Preserved intention understanding during moral judgments in schizophrenia.

Lisa Kronbichler,Wolfgang Aichhorn,Brandy-Gale Pearce,Martin Kronbichler,Renate Stelzig-Schöler,Melanie Lenger,Luise-Antonia Reich,Stefanie Weber,Peter John Mckenna

doi:10.1371/journal.pone.0251180

Abstract

Although there is convincing evidence for socio-cognitive impairments in schizophrenia spectrum disorder (SSD), little evidence is found for deficient moral cognition. We investigated whether patients with SSD showed altered moral judgments in a story task where the protagonist either had a neutral or malicious intention towards another person. This paradigm examined whether SSD relates to altered moral cognition in general or specifically to impaired integration of prior information (such as beliefs) in moral judgments. 23 patients and 32 healthy controls read vignettes created in a 2 x 2 design. The protagonist in each story either had a neutral or negative intention towards another person which, as a result, either died (negative outcome) or did not die (neutral outcome). Participants rated the moral permissibility of the protagonist's action. Standard null hypothesis significance testing and equivalent Bayes analyses are reported. Schizophrenia patients did not differ significantly in permissibility ratings from healthy controls. This finding was supported by the Bayes analyses which favoured the null hypothesis. Task performance was not related to symptom severity or medication. The current findings do not support the notion that moral judgments are deficient in schizophrenia. Furthermore, the current study shows that patients do not have observable difficulties in integrating the protagonist's belief in the rating of the moral permissibility of the action-outcome.

Highlights

There is convincing evidence for socio-cognitive impairments in schizophrenia spectrum disorder (SSD), little evidence is found for deficient moral cognition
The current findings do not support the notion that moral judgments are deficient in schizophrenia
The current study shows that patients do not have observable difficulties in integrating the protagonist’s belief in the rating of the moral permissibility of the action-outcome

Summary

Introduction

There is convincing evidence for socio-cognitive impairments in schizophrenia spectrum disorder (SSD), little evidence is found for deficient moral cognition. We investigated whether patients with SSD showed altered moral judgments in a story task where the protagonist either had a neutral or malicious intention towards another person. This paradigm examined whether SSD relates to altered moral cognition in general or to impaired integration of prior information (such as beliefs) in moral judgments. Moral cognition describes the thinking about (culture-specific) sets of values and behavior that guide socially accepted manners. It is reflected in research on for example harm and pro- or antisocial behavior [8,9]. Moral cognition is related to activation in regions that are involved in ToM processes such as TPJ, PFC and precuneus, and the orbitofrontal cortex and the amygdala [10,11]

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Conclusion