Moral competence and brain connectivity: A resting-state fMRI study

Predictive cues elicit a liminal confirmation bias in the moral evaluation of real-world images

Previous research suggested that predictive cues enhance the preference and reduce the response time for congruent targets during bivalent food evaluation, indicating a confirmation bias. Less is known about how prior processing affects subjective moral evaluation. Here, we used three different types of predictive cues to elicit directional vs. non-predictive prior processing and then asked the participants to perform moral evaluations on a continuous scale from -10 ("very immoral") to +10 ("very moral") with a diverse set of real-world images. Our experimental image database balanced the morality of image content and the volatility of the ratings based on the means and standard deviations in a preliminary study. Ratings, response times, and gaze positions were measured to examine the effects of predictive cues on the moral evaluation of real-world images. We found that the moral ratings were in line with the expectations induced by the cues. Compared to the non-predictive condition, the moral evaluation in the directional conditions was more polarized. For neutral images, the predictive cues tilted the evaluations to positive vs. negative, indicating a decisive liminal influence. High-volatility images were impacted more than low-volatility images in ratings as well as response times. Furthermore, the gaze positions during the interval between the predictive cue and the image showed a spatial displacement in line with the cue instruction, indicating a response bias. Together, the results show that predictive cues elicit a liminal confirmation bias in moral image evaluation, much in the same way as in bivalent food evaluation.

Parcellation-Based Connectivity Model of the Judgement Core

Judgement is a higher-order brain function utilized in the evaluation process of problem solving. However, heterogeneity in the task methodology based on the many definitions of judgement and its expansive and nuanced applications have prevented the identification of a unified cortical model at a level of granularity necessary for clinical translation. Forty-six task-based fMRI studies were used to generate activation-likelihood estimations (ALE) across moral, social, risky, and interpersonal judgement paradigms. Cortical parcellations overlapping these ALEs were used to delineate patterns in neurocognitive network engagement for the four judgement tasks. Moral judgement involved the bilateral superior frontal gyri, right temporal gyri, and left parietal lobe. Social judgement demonstrated a left-dominant frontoparietal network with engagement of right-sided temporal limbic regions. Moral and social judgement tasks evoked mutual engagement of the bilateral DMN. Both interpersonal and risk judgement were shown to involve a right-sided frontoparietal network with accompanying engagement of the left insular cortex, converging at the right-sided CEN. Cortical activation in normophysiological judgement function followed two separable patterns involving the large-scale neurocognitive networks. Specifically, the DMN was found to subserve judgement centered around social inferences and moral cognition, while the CEN subserved tasks involving probabilistic reasoning, risk estimation, and strategic contemplation.

Systematic Review of Gaming and Neuropsychological Assessment of Social Cognition

Playing video games is associated with cognitive changes and possibly psychosocial difficulties. Problematic gaming occurs upon the loss of control over videogame playing; gaming disorder is considered a behavioral addiction in the 11th version of the International Classification of Diseases. Models used to understand behavioral addictions include cognition as an essential factor in the development, maintenance, and relapse of addiction. Nevertheless, some aspects of cognition, such as social cognition, remain underexplored, despite evidence of alterations in cognitive and social function among patients with problematic gaming. This review aimed to describe the current understanding of social cognition in individuals exposed to videogames. We included all studies assessing social cognition in participants of any age with a wide range of exposure to video games (from simple use of video games (such as at least two exposures) to problematic gaming, defined according to the included study). This wide range of exposure allowed us to explore the whole process from repeated exposure to addiction. We included only studies that used neuropsychological tasks to assess social cognition. Patient-reported outcomes that could be biased by subjective self-report data were not included. The search was conducted from inception to January 2022 in three databases (PubMed, PsycINFO, and Web of Science). The systematic search identified 39 studies that assessed facial emotion processing, empathy, theory of mind, social decision-making, aggressive behavior, and moral competence. In general, results have been mixed, and a number of questions remain unanswered. Nevertheless, several studies showed cerebral changes when processing facial emotion that were linked with problematic gaming, while no link was obtained between nonproblematic gaming and empathy alterations. The influences of cooperation patterns, theory of mind, moral competence, and gaming frequency were highlighted. Finally, there was substantial heterogeneity in the population assessed and the methods used.

Emotional descriptions increase accidental harm punishment and its cortico-limbic signatures during moral judgment in autism

Individuals with autism spectrum disorder (ASD) present difficulties in integrating mental state information in complex moral tasks. Yet, ASD research has not examined whether this process is influenced by emotions, let alone while capturing its neural bases. We investigated how language-induced emotions modulate intent-based moral judgment in ASD. In a fMRI task, 30 adults with ASD and 27 neurotypical controls read vignettes whose protagonists commit harm either accidentally or intentionally, and then decided how much punishment the protagonist deserved. Emotional content was manipulated across scenarios through the use of graphic language (designed to trigger arousing negative responses) vs. plain (just-the-facts, emotionless) language. Off-line functional connectivity correlates of task performance were also analyzed. In ASD, emotional (graphic) descriptions amplified punishment ratings of accidental harms, associated with increased activity in fronto-temporo-limbic, precentral, and postcentral/supramarginal regions (critical for emotional and empathic processes), and reduced connectivity among the orbitofrontal cortex and the angular gyrus (involved in mentalizing). Language manipulation did not influence intentional harm processing in ASD. In conclusion, in arousing and ambiguous social situations that lack intentionality clues (i.e. graphic accidental harm scenarios), individuals with ASD would misuse their emotional responses as the main source of information to guide their moral decisions. Conversely, in face of explicit harmful intentions, they would be able to compensate their socioemotional alterations and assign punishment through non-emotional pathways. Despite limitations, such as the small sample size and low ecological validity of the task, results of the present study proved reliable and have relevant theoretical and translational implications.

Individual differences in harm-related moral values are associated with functional integration of large-scale brain networks of emotional regulation

Emotions affects moral judgements, and controlled cognitive processes regulate those emotional responses during moral decision making. However, the neurobiological basis of this interaction is unclear. We used a graph theory measurement called participation coefficient ('PC') to quantify the resting-state functional connectivity within and between four meta-analytic groupings (MAGs) associated with emotion generation and regulation, to test whether that measurement predicts individual differences in moral foundations-based values. We found that the PC of one of the MAGs (MAG2) was positively correlated with one of the five recognized moral foundations-the one based on harm avoidance. We also found that increased inter-module connectivity between the ventromedial prefrontal cortex, dorsolateral prefrontal cortex and middle temporal gyrus with other nodes in the four MAGs was likewise associated with higher endorsement of the Harm foundation. These results suggest that individuals' sensitivity to harm is associated with functional integration of large-scale brain networks of emotional regulation. These findings add to our knowledge of how individual variations in our moral values could be reflected by intrinsic brain network organization and deepen our understanding of the relationship between emotion and cognition during evaluations of moral values.

[Moral Competence in Medical Students - Comparison Between First Semester and Practical Year Students]

OBJECTIVE

In addition to teaching theoretical and clinical-practical skills, the development of individual moral competence should be another core concern in medical school. However, research suggests that moral competence in students of human medicine stagnates or even declines during the course of medical school. Therefore, the present cross-sectional study investigated the moral competence of medical students at the beginning of their studies and during their practical year, as well as the effects of testosterone as a neurohormone on moral judgment.

METHODS

By means of a cross-sectional study, the moral judgment ability of 24 first-year and 16 practical year students of Hannover Medical School was recorded and evaluated with the Moral Competence Test (MCT) according to Lind. The testosterone serum level of the study participants was statistically related to the MCT results.

RESULTS

No significant differences between first-year (mean±standard deviation (SD): 13.16±8.21) and practical year students (mean±SD: 11.24±8.07) with regard to moral competence as per the MCT were identified (p=0.36). Higher serum testosterone levels did not show a statistically significant correlation with moral competence (r=-0.09, p=0.58).

CONCLUSION

Our results do not show a clear trend whether moral competence is lower in medical students in advanced semesters compared to the beginning of medical school and whether moral competence is influenced by the neurohormone testosterone. Nevertheless, it seems reasonable to implement moral competence training for medical students early, continuously, and as individually designed as possible during medical school (and to evaluate it in further studies) in order to preventively counteract stagnation or regression of moral judgment.

Altered effective connectivity from the posterior insula to the amygdala mediates the relationship between psychopathic traits and endorsement of the Harm foundation

Psychopathic traits have been demonstrated to be associated with different moral foundations. However, the neuropsychological mechanism underlying the relationship between psychopathic traits and moral foundations remains obscure. Our study examined the effective connectivity (EC) of psychopathy-related brain regions and its association with endorsement to moral foundations (Harm, Fairness, Loyalty, Authority, and Purity)-combining questionnaire measures, resting-state fMRI (RS-fMRI), and Granger causality analysis. We administered the Levenson Self-Report Psychopathy Scale and Moral Foundation Questionnaire to 78 college students after RS-fMRI scanning. Our results showed that total and primary psychopathy negatively predicted endorsement of the Harm foundation. The EC from the posterior insula to the amygdala was negatively associated with primary psychopathy but positively associated with endorsement of the Harm foundation. Altered posterior insula-amygdala EC partially mediated the relationship between primary psychopathy and endorsement of the Harm foundation. Our findings demonstrated that individuals with elevated psychopathic traits may have atypical processes in recognizing and integrating bodily state information into emotional responses -leading to less concern for harm-related morality. Our findings deepen the understanding of the neuropsychological mechanism underlying the relationship between psychopathic traits and morality, providing potential neurobiological explanations for increased moral transgressions, especially those harm-related transgressions, committed by psychopathic individuals.

Effective Connectivity and Criminal Sentencing Decisions: Dynamic Causal Models in Laypersons and Legal Experts

This magnetic resonance imaging study is designed to obtain relevant implications for criminal justice and explores the effective connectivity underlying expertise. Laypersons and experts considered sentences for remorseful and remorseless defendants, respectively, with and without mitigation, in hypothetical murder cases. Two groups revealed no differential activation. However, dynamic causal modeling analysis found distinct patterns of connectivity associated with subjects’ expertise and mitigating factors. In sentencing for remorseful defendants, laypersons showed increased strength in all bidirectional connections among activated regions of Brodmann area (BA) 32, BA23, the right posterior insula, and the precuneus. In contrast, legal experts sentenced based on mitigation reasoning, showed increased strength only in the bidirectional connection between the insula and the precuneus. When sentencing for remorseless ones without mitigation, both laypersons and experts increased the connection strength, but with reverse directionality, between regions; legal experts strengthened connectivity from BA10 to other regions, that is, the right anterior insula and BA23, but the directionality was reversed in laypersons. In addition, the strength of connection to BA32 and BA10 was correlated with changes in punishments by mitigating factors. This is a crucial result that establishes the validity of the connectivity estimates, which were uninformed by the independent (behavioral) differences in the severity of punishment.

Age differences in intuitive moral decision-making: Associations with inter-network neural connectivity

Positions of power involving moral decision-making are often held by older adults (OAs). However, little is known about age differences in moral decision-making and the intrinsic organization of the aging brain. In this study, younger adults (YAs; n = 117, Mage = 22.11) and OAs (n = 82, Mage = 67.54) made decisions in hypothetical moral dilemmas and completed resting-state multi-echo functional magnetic resonance imaging (fMRI) scans. Relative to YAs, OAs were more likely to endorse deontological decisions (i.e., decisions based on adherence to a moral principle or duty), but only when the choice was immediately compelling or intuitive. By contrast, there was no difference between YAs and OAs in utilitarian decisions (i.e., decisions aimed at maximizing collective well-being) when the utilitarian choice was intuitive. Enhanced connections between the posterior medial core of the default network (pmDN) and the dorsal attention network, and overall reduced segregation of pmDN from the rest of the brain, were associated with this increased deontological-intuitive moral decision-making style in OAs. The present study contributes to our understanding of age differences in decision-making styles by taking into account the intuitiveness of the moral choice, and it offers further insights as to how age differences in intrinsic brain connectivity relate to these distinct moral decision-making styles in YAs and OAs. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Intrinsic functional connectivity of medial prefrontal cortex predicts the individual moral bias in economic valuation partially through the moral sensitivity trait

An individual's economic valuation of a given object is biased by the moral status of the persons to whom the object is attached. The neural basis for how such "moral bias" occurs, especially how it is maintained in the resting state, are largely unknown. In the current study, we explored this question by correlating the functional connectivity with participants' behavioral performance measured in a novel task which captured how the economic valuation was influenced by given moral information. Seed-based FC analysis showed that the functional connectivity between the mPFC and the orbital mPFC (omPFC), the mPFC and the precuneus, the mPFC and the left anterior cingulum, were significantly associated with the behavioral index of morality effect on economic valuation. Multivariate machine learning-based regression analysis showed that connections in the mPFC network, as well as in the putamen network could well predict the behavior performance, indicating that this mPFC network and the putamen network were crucial for this moral bias. Our results further revealed that the individuals' personal trait of moral sensitivity served as a mediator between the rsFC of mPFC network and the behavioral index of morality effect on economic valuation.

Effect of age at time of injury on long-term changes in intrinsic functional connectivity in traumatic brain injury

BACKGROUND

Alterations in resting-state functional connectivity (rsFC) occur in the acute and chronic phases following traumatic brain injury (TBI); however, few studies have assessed long-term (>1 year) changes in rsFC.

METHODS

Resting-state functional magnetic resonance imaging (rsfMRI) scans were obtained from the Federal Interagency Traumatic Brain Injury Research Informatics Systems. Patients with primarily mild TBI (n = 39) completed rsfMRI scans at the sub-acute (~10 days) and long-term (~18 months) phases. We examined changes in voxel-based rsFC from anterior medial prefrontal cortex (aMPFC) and posterior cingulate cortex (PCC) seeds in the default mode network (DMN) between both phases. The effect of age at the time of injury on long-term rsFC was also examined.

RESULTS

Increased rsFC from the aMPFC and the PCC to frontal and temporal regions was shown at ~18-months post-injury. Widespread increases in rsFC from the aMPFC and between the PCC and frontal regions were shown for younger patients at time of injury, but limited increases of rsFC were noted at ~18 months in older patients.

CONCLUSION

Long-term increases in rsFC were found following TBI, but age at the time of injury was associated with distinct rsFC profiles suggesting that younger patients show greater increases in rsFC over time.

Social norms in patients with relapsing-remitting multiple sclerosis: Impairment of the moral/conventional distinction?

In multiple sclerosis, conflicting results have been reported between social impairment and relatively preserved moral judgments, mainly tested with moral dilemmas. Some results even yet suggest signs of "ultra-morality" in these patients. The objective of the present study was to test this hypothesis with the moral/conventional distinction task, investigating the knowledge of social norms and the judgment of moral versus conventional transgressions. In the first condition, the permissibility of social situations was estimated. If the participant judged the situation as wrong, he had to estimate the seriousness of the transgression, to give verbal justifications and to re-estimate the permissibility when the law authorizes the act (generalization condition) and when a social authority recommends the act (dependency condition). Forty-six multiple sclerosis patients matched to healthy controls completed this task. Contrary to our hypotheses, patients showed less permissibility for moral transgressions or a higher seriousness but, unexpectedly, for conventional transgressions. Most importantly, abnormal justifications were observed (strictly moral arguments for conventional transgressions and vice versa). This suggests a lack of distinction between conventional and moral judgment in multiple sclerosis. This confusion may explain the "ultra-morality" sometimes reported, if patients base their judgment mainly on social knowledge and not on emotional processing.

The moral brain and moral behaviour in patients with Parkinson's disease: a review of the literature

Morality is a complex and versatile concept that necessitates the integrated activity of multiple interacting networks in the brain. Numerous cortical and subcortical areas, many of which are implicated in either emotional and cognitive control or Theory of Mind, are involved in the processing of moral behaviour. Different methods have been used to investigate various aspects of morality, which has lead to confusing and sometimes opposing results. Emotional, cognitive and personality changes have long been recognized in Parkinson's disease (PD) patients, suggesting a potential impact on moral aspects of behaviour in daily living situations. Alterations in social cognition have been described in all stages of PD but these are rather directly related to PD pathology and not to dopaminergic or DBS treatment. There are no convincing data supporting the hypothesis that dopaminergic treatment or deep brain stimulation of the STN per se interfere with morality in PD patients, although subgroups of patients may display socially unacceptable behaviour. Research in social cognition in PD patients is a fascinating topic that needs further attention in view of the impact on quality of life for PD patients and their caregivers.

The Neural Association between Tendency to Forgive and Spontaneous Brain Activity in Healthy Young Adults

The tendency to forgive (TTF) refers to one’s global dispositional level of forgiveness across situations and relationships. Previous brain imaging studies examined activation patterns underlying forgiving process, yet the association between individual differences in the TTF and spontaneous brain activity at resting-state remains unknown. In this study, resting-state functional magnetic resonance imaging (fMRI) was used to investigate the correlation between the TTF and spontaneous brain activity in a young adult sample. Participants were 178 young students (55 men) who completed the TTF scale and underwent a resting-state fMRI scan. Multiple regression analysis was conducted to assess the association between the regional amplitude of low-frequency fluctuations (ALFF) and TTF scores corrected for age and sex. Results showed that the ALFF value in the right dorsomedial prefrontal cortex (dmPFC), precuneus and inferior parietal lobule (IPL) were negatively associated with TTF scores. These findings suggest that the spontaneous brain activity of brain regions like the dmPFC, precuneus and IPL which are implicated in mentalizing and empathic response are associated with individual differences in the TTF.

Post-conventional moral reasoning is associated with increased ventral striatal activity at rest and during task

People vary considerably in moral reasoning. According to Kohlberg’s theory, individuals who reach the highest level of post-conventional moral reasoning judge moral issues based on deeper principles and shared ideals rather than self-interest or adherence to laws and rules. Recent research has suggested the involvement of the brain’s frontostriatal reward system in moral judgments and prosocial behaviors. However, it remains unknown whether moral reasoning level is associated with differences in reward system function. Here, we combined arterial spin labeling perfusion and blood oxygen level-dependent functional magnetic resonance imaging and measured frontostriatal reward system activity both at rest and during a sequential risky decision making task in a sample of 64 participants at different levels of moral reasoning. Compared to individuals at the pre-conventional and conventional level of moral reasoning, post-conventional individuals showed increased resting cerebral blood flow in the ventral striatum and ventromedial prefrontal cortex. Cerebral blood flow in these brain regions correlated with the degree of post-conventional thinking across groups. Post-conventional individuals also showed greater task-induced activation in the ventral striatum during risky decision making. These findings suggest that high-level post-conventional moral reasoning is associated with increased activity in the brain’s frontostriatal system, regardless of task-dependent or task-independent states.