showed varying responses in social brain areas to varying intensities of fearful expression, including differential activations in the left and right amygdala. This response in the social brain was absent in the HFA/AS group. HFA/AS are associated with different patterns of activation of social brain areas during fearful emotion processing, and the absence in the HFA/AS brain of a response to varying emotional intensity.     

Social cognition in schizophrenia: The role of mentalizing in moral dilemma decision-making

BackgroundPatients with schizophrenia have difficulties in several aspects of social cognition, e.g. emotion recognition and mentalizing. It is yet unclear if patients also show deficits in moral decision-making and whether the two aspects interact. Deficits in moral decision-making abilities might put patients in disadvantageous positions in every-day interactions.MethodTwenty-five patients with schizophrenia and twenty-five matched healthy controls participated in six moral dilemma tasks, a standard moral competency test and two mentalizing tasks. In addition, we assessed psychopathology and empathy abilities. In a brief intervention patients were asked to empathize with characters in the moral dilemmas. We expected that the decisions made by patients with schizophrenia would be more out-come-oriented, i.e. utilitarian, as compared to those made by healthy controls.ResultsPatients and healthy controls did not decide significantly differently on the moral dilemmas and patients showed normal moral competencies. Deficits in mentalizing in patients were replicated. Only in a regression analysis, however, we were able to show that PANSS positive scores and the Comic Strip task scores contributed to the moral decisions. Empathy training did not have an altering influence on decision-making.DiscussionAlthough an overlap between social cognition and moral decision-making networks has been proposed, deficits in moral decision-making and explicit associations with mentalizing were not present in patients. Psychopathology together with mentalizing abilities, however, contributed to decision-making in patients. Our findings suggest that in schizophrenia some aspects, e.g. mentalizing, are more strongly impaired while other aspects, e.g. moral decision-making, are preserved. Further research is needed to elucidate the different aspects forming social cognition and their mutual contributions, specifically in schizophrenia.     

Levels of emotional awareness and autism: an fMRI study

Autism is associated with an inability to identify and distinguish one's own feelings. We assessed this inability using alexithymia and empathy questionnaires, and used fMRI to investigate brain activity while introspecting on emotion. Individuals with high functioning autism/Asperger syndrome (HFA/AS) were compared with matched controls. Participants rated stimuli from the International Affective Picture System twice, once according to the degree of un/pleasantness that the pictures induced, and once according to their color balance. The groups differed significantly on both alexithymia and empathy questionnaires. Alexithymia and lack of empathy were correlated, indicating a link between understanding one's own and others' emotions. For both groups a strong relationship between questionnaire scores and brain activity was found in the anterior insula (AI), when participants were required to assess their feelings to unpleasant pictures. Regardless of self-reported degree of emotional awareness, individuals with HFA/AS differed from controls when required to introspect on their feelings by showing reduced activation in self-reflection/mentalizing regions. Thus, we conclude that difficulties in emotional awareness are related to hypoactivity in AI in both individuals with HFA/AS and controls, and that the particular difficulties in emotional awareness in individuals with HFA/AS are not related to their impairments in self-reflection/mentalizing.     

Levels of emotional awareness and autism: An fMRI study

Abstract

Autism is associated with an inability to identify and distinguish one's own feelings. We assessed this inability using alexithymia and empathy questionnaires, and used fMRI to investigate brain activity while introspecting on emotion. Individuals with high functioning autism/Asperger syndrome (HFA/AS) were compared with matched controls. Participants rated stimuli from the International Affective Picture System twice, once according to the degree of un/pleasantness that the pictures induced, and once according to their color balance. The groups differed significantly on both alexithymia and empathy questionnaires. Alexithymia and lack of empathy were correlated, indicating a link between understanding one's own and others’ emotions. For both groups a strong relationship between questionnaire scores and brain activity was found in the anterior insula (AI), when participants were required to assess their feelings to unpleasant pictures. Regardless of self-reported degree of emotional awareness, individuals with HFA/AS differed from controls when required to introspect on their feelings by showing reduced activation in self-reflection/mentalizing regions. Thus, we conclude that difficulties in emotional awareness are related to hypoactivity in AI in both individuals with HFA/AS and controls, and that the particular difficulties in emotional awareness in individuals with HFA/AS are not related to their impairments in self-reflection/mentalizing.     

Experimental Study on the Influence of Cognition and Emotion on Moral Judgment of College Students in Dilemma Situation

Objective: To study the influence of cognition and emotion on moral judgment of college students under the circumstance of whether the cognitive resources are occupied and whether the emotion is induced. Methods: This experiment uses a multi-factor mixed experiment method to divide experiments and groups. Experiment 1 uses a two-factor mixed experimental design of 2 (cognitive resource occupancy group, cognitive resource non-occupied group) × 3 (difficult situation type). Experiment 2 uses a two-factor mixed experimental design of 2 (emotion induction group, emotion induction and cognitive resource occupation group) × 3 (three types of dilemma situation types) is adopted. The dependent variable of this experiment (including Experiment 1 and Experiment 2) is the judgment response time and the judgment result is “Yes” (F) or “No” (J). Results: (1) The reaction time of the cognitive resource occupancy group was significantly higher than that of the cognitive resource non-occupied group, and the cognitive resource occupancy group in the three types of dilemma situations of high personal involvement, low personal involvement, and non-personal participation. There is no significant difference between the results of moral judgments and the cognitive resource non-occupied group. (2) In the three dilemmas of high personal involvement, low personal involvement, and non-personal participation, the emotion-induced group and the emotion-induced and cognitive resource occupation group have no significant differences in reaction time and moral judgment results. (3) In the three dilemmas of high personal involvement, low personal involvement, and non-personal participation, the reaction time difference between the cognitive resource occupation group and the emotionally induced and cognitive resource occupation is not significant, while In the dilemma of low personal involvement, the number of people in the cognitive resource occupation group whose moral judgment is “Yes” was significantly higher than that in the emotionally induced and cognitive resource occupation group. (4) In the three dilemmas of high personal involvement, low personal involvement, and non-personal participation, the reaction time of the emotionally induced group was significantly higher than that of the cognitive resource non-occupied group, and the moral judgment results of the two groups were both There is no significant difference. Conclusion: When the occupation of cognitive resources and the induction of emotions will signifi- cantly affect the response of individual moral judgments, different types of dilemmas will significantly affect the results of individual moral judgments.     

The Role of Causal and Intentional Judgments in Moral Reasoning in Individuals with High Functioning Autism

In the present study, we investigated the ability to assign moral responsibility and punishment in adults with high functioning autism or Asperger Syndrome (HFA/AS), using non-verbal cartoons depicting an aggression, an accidental harm or a mere coincidence. Participants were asked to evaluate the agent’s causal and intentional roles, his responsibility and the punishment he deserves for his action. Adults with HFA/AS did not differ in judgments of suffering and causality from adults with typical development. However, subtle difficulties with judgments of intentional action and moral judgments were observed in participants with HFA/AS. These results are discussed in the light of emerging studies that deal with integrity of moral reasoning in individuals with autism spectrum disorders.     

Superior nonverbal intelligence in children with high-functioning autism or Asperger's syndrome

Some early studies showed discordance in cognitive strengths and weaknesses in individuals with high-functioning autism (HFA) or Asperger's syndrome (AS). The present study administered the French version of Colored Raven's Progressive Matrices in 14 children with HFA/AS and in 26 chronological age matched peers with typical development. We found a trend of superior nonverbal performance in Raven's Test in our HFA/AS participants compared to controls, and this “superiority” achieved statistical significance in the HFA/AS subgroup with a FIQ ≥ 90. Superior fluid intelligence seemed to exist in individuals both with HFA and with AS. A complementary use of both the Raven's Test and the Wechsler Intelligence Scales seems to be important for exploring the domain-specific as well as multidimensional profiles in individuals with autism.     

Moral dilemmas in cognitive neuroscience of moral decision-making: a principled review

Moral dilemma tasks have been a much appreciated experimental paradigm in empirical studies on moral cognition for decades and have, more recently, also become a preferred paradigm in the field of cognitive neuroscience of moral decision-making. Yet, studies using moral dilemmas suffer from two main shortcomings: they lack methodological homogeneity which impedes reliable comparisons of results across studies, thus making a metaanalysis manifestly impossible; and second, they overlook control of relevant design parameters. In this paper, we review from a principled standpoint the studies that use moral dilemmas to approach the psychology of moral judgment and its neural underpinnings. We present a systematic review of 19 experimental design parameters that can be identified in moral dilemmas. Accordingly, our analysis establishes a methodological basis for the required homogeneity between studies and suggests the consideration of experimental aspects that have not yet received much attention despite their relevance.     

Cognitive variability in adults with ADHD and AS: Disentangling the roles of executive functions and social cognition

Attention-deficit/hyperactivity disorder (ADHD) and Asperger's Syndrome (AS) share a heterogeneous cognitive profile. Studies assessing executive functions (EF) and social cognition in both groups have found preserved and impaired performances. These inconsistent findings would be partially explained by the cognitive variability reported in these disorders. First, the present study explored the inter-individual variability in EF and social cognition in both patient groups. Second, we compared differential characteristics and commonalities in the cognitive profiles of EF and social cognition between ADHD, AS and control adults. We assessed 22 patients with ADHD, 23 adults with AS and 21 matched typically developing subjects using different measures of EF (working memory, cognitive flexibility and multitasking) and social cognition (theory of mind and decision-making). Group comparisons and multiple case series analyses (MCSA) were conducted. The between-group comparisons showed an EF deficit in working memory in ADHD and a theory of mind (ToM) impairment in AS. The MCSA evidenced that, compared to controls, ADHD patients had a higher inter-individual variability in EF, while individuals with AS had a more heterogeneous profile in social cognition tasks compared to both groups. Finally, the AS and ADHD groups presented higher task-related variability compared to controls and shared a common heterogeneous profile in EF. This is the first study to compare variability in EF and social cognition profiles of ADHD and AS. We propose that heterogeneity in EF performance is a link between ADHD and AS which may explain the overlap of symptomatology between both diagnoses. In addition, patients with AS seem to show a unique heterogeneous profile in ToM which may explain the low probability of finding AS symptoms in patients with ADHD.     

Hot utilitarianism and cold deontology: Insights from a response patterns approach to sacrificial and real world dilemmas

Research on moral judgment with moral dilemmas suggests that “utilitarian” responses (UR) to sacrificial high-conflict dilemmas are due to decreased harm aversion, not only in individuals with clinical conditions, but also in healthy participants with high scores in antisocial personality traits. We investigated the patterns of responses to different dilemma types in healthy participants and present evidence that some URs to sacrificial dilemmas are morally motivated, as indicated by their empathic concern (EC) or primary psychopathy (PP) scores. In study 1 (N = 230) we tested students with four categories of sacrificial dilemmas featuring innocent victims. In study 2 (N = 590) we tested students with two categories of sacrificial dilemmas and two “real-world” moral dilemmas, where the agent can improve the lot of strangers by making a personal sacrifice. Results in both studies showed no decreased harm aversion in a pattern where the only UR is to the sacrificial dilemma where the number of saved people is very high, and significantly lower harm aversion only in the pattern of all-deontological respondents in Study 2. The analysis by response patterns allowed a better discrimination of the moral motivations of participants and showed that at least some of them express moral concerns in their URs.     

Individual differences in moral judgment competence influence neural correlates of socio-normative judgments

To investigate how individual differences in moral judgmentcompetence are reflected in the human brain, we used event-relatedfunctional magnetic resonance imaging, while 23 participantsmade either socio-normative or grammatical judgments. Participantswith lower moral judgment competence recruited the left ventromedialprefrontal cortex and the left posterior superior temporal sulcusmore than participants with greater competence in this domainwhen identifying social norm violations. Moreover, moral judgmentcompetence scores were inversely correlated with activity inthe right dorsolateral prefrontal cortex (DLPFC) during socio-normativerelative to grammatical judgments. Greater activity in rightDLPFC in participants with lower moral judgment competence indicatesincreased recruitment of rule-based knowledge and its controlledapplication during socio-normative judgments. These data supportcurrent models of the neurocognition of morality according towhich both emotional and cognitive components play an importantrole.     

The neural basis of intuitive and counterintuitive moral judgment

Neuroimaging studies on moral decision-making have thus far largely focused on differences between moral judgments with opposing utilitarian (well-being maximizing) and deontological (duty-based) content. However, these studies have investigated moral dilemmas involving extreme situations, and did not control for two distinct dimensions of moral judgment: whether or not it is intuitive (immediately compelling to most people) and whether it is utilitarian or deontological in content. By contrasting dilemmas where utilitarian judgments are counterintuitive with dilemmas in which they are intuitive, we were able to use functional magnetic resonance imaging to identify the neural correlates of intuitive and counterintuitive judgments across a range of moral situations. Irrespective of content (utilitarian/deontological), counterintuitive moral judgments were associated with greater difficulty and with activation in the rostral anterior cingulate cortex, suggesting that such judgments may involve emotional conflict; intuitive judgments were linked to activation in the visual and premotor cortex. In addition, we obtained evidence that neural differences in moral judgment in such dilemmas are largely due to whether they are intuitive and not, as previously assumed, to differences between utilitarian and deontological judgments. Our findings therefore do not support theories that have generally associated utilitarian and deontological judgments with distinct neural systems.     

Stress alters personal moral decision making

While early studies of moral decision making highlighted the role of rational, conscious executive processes involving frontal lobe activation more recent work has suggested that emotions and gut reactions have a key part to play in moral reasoning. Given that stress can activate many of the same brain regions that are important for and connected to brain centres involved in emotional processing we sought to evaluate if stress could influence moral decision making. Sixty-five undergraduate volunteers were randomly assigned to control (n=33) and experimental groups (n=32). The latter underwent the Trier Social Stress Test (TSST) and induction of stress was assessed by measurement of salivary cortisol levels. Subjects were then required to provide a response to thirty moral dilemmas via a computer interface that recorded both their decision and reaction time. Three types of dilemmas were used: non-moral, impersonal moral and personal moral. Using a binary logistic model there were no significant predicators of utilitarian response in non-moral and impersonal moral dilemmas. However the stressed group and females were found to predict utilitarian responses to personal moral dilemmas. When comparing percentage utilitarian responses there were no significant differences noted for the non-moral and impersonal moral dilemmas but the stressed group showed significantly less utilitarian responses compared to control subjects. The stress response was significantly negatively correlated with utilitarian responses. Females also showed significantly less utilitarian responses than males. We conclude that activation of the stress response predisposed participants to less utilitarian responses when faced with high conflict personal moral dilemmas and suggest that this offers further support for dual process theory of moral judgment. We also conclude that females tend to make less utilitarian personal moral decisions compared to males, providing further evidence that there are gender differences in moral reasoning.     

Social Competence Intervention for Youth with Asperger Syndrome and High-functioning Autism: An Initial Investigation

Individuals with high functioning autism (HFA) or Asperger Syndrome (AS) exhibit difficulties in the knowledge or correct performance of social skills. This subgroup’s social difficulties appear to be associated with deficits in three social cognition processes: theory of mind, emotion recognition and executive functioning. The current study outlines the development and initial administration of the group-based Social Competence Intervention (SCI), which targeted these deficits using cognitive behavioral principles. Across 27 students age 11–14 with a HFA/AS diagnosis, results indicated significant improvement on parent reports of social skills and executive functioning. Participants evidenced significant growth on direct assessments measuring facial expression recognition, theory of mind and problem solving. SCI appears promising, however, larger samples and application in naturalistic settings are warranted.     

Disrupting the right prefrontal cortex alters moral judgement

Humans daily face social situations involving conflicts between competing moral decision. Despite a substantial amount of studies published over the past 10 years, the respective role of emotions and reason, their possible interaction, and their behavioural expression during moral evaluation remains an unresolved issue. A dualistic approach to moral evaluation proposes that the right dorsolateral prefrontal cortex (rDLPFc) controls emotional impulses. However, recent findings raise the possibility that the right DLPFc processes emotional information during moral decision making. We used repetitive transcranial magnetic stimulation (rTMS) to transiently disrupt rDLPFc activity before measuring decision making in the context of moral dilemmas. Results reveal an increase of the probability of utilitarian responses during objective evaluation of moral dilemmas in the rTMS group (compared to a SHAM one). This suggests that the right DLPFc function not only participates to a rational cognitive control process, but also integrates emotions generated by contextual information appraisal, which are decisive for response selection in moral judgements.     

The 'amygdala theory of autism' revisited: linking structure to behavior

The 'amygdala theory of autism' suggests a crucial role for the amygdala in the neurobiological basis of autism spectrum disorders. However, to date evidence is lacking of a direct relationship between amygdala measures and behavioral manifestations of autism in affected individuals. In 17 adult individuals with Asperger syndrome (AS) and 17 well-matched controls we therefore assessed associations between MRI-derived amygdala volume and behavioral variables of emotion recognition and social cognition, as well as with core AS symptomatology. Results revealed that individuals with AS exhibited impairments in emotion recognition and social cognition compared to controls and also showed atypical relationships between amygdala volumes and overall head size. We found positive associations between emotional and social understanding and amygdala volume in the control group, but not in the AS group. In the AS group however, amygdala size was negatively related to diagnostic parameters, with smaller amygdala volumes involving higher levels of restricted-repetitive behavior domains. Our data seem to indicate that in AS the amygdala is not crucially involved in social and emotional understanding. It may, however, be a mediator for narrow interest patterns and the imposition of routines and rituals. Our data, in conjunction with current literature, seem to argue for a modification of the 'amygdala theory of autism'.     

A preliminary fMRI study of moral judgment task in high functioning autistic children

Autistic patients show social cognitive disorders and hardly recognize their situations. This means it is difficult for them to obey rules or conform to customs. Humans have social intelligence thought to be related to a network connected to amygdala, the orbito-frontal cortex, and the superior temporal gyrus. It has been reported that normal participants judged morality in dilemma sentences through which the medial orbito-frontal cortex and the right lateral prefrontal cortex were activated. However, where autism is concerned, there has been no fMRI study during the moral judgment task. The study herein showed changes of autistic brain areas related to moral judgment. This study included one high-functioning autistic child, one Asperger's syndrome child, and three normal children. Pictures of social situations were painted and the children present were asked to judge whether the contents were moral or immoral. The results of fMRI demonstrated the orbito-frontal cortex was active in normal children but not active in the autistic children with regard to moral judgment. This suggested autistic people have functional disorders in this area. BA11 and BA22 were activated in the control group and these areas are thought to be related to sociality and "theory of mind". Furthermore, BA38 was activated in one control and this area is also related to "theory of mind" and emotions. Moral judgments about personal affairs activate brain areas related to emotions (bilateral medial frontal gyri, bilateral cingulated gyri and bilateral angular gyri) and moral judgments about public affairs activate brain areas related to working memory (left medial frontal gyrus and bilateral temporal cortices). Based on the results above, we think moral judgment is related to "theory of mind" and social cognition, and shares a common sense processing mechanism. Recently Greene et al. reported that the prefrontal cortex was active during moral judgment in an fMRI study of normally developed people. Their result reinforces our results.     

Are ‘counter-intuitive’ deontological judgments really counter-intuitive? An empirical reply to

A substantial body of evidence indicates that utilitarian judgments (favoring the greater good) made in response to difficult moral dilemmas are preferentially supported by controlled, reflective processes, whereas deontological judgments (favoring rights/duties) in such cases are preferentially supported by automatic, intuitive processes. A recent neuroimaging study by Kahane et al. challenges this claim, using a new set of moral dilemmas that allegedly reverse the previously observed association. We report on a study in which we both induced and measured reflective responding to one of Greene et al.’s original dilemmas and one of Kahane et al.’s new dilemmas. For the original dilemma, induced reflection led to more utilitarian responding, replicating previous findings using the same methods. There was no overall effect of induced reflection for the new dilemma. However, for both dilemmas, the degree to which an individual engaged in prior reflection predicted the subsequent degree of utilitarian responding, with more reflective subjects providing more utilitarian judgments. These results cast doubt on Kahane et al.’s conclusions and buttress the original claim linking controlled, reflective processes to utilitarian judgment and automatic, intuitive processes to deontological judgment. Importantly, these results also speak to the generality of the underlying theory, indicating that what holds for cases involving utilitarian physical harms also holds for cases involving utilitarian lies.     

Social Anxiety in High-functioning Children and Adolescents with Autism and Asperger Syndrome

We examined social anxiety and internalizing symptoms using the Social Phobia and Anxiety Inventory for Children (SPAI-C), the Social Anxiety Scale for Children -Revised (SASC-R), and the Child Behavior Checklist (CBCL) in a sample of fifty-four high-functioning subjects with autism or Asperger syndrome (HFA/AS) (M = 11.2 ± 1.7 years) and 305 community subjects (M = 12.2 ± 2.2 years). Children and adolescents completed the SPAI-C and SASC-R, and their parents completed the CBCL Internalizing scale. Adolescents with HFA/AS scored higher than the community sample on all measures. Behavioural avoidance and evaluative social anxiety increased by age within the HFA/AS group, whereas behavioural avoidance decreased by age in control participants. Data support that HFA/AS in adolescents may be associated with clinically relevant social anxiety symptoms.