McGuire Jonathan, Brüne Martin, Langdon Robyn
Department of Cognitive Science and ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, NSW 2109, Australia.
LWL University Hospital, Ruhr University Bochum Clinic for Psychiatry, Psychotherapy and Preventive Medicine, Alexandrinenstrasse 1-3, D-44791 Bochum.
Compr Psychiatry. 2017 Jul;76:160-168. doi: 10.1016/j.comppsych.2017.04.008. Epub 2017 May 4.
Despite evidence of pervasive social-cognitive deficits in schizophrenia, little is known of moral cognition in this population. While recent research indicates that impairment of explicit moral reasoning is explained by these individuals' other cognitive deficits, their capacities for basic moral judgment are unknown.
45 people with schizophrenia and 27 healthy controls completed the Moral-Conventional Distinction Task: a classic task that assesses judgment of violations of moral or social convention on permissibility, severity, and authority-contingence. Justifications of judgments were also probed. Basic cognition was indexed by measures of IQ, verbal memory, and information processing speed. Self-report inventories were used to assess different facets of 'empathy' (e.g., perspective-taking, or theory of mind, and empathic concern), and aggressive tendencies.
Groups did not differ significantly in judgments of permissibility or authority-contingency, or justifications of judgments. Patients did, however, rate violations of social (but not moral) convention more harshly. They also took longer to judge impermissibility of moral (but nor social) transgressions. Slower moral judgment in patients was associated with lower levels of self-reported empathic concern, while harsher condemnation of social transgression was associated with poorer (self-reported) perspective-taking.
Findings provide no evidence that moral judgment is fundamentally compromised in schizophrenia. Evidence of slower moral judgment in schizophrenia does suggest, however, that patients were less influenced by automatic aversive responses to amoral conduct. The association found between poorer (self-reported) perspective-taking and greater condemnation of social transgressions also suggests that an insensitivity to others' extenuating motives may exacerbate social misunderstandings in schizophrenia.
尽管有证据表明精神分裂症患者普遍存在社会认知缺陷，但对于该群体的道德认知却知之甚少。虽然最近的研究表明，这些个体明确的道德推理受损可由其他认知缺陷来解释，但其基本道德判断能力尚不清楚。
45名精神分裂症患者和27名健康对照者完成了道德-习俗区分任务：这是一项经典任务，用于评估对违反道德或社会习俗行为在可允许性、严重性和权威依赖性方面的判断。同时也探究了判断的理由。通过智商、言语记忆和信息处理速度等指标来衡量基本认知。使用自我报告量表评估“同理心”的不同方面（例如，观点采择或心理理论，以及共情关注）和攻击倾向。
两组在可允许性判断、权威依赖性判断或判断理由方面没有显著差异。然而，患者对违反社会（而非道德）习俗行为的评分更为严厉。他们判断道德（而非社会）违规行为不可允许的时间也更长。患者较慢的道德判断与较低水平的自我报告共情关注相关，而对社会违规行为更严厉的谴责与较差的（自我报告）观点采择相关。
研究结果没有提供证据表明精神分裂症患者的道德判断存在根本缺陷。然而，精神分裂症患者道德判断较慢的证据确实表明，患者较少受到对不道德行为的自动厌恶反应的影响。自我报告的较差观点采择与对社会违规行为更强烈谴责之间的关联还表明，对他人情有可原动机的不敏感可能会加剧精神分裂症患者的社会误解。
