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McCormick BF, Glenn AL. Youth with Low Pre-injury Mental Health Symptoms Are at a Higher Risk for Symptoms Following Mild Traumatic Brain Injury. Child Psychiatry Hum Dev 2024; 55:488-496. [PMID: 36066656 DOI: 10.1007/s10578-022-01433-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/30/2022] [Indexed: 11/25/2022]
Abstract
Mild traumatic brain injury (mTBI) is a growing public health concern, and it is a common injury amongst children and adolescents. Existing evidence suggests that mTBI in youth may be related to both externalizing and internalizing symptoms. However, many existing studies fail to control for pre-injury symptoms or consider the potential interaction between mTBI and pre-injury symptom levels. The current study employed data from a longitudinal sample (N = 1,803) of youth from the Project on Human Development in Chicago Neighborhoods to assess the interaction between pre-injury externalizing and internalizing symptoms and outcomes following mTBI in youth. The results showed, contrary to our expectations, that participants with lower pre-injury symptoms were at a greater risk for increased psychopathology following mTBI, compared to participants with higher pre-injury symptoms and non-injured participants. Potential explanations for the results and implications are discussed.
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Affiliation(s)
- Brandon F McCormick
- Department of Psychology, Center for Youth Development and Intervention, The University of Alabama, 348 Gordon Palmer Hall, Tuscaloosa, AL, 35487, USA.
| | - Andrea L Glenn
- Department of Psychology, Center for Youth Development and Intervention, The University of Alabama, 348 Gordon Palmer Hall, Tuscaloosa, AL, 35487, USA
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2
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Snowden T, Morrison J, Boerstra M, Eyolfson E, Acosta C, Grafe E, Reid H, Brand J, Galati M, Gargaro J, Christie BR. Brain changes: aerobic exercise for traumatic brain injury rehabilitation. Front Hum Neurosci 2023; 17:1307507. [PMID: 38188504 PMCID: PMC10771390 DOI: 10.3389/fnhum.2023.1307507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/28/2023] [Indexed: 01/09/2024] Open
Abstract
Introduction Traumatic Brain Injury (TBI) accounts for millions of hospitalizations and deaths worldwide. Aerobic exercise is an easily implementable, non-pharmacological intervention to treat TBI, however, there are no clear guidelines for how to best implement aerobic exercise treatment for TBI survivors across age and injury severity. Methods We conducted a PRISMA-ScR to examine research on exercise interventions following TBI in children, youth and adults, spanning mild to severe TBI. Three electronic databases (PubMed, PsycInfo, and Web of Science) were searched systematically by two authors, using keywords delineated from "Traumatic Brain Injury," "Aerobic Exercise," and "Intervention." Results Of the 415 papers originally identified from the search terms, 54 papers met the inclusion criteria and were included in this review. The papers were first grouped by participants' injury severity, and subdivided based on age at intervention, and time since injury where appropriate. Discussion Aerobic exercise is a promising intervention for adolescent and adult TBI survivors, regardless of injury severity. However, research examining the benefits of post-injury aerobic exercise for children and older adults is lacking.
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Affiliation(s)
- Taylor Snowden
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
| | - Jamie Morrison
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
| | - Meike Boerstra
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
| | - Eric Eyolfson
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
| | - Crystal Acosta
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
| | - Erin Grafe
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
| | - Hannah Reid
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
| | - Justin Brand
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
| | | | - Judith Gargaro
- KITE Research Institute, University Health Network, Toronto, ON, Canada
| | - Brian R. Christie
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
- Island Medical Program and Department of Cellular and Physiological Sciences, The University of British Columbia, Victoria, BC, Canada
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Edwards M, Morrow EL, Duff MC. Intact moral decision-making in adults with moderate-severe traumatic brain injury. BRAIN IMPAIR 2023; 24:568-585. [PMID: 38124901 PMCID: PMC10730091 DOI: 10.1017/brimp.2022.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background and aim Deficits in decision-making are a common consequence of moderate-severe traumatic brain injury (TBI). Less is known, however, about how individuals with TBI perform on moral decision-making tasks. To address this gap in the literature, the current study probed moral decision-making in a sample of individuals with TBI using a widely employed experimental measure. Methods/hypothesis We administered a set of 50 trolley-type dilemmas to 31 individuals with TBI and 31 demographically matched, neurotypical comparison participants. We hypothesized that individuals with TBI would be more likely to offer utilitarian responses to personal dilemmas than neurotypical peers. Results In contrast to our hypothesis, we observed that individuals with TBI were not more likely to offer utilitarian responses for personal dilemmas. Conclusion Our results suggest that moral decision-making ability is not uniformly impaired following TBI. Rather, neuroanatomical (lesion location) and demographic (age at injury) characteristics may be more predictive of a disruption in moral decision-making than TBI diagnosis or injury severity alone. These results inform the neurobiology of moral decision-making and have implications for characterizing patterns of spared and impaired cognitive abilities in TBI.
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Affiliation(s)
| | - Emily L. Morrow
- Department of Hearing & Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Melissa C. Duff
- Meharry Medical College, Nashville, TN, USA
- Department of Hearing & Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
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Vlot N, Postma A, Oudman E. When Do Korsakoff Patients Justify Immoral Behaviors? The Influence of Premorbid Delinquency and Self-Other Perspectives in Moral Decision-Making and Moral Reasoning. J Clin Med 2023; 12:6257. [PMID: 37834901 PMCID: PMC10573903 DOI: 10.3390/jcm12196257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
Korsakoff's syndrome (KS) is a chronic neuropsychiatric disorder caused by a vitamin B1 deficiency. KS is characterized by profound amnesia and often accompanied by poor executive functioning, decreased social-cognitive abilities, and difficulties in behavioral regulation. As moral behaviors and attitudes may provide insight in socio-behavioral interactions, the current study aimed to evaluate everyday moral maturity by administering self- versus other-oriented moral dilemmas in a group of KS patients (n = 20) and healthy controls (n = 20). Responses were scored according to the Kohlberg stages of moral reasoning. Furthermore, we assessed premorbid delinquency and current neurocognitive functioning as possible relevant factors. Our results show that KS patients were prone to lower levels of moral maturity when confronted with moral dilemmas relating to themselves, compared to dilemmas relating to (un)personal others in KS patients, while healthy subjects showed an opposite pattern. Moral immaturity could find its origin already before the onset of the KS diagnosis, as suggested by the elevated premorbid levels of delinquent behavior and correlation between premorbid delinquency and moral maturity in KS. Lower moral maturity could therefore be a possible predisposing factor to both delinquency and later development of Korsakoff's syndrome.
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Affiliation(s)
- Nairobi Vlot
- Experimental Psychology, Helmholtz Institute, Utrecht University, 3584 CS Utrecht, The Netherlands (A.P.)
- Lelie Care Group, Slingedael Korsakoff Expertise Center, Slinge 901, 3086 EZ Rotterdam, The Netherlands
| | - Albert Postma
- Experimental Psychology, Helmholtz Institute, Utrecht University, 3584 CS Utrecht, The Netherlands (A.P.)
- Lelie Care Group, Slingedael Korsakoff Expertise Center, Slinge 901, 3086 EZ Rotterdam, The Netherlands
| | - Erik Oudman
- Experimental Psychology, Helmholtz Institute, Utrecht University, 3584 CS Utrecht, The Netherlands (A.P.)
- Lelie Care Group, Slingedael Korsakoff Expertise Center, Slinge 901, 3086 EZ Rotterdam, The Netherlands
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Fusi G, Crepaldi M, Palena N, Segatta C, Bariselli M, Cerrano C, Rusconi ML, Vascello MGF. Decision-making abilities under risk and ambiguity in adults with traumatic brain injury: what do we know so far? A systematic review and meta-analysis. J Clin Exp Neuropsychol 2023; 45:389-410. [PMID: 37585702 DOI: 10.1080/13803395.2023.2245107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 07/21/2023] [Indexed: 08/18/2023]
Abstract
Traumatic brain injury (TBI) is a major health and socio-economic problem since it is one of the major sources of death and disability worldwide. TBI patients usually show high heterogeneity in their clinical features, including both cognitive and emotional/behavioral alterations. As it specifically concerns cognitive functioning, these patients usually show decision-making (DM) deficits. DM is commonly considered a complex and multistep process that is strictly linked to both hot and cold executive functioning and is pivotal for daily life functioning and patients' autonomy. However, the results are not always in agreement, with some studies that report huge alterations in the DM processes, while others do not. The present systematic review and meta-analysis aims to integrate past literature on this topic, providing a clear and handy picture both for researchers and clinicians. Thirteen studies addressing domain-general DM abilities were included from an initial N = 968 (from three databases). Results showed low heterogeneity between the studies (I2 = 7.90, Q (12) = 13.03, p = .37) supporting the fact that, overall, TBI patients showed lower performance in DM tasks as compared to healthy controls (k = 899, g = .48, 95% CI [0.33; 0.62]) both in tasks under ambiguity and under risk. The evidence that emerged from this meta-analysis denotes a clear deficit of DM abilities in TBI patients. However, DM tasks seemed to have good sensitivity but low specificity. A detailed description of patients' performances and the role of both bottom-up, hot executive functions and top-down control functions have been further discussed. Finally, future directions and practical implications for both researchers and clinicians have been put forward.
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Affiliation(s)
- Giulia Fusi
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Maura Crepaldi
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Nicola Palena
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Cecilia Segatta
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Martina Bariselli
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Costanza Cerrano
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Maria Luisa Rusconi
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
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More to the story than executive function: Effortful control soon after injury predicts long-term functional and social outcomes following pediatric traumatic brain injury in young children. J Int Neuropsychol Soc 2022; 29:325-335. [PMID: 36102333 PMCID: PMC10011017 DOI: 10.1017/s1355617722000315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine the impact of early traumatic brain injury (TBI) on effortful control (EC) over time and the relationship of EC and executive functioning (EF) to long-term functional and social outcomes. METHOD Parents of children (N = 206, ages 3-7) with moderate-to-severe TBI or orthopedic injuries (OIs) rated EC using the Child Behavior Questionnaire at 1 (pre-injury), 6, 12, and 18 months post-injury. Child functioning and social competence were assessed at 7 years post-injury. Mixed models examined the effects of injury, time since injury, and their interaction on EC. General linear models examined the associations of pre-injury EC and EC at 18 months with long-term functional and social outcomes. Models controlled for EF to assess the unique contribution of EC to outcomes. RESULTS Children with severe TBI had significantly lower EC than both the OI and moderate TBI groups at each post-injury time point. Both pre-injury and 18-month EC were associated with long-term outcomes. Among those with low EC at baseline, children with moderate and severe TBI had more functional impairment than those with OI; however, no group differences were noted at high levels of EC. EC had main effects on parent-reported social competence that did not vary by injury type. CONCLUSIONS Findings suggest that EC is sensitive to TBI effects and is a unique predictor of functional outcomes, independent of EF. High EC could serve as a protective factor, and as such measures of EC could be used to identify children for more intensive intervention.
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Sociomoral Reasoning Skills during Childhood: A Comprehensive and Predictive Approach. Brain Sci 2022; 12:brainsci12091226. [PMID: 36138963 PMCID: PMC9496755 DOI: 10.3390/brainsci12091226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 08/27/2022] [Accepted: 09/07/2022] [Indexed: 11/30/2022] Open
Abstract
Sociomoral reasoning (SMR) is an essential component of social functioning allowing children to establish judgments based on moral criteria. The progressive emergence and complexification of SMR during childhood is thought to be underpinned by a range of characteristics and abilities present in the preschool years. Past studies have mostly examined concurrent associations between individual factors and SMR. Using a more comprehensive and predictive approach to identify early predictors of school-age SMR would contribute to a more complete picture of SMR development. This study aimed to investigate the contribution of four domains of preschool predictors to SMR at school-age: demographic (age, sex, parental education), cognitive (executive and sociocognitive functions), behavioral (internalizing and externalizing behaviors), and familial (parent–child interactions, parental stress) factors. Parents of 122 children 3 to 5 years (M = 3.70, SD = 0.66 years, 51% girls) completed questionnaires and children were administered executive and sociocognitive tasks. Parent–child interactions were assessed using an observational approach. SMR was measured four years later using the SoMoral task. A four-step hierarchical regression analysis revealed that executive functions and internalizing problems were significant independent predictors of SMR. These findings provide a more comprehensive understanding of the early precursors of SMR during childhood.
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Zarglayoun H, Laurendeau-Martin J, Tato A, Vera-Estay E, Blondin A, Lamy-Brunelle A, Chaieb S, Morasse F, Dufresne A, Nkambou R, Beauchamp MH. Assessing and Optimizing Socio-Moral Reasoning Skills: Findings From the MorALERT Serious Video Game. Front Psychol 2022; 12:767596. [PMID: 35126234 PMCID: PMC8815380 DOI: 10.3389/fpsyg.2021.767596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/29/2021] [Indexed: 12/18/2022] Open
Abstract
Background Social cognition and competence are a key part of daily interactions and essential for satisfying relationships and well-being. Pediatric neurological and psychological conditions can affect social cognition and require assessment and remediation of social skills. To adequately approximate the complex and dynamic nature of real-world social interactions, innovative tools are needed. The aim of this study was to document the performance of adolescents on two versions of a serious video game presenting realistic, everyday, socio-moral conflicts, and to explore whether their performance is associated with empathy or sense of presence, factors known to influence social cognition. Methods Participants (12–17 years, M = 14.39; SD = 1.35) first completed a pre-test measure of socio-moral reasoning based on three dilemmas from a previously validated computer task. Then, they either played an evaluative version (n = 24) or an adaptive (n = 33) version of a video game presenting nine social situations in which they made socio-moral decisions and provided justifications. In the evaluative version, participants’ audio justifications were recorded verbatim and coded manually to obtain a socio-moral reasoning maturity score. In the adaptive version (AV), tailored feedback and social reinforcements were provided based on participant responses. An automatic coding algorithm developed using artificial intelligence was used to determine socio-moral maturity level in real-time and to provide a basis for the feedback and reinforcements in the game. All participants then completed a three-dilemma post-test assessment. Results Those who played the adaptive version showed improved SMR across the pre-test, in-game and post-test moral maturity scores, F(1.97,63.00) = 9.81, pHF < 0.001, ϵ2 = 0.21, but those who played the Evaluative version did not. Socio-moral reasoning scores from both versions combined did not correlate with empathy or sense of presence during the game, though results neared significance. The study findings support preliminary validation of the game as a promising method for assessing and remediating social skills during adolescence.
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Affiliation(s)
- Hamza Zarglayoun
- Department of Psychology, University of Montreal, Montreal, QC, Canada.,Sainte-Justine Hospital Research Center, Montreal, QC, Canada
| | | | - Ange Tato
- Department of Computer Science, Université du Québec à Montréal, Montreal, QC, Canada
| | - Evelyn Vera-Estay
- School of Psychology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Aurélie Blondin
- Department of Psychology, University of Montreal, Montreal, QC, Canada.,Sainte-Justine Hospital Research Center, Montreal, QC, Canada
| | | | - Sameh Chaieb
- Department of Communication, University of Montreal, Montreal, QC, Canada
| | - Frédérick Morasse
- Department of Psychology, University of Montreal, Montreal, QC, Canada
| | - Aude Dufresne
- Department of Communication, University of Montreal, Montreal, QC, Canada
| | - Roger Nkambou
- Department of Computer Science, Université du Québec à Montréal, Montreal, QC, Canada
| | - Miriam H Beauchamp
- Department of Psychology, University of Montreal, Montreal, QC, Canada.,Sainte-Justine Hospital Research Center, Montreal, QC, Canada
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Social Cognition in Paediatric Traumatic Brain Injury: A Systematic Review and Meta-analysis. Neuropsychol Rev 2021; 32:127-148. [PMID: 33855655 DOI: 10.1007/s11065-021-09488-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 02/11/2021] [Indexed: 01/11/2023]
Abstract
Recent evidence suggests social cognitive deficits may be among the most profound and disabling consequences of childhood traumatic brain injury (TBI); however, it is only over the last decade that this area has received increasing research attention. This study aims to systematically review all studies reporting on the effects of childhood TBI on social cognition. Meta-analytic techniques were employed to determine the magnitude of social cognitive deficits in childhood TBI. Literature searches were conducted in electronic databases (Medline/PubMed, Scopus, Cochrane, EMBASE, PsycINFO and CINAHL) to retrieve relevant articles on social cognitive outcomes of paediatric TBI published from 2007-2019. The systematic review identified fourteen eligible studies, which examined the effect of paediatric TBI on five dimensions of social cognition, including emotion recognition or perception, theory of Mind (ToM), pragmatic language, moral reasoning, and social problem solving. Of these studies, eleven articles were included in subsequent meta-analyses, which included 482 children with TBI. Meta-analysis using a random-effects model revealed non-significant differences between TBI and typically developing (TD) control groups on measures of emotion perception or recognition. In contrast, children and adolescents with TBI performed significantly worse than control groups on ToM and pragmatic language tasks, with small and medium effect sizes, respectively (Hedge's g = -0.46; -0.73). Meta-regression indicated that post-injury social cognitive deficits were not moderated by child age. While the effect of time since injury was not statistically significant, poorer social cognitive outcomes are documented soon after injury. Despite relatively intact basic social cognitive skills (i.e. emotion perception or recognition) children and adolescents with TBI are vulnerable to deficits in higher-order aspects of social cognition, including ToM and pragmatic language. These findings underscore the importance of further research, using well-validated, standardised outcome instruments, in larger paediatric TBI samples. Furthermore, longitudinal prospective studies are needed to evaluate the respective contribution of injury and non-injury factors to individual variation in outcome and recovery of social cognition after paediatric TBI.
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Unravelling moral cognition in acquired brain injury: a scoping review. BRAIN IMPAIR 2021. [DOI: 10.1017/brimp.2021.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Background:
Acquired brain injury (ABI) is accompanied by impairments in social, emotional, cognitive and behavioural skills and highly prevalent in the population. Social and emotional skills are crucial for moral cognition, but the extent to which moral cognition contributes to social competence deficits in people with ABI is largely unclear.
Method:
To provide more insight on this topic, we conducted a scoping review according to the PRISMA guidelines. After screening 1269 articles that we obtained via PubMed and Scopus, we found 27 articles on moral cognition in ABI.
Results:
We encountered four important topics across these studies which include traumatic brain injury (TBI) versus non-TBI, the influence of the different approaches used to measure moral cognition in ABI, the role of age of onset and the role of location of the injury. Overall, evidence suggests that the earlier the brain damage occurred, the more this leads to impairments in moral cognitive functioning. The location of the injury furthermore seems to differentially affect the way impairments are manifested. Finally, we found that the use of different measurement approaches can heavily influence the interpretation of the impairment.
Conclusion:
We conclude that impairments in moral cognition in people with ABI are derived from a complex interplay between the age of onset, the location and the approach used to index moral cognition.
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Oudman E, van Stigt Thans S, Montoya ER, Postma A. Moral reasoning, moral decision-making, and empathy in Korsakoff's syndrome. J Neuropsychol 2020; 15:462-476. [PMID: 33245621 PMCID: PMC8518936 DOI: 10.1111/jnp.12233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 10/23/2020] [Indexed: 11/30/2022]
Abstract
Korsakoff's syndrome (KS) is a neuropsychiatric disorder, caused by a vitamin B1 deficiency. Although it is known that patients with KS display diminished theory of mind functioning and frequently exhibit marked antisocial interactions little attention has so far focused on the integrity of moral decision-making abilities, moral reasoning, and empathy. In an experimental cross-sectional design, 20 patients diagnosed with KS, and twenty age-, education-, and gender-equivalent healthy participants performed tests assessing moral decision-making, moral reasoning maturity, empathy, and executive functioning. Participants were administered the Moral Behaviour Inventory (MBI) for everyday moral dilemmas, and ten cartoons of abstract moral dilemmas. Responses were scored according to the Kohlberg stages of moral reasoning. Empathy and executive functioning were assessed with the Interpersonal Reactivity Index (IRI) and the Frontal Assessment Battery (FAB). In contrast to frontal traumatic brain injury patients, KS patients did not display a utilitarian bias, suggesting preserved moral decision-making abilities. Of interest, KS patients had significantly lower levels of moral reasoning maturity on everyday moral dilemmas, and abstract moral dilemmas. In patients, empathy was moderately related to the level of moral maturity on both tasks, while executive functioning was not. In conclusion, KS patients have preserved moral decision-making abilities, but their moral reasoning abilities are poorer in everyday and abstract situations. Lower moral reasoning abilities and lower levels of empathy together may be responsible for adverse social functioning in KS.
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Affiliation(s)
- Erik Oudman
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands.,Lelie Care Group, Slingedael Korsakoff Center, Rotterdam, The Netherlands
| | - Sioux van Stigt Thans
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands.,Lelie Care Group, Slingedael Korsakoff Center, Rotterdam, The Netherlands
| | - Estrella R Montoya
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - Albert Postma
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands.,Lelie Care Group, Slingedael Korsakoff Center, Rotterdam, The Netherlands
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