Judgment of moral and social transgression in schizophrenia

McGuire, Jonathan; Brüne, Martin; Langdon, Robyn

doi:10.1016/j.comppsych.2017.04.008

Cited by 11 publications

(12 citation statements)

References 44 publications

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“…Assuming that there exists a true alteration in moral judgments in SSD, the current data might be explained by either a task insensitivity to detect subtle changes or that alterations in moral judgment become evident only later in the course of illness or merely occur in more severe forms of SSD. However, neither symptom severity (rs(26) < .127, ps > .521) nor illness duration (rs(26) < .336, ps > .100) were related to task performance in our sample and currently available studies on moral judgment in SSD suggest a rather subtle dysfunction even in more severe forms of SSD [21,52].…”

Section: Plos Onecontrasting

confidence: 80%

Preserved intention understanding during moral judgments in schizophrenia

et al. 2021

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Introduction 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. Methods 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. Results 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. Conclusions 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.

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Section: Plos Onecontrasting

confidence: 80%

Preserved intention understanding during moral judgments in schizophrenia

et al. 2021

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Section: Introductionmentioning

confidence: 99%

“…In addition to the psychotic symptoms and moral cognitions, the cognitive impairment experienced by many patients with schizophrenia may also play a role in impairing patients’ capacity to make sound judgments regarding moral behaviour when actively psychotic [55–57]. There may also be patients who are so cognitively impaired that they are incapable of moral reasoning [48, 57]. Because we have shown that moral cognition is relevant to acts of serious violence committed by forensic patients [12], and because of the possible association between psychotic symptoms and moral cognition at the time of the offence, we sought to explore moral cognition as a mediating factor for psychotic symptoms and violence.…”

Section: Introductionmentioning

confidence: 99%

Moral cognition, the missing link between psychotic symptoms and acts of violence: a cross-sectional national forensic cohort study

et al. 2019

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BackgroundPeople with schizophrenia are ten times more likely to commit homicide than a member of the general population. The relationship between symptoms of schizophrenia and acts of violence is unclear. There has also been limited research on what determines the seriousness and form of violence, such as reactive or instrumental violence. Moral cognition may play a paradoxical role in acts of violence for people with schizophrenia. Thoughts which have moral content arising from psychotic symptoms may be a cause of serious violence.MethodWe investigated if psychotic symptoms and moral cognitions at the time of a violent act were associated with acts of violence using a cross-sectional national forensic cohort (n = 55). We examined whether moral cognitions were associated with violence when controlling for neurocognition and violence proneness. We explored the association between all psychotic symptoms present at the time of the violent act, psychotic symptoms judged relevant to the violent act and moral cognitions present at that time. Using mediation analysis, we examined whether moral cognitions were the missing link between symptoms and the relevance of symptoms for violence. We also investigated if specific moral cognitions mediated the relationship between specific psychotic symptoms, the seriousness of violence (including homicide), and the form of violence.ResultsPsychotic symptoms generally were not associated with the seriousness or form of violence. However, specific moral cognitions were associated with the seriousness and form of violence even when controlling for neurocognition and violence proneness. Specific moral cognitions were associated with specific psychotic symptoms present and relevant to violence. Moral cognitions mediated the relationship between the presence of specific psychotic symptoms and their relevance for violence, homicide, seriousness of violence, and the form of violence.ConclusionsMoral cognitions including the need to reduce suffering, responding to an act of injustice or betrayal, the desire to comply with authority, or the wish to punish impure or disgusting behaviour, may be a key mediator explaining the relationship between psychotic symptoms and acts of violence. Our findings may have important implications for risk assessment, treatment and violence prevention.

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“…Moral cognition is a multidimensional process, driven by moral reasoning, moral judgement, and decision-making, that influence a person’s behavior [ 15 ]. Moral cognition, which focuses on thinking processes, is actionable in schizophrenia, and it can be widely upheld under conditions of reasonable moral pluralism across different cultures, traditions and rules [ 16 , 17 , 18 ]. Moral reasoning determines whether a behavior is morally acceptable (right or wrong) [ 19 ] and plays a paradoxical role in schizophrenia [ 16 , 17 , 18 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of Integrated Moral Reasoning Development Intervention for Management of Violence in Schizophrenia: A Randomized Controlled Trial

Hsu

Ouyang

2022

JCM

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Moral cognition is an important and multidimensional, but often overlooked, determinant of violence. Very few interventions have systematically examined the role of moral reasoning, anger management and problem-solving together in violence. A randomized controlled trial was conducted to comprehensively evaluate the sustained effects of an integrated Moral Reasoning Development Intervention (MRDI) in the management of repetitive violence in schizophrenia. This study placed special emphasis on essential components related to moral reasoning and violence in patients with schizophrenia. Evaluations, including measures of violence, moral reasoning, ethical valuation and judgement, decision-making, conflict management style, and personality traits, were performed at baseline, end of intervention, and 1-month follow-up after intervention. We found that MRDI was superior to treatment-as-usual, in improving moral reasoning and related variables and violence outcomes (p < 0.05). In comparison with the treatment-as-usual group (n = 22), patients in the MRDI group (n = 21) showed improved levels of moral reasoning, with decreased levels of violent behaviors. The MRDI participants also experienced significantly greater improvements or changes (p < 0.05) in their ethical valuation and judgement, decision-making style and preferences, and conflict management style. Our findings provide important implications for risk assessment and violence management and prevention.

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Judgment of moral and social transgression in schizophrenia

Cited by 11 publications

References 44 publications

Preserved intention understanding during moral judgments in schizophrenia

Preserved intention understanding during moral judgments in schizophrenia

Moral cognition, the missing link between psychotic symptoms and acts of violence: a cross-sectional national forensic cohort study

Effects of Integrated Moral Reasoning Development Intervention for Management of Violence in Schizophrenia: A Randomized Controlled Trial

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