Peng Xing, Ding Yu-Shen, Ren Bo, Zhao Xi-Xi, Wang Fei-Fei, Zhao Jie, Zhang Yuan-Yuan, Zhang Xiu-Jun, Zhou Fu-Chun, Wang Chuan-Yue
School of Public Health, North China University of Science and Technology, Tangshan, China.
Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.
Front Psychiatry. 2024 Sep 30;15:1432407. doi: 10.3389/fpsyt.2024.1432407. eCollection 2024.
The aim of this study was to investigate whether a potential moral cognitive impairment (failure in understanding moral rules) exists in patients with schizophrenia (SCZ) and to explore the effect of childhood trauma (CT) on moral cognition in a group of patients with SCZ.
A total of 99 patients with SCZ and 102 healthy controls (HCs) were included in this study. The Childhood Trauma Questionnaire-Short Form (CTQ) was administered to assess childhood trauma experiences in both groups, while the Moral Identity Measure (MIM) and the Moral Foundations Questionnaire (MFQ) were applied for a comparative evaluation of moral cognition across the two groups. The Positive and Negative Syndrome Scale (PANSS) was administered to assess the psychopathology.
Patients with schizophrenia had significantly greater CTQ scores than HCs (42.77 ± 13.50 vs. 29.11 ± 4.25, =9.697, <0.001). The prevalence of childhood trauma ( = 58.452, <0.001) and history of aggressive behaviors ( = 23.565, =0.001) among patients with SCZ were greater than that among HCs. In addition, the scores of moral cognition (MIM: 61.82 ± 15.12 vs. 70.88 ± 8.87, =0.001; MFQ: 87.24 ± 22.30 vs. 112.62 ± 23.42, =0.045) in the SCZ group was lower than that in the HC group after controlling for the influence of CT covariates. The MFQ score was negatively correlated with the CTQ score, the emotional abuse (EA) score, the physical abuse (PA) score and the physical neglect (PN) score in SCZ patients. Among HCs, the MFQ score was positively correlated with the CTQ score, as well as with the dimensions of physical abuse (PA) and emotional Neglect (EN). Multiple linear regression analyses revealed that impaired moral cognition performance was significantly predicted by the CTQ score (=-0.235, =0.034, 95% CI -0.743 to -0.031) in patients with SCZ but was significantly predicted by years of education (=-0.392, <0.001, 95% CI -4.783 to -1.876), alcohol use (=0.210, =0.023, 95% CI 2.191 to 29.399) and the CTQ score (=0.184, =0.046, 95% CI 0.019 to 1.928) in HCs. CTQ moderated the effect of SCZ on MFQ ( = 0.516); Simple tests revealed that the group effect on the MFQ was =12.306 at the lower level(-1SD) and = 54.089 at the higher level(+1SD) of the CTQ scores.
SCZ patients exhibit impaired moral cognition. The contribution of CT to the presence of moral cognitive impairments seems to be independent of psychopathology.
本研究旨在调查精神分裂症（SCZ）患者是否存在潜在的道德认知障碍（无法理解道德规则），并探讨童年创伤（CT）对一组SCZ患者道德认知的影响。
本研究共纳入99例SCZ患者和102名健康对照者（HCs）。采用儿童创伤问卷简表（CTQ）评估两组的童年创伤经历，同时应用道德认同量表（MIM）和道德基础问卷（MFQ）对两组的道德认知进行比较评估。采用阳性和阴性症状量表（PANSS）评估精神病理学。
SCZ患者的CTQ评分显著高于HCs（42.77±13.50 vs. 29.11±4.25，t=9.697，P<0.001）。SCZ患者童年创伤的患病率（χ²=58.452，P<0.001）和攻击行为史（χ²=23.565，P=0.001）高于HCs。此外，在控制CT协变量的影响后，SCZ组的道德认知得分（MIM：61.82±15.12 vs. 70.88±8.87，t=0.001；MFQ：87.24±22.30 vs. 112.62±23.42，t=0.045）低于HC组。SCZ患者的MFQ评分与CTQ评分、情感虐待（EA）评分、身体虐待（PA）评分和身体忽视（PN）评分呈负相关。在HCs中，MFQ评分与CTQ评分以及身体虐待（PA）和情感忽视（EN）维度呈正相关。多元线性回归分析显示，CTQ评分（β=-0.235，P=0.034，95%CI -0.743至-0.031）显著预测了SCZ患者的道德认知表现受损，但在HCs中，受教育年限（β=-0.392，P<0.001，95%CI -4.783至-1.
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