Nazarov Anthony, Walaszczyk Victoria, Frewen Paul, Oremus Carolina, Lanius Ruth, McKinnon Margaret C
Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.
Eur J Psychotraumatol. 2016 Nov 8;7:31028. doi: 10.3402/ejpt.v7.31028. eCollection 2016.
Preliminary evidence suggests that relative to healthy controls, patients with posttraumatic stress disorder (PTSD) show deficits on several inter-related social cognitive tasks, including theory of mind, and emotion comprehension. Systematic investigations examining other aspects of social cognition, including moral reasoning, have not been conducted in PTSD stemming from childhood trauma.
To conduct a comprehensive assessment of moral reasoning performance in individuals with PTSD stemming from childhood abuse.
Moral reasoning performance was assessed in 28 women with PTSD related to prolonged childhood trauma and 19 matched healthy controls. Performance was assessed using 12 modified moral dilemmas and was queried in three domains: utilitarian/deontological sacrificial dilemmas (personal and impersonal), social order vs. compassion, and altruism vs. self-interest. Participants were asked whether a proposed action was morally acceptable or unacceptable and whether or not they would perform this action under the circumstances described.
Women with PTSD were less likely to carry out utilitarian actions in personal, sacrificial moral dilemmas, a choice driven primarily by consequential intrapersonal disapproval. Increased concern regarding intrapersonal disapproval was related to higher symptoms of guilt in the PTSD group. Patients with PTSD demonstrated less altruistic moral reasoning, primarily associated with decreased empathic role-taking for beneficiaries.
Women with PTSD due to childhood trauma show alterations in moral reasoning marked by decreased utilitarian judgment and decreased altruism. Childhood trauma may continue to impact moral choices made into adulthood.
初步证据表明，与健康对照组相比，创伤后应激障碍（PTSD）患者在一些相互关联的社会认知任务上存在缺陷，包括心理理论和情绪理解。尚未对童年创伤所致PTSD患者的社会认知其他方面（包括道德推理）进行系统研究。
全面评估童年期受虐所致PTSD患者的道德推理表现。
对28名与童年长期创伤相关的PTSD女性患者和19名匹配的健康对照者进行道德推理表现评估。使用12个修改后的道德困境对表现进行评估，并在三个领域进行询问：功利主义/道义论的牺牲困境（个人和非个人的）、社会秩序与同情心、利他主义与自身利益。参与者被问及提议的行为在道德上是否可接受，以及在所述情况下他们是否会实施该行为。
患有PTSD的女性在个人牺牲道德困境中实施功利主义行为的可能性较小，这一选择主要由结果性的个人内反对驱动。PTSD组中对个人内反对的关注度增加与更高的内疚症状相关。PTSD患者表现出较少的利他主义道德推理，主要与对受益者的移情角色采择减少有关。
童年创伤所致PTSD女性患者的道德推理存在改变，表现为功利主义判断减少和利他主义减少。童年创伤可能会持续影响到成年后的道德选择。
