1
|
Gury P, Moulin M, Laroye R, Trachino M, Montazel M, Narme P, Ehrlé N. Happy facial emotional congruence in patients with relapsing-remitting multiple sclerosis. J Clin Exp Neuropsychol 2024:1-11. [PMID: 39140395 DOI: 10.1080/13803395.2024.2391362] [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: 02/11/2024] [Accepted: 08/07/2024] [Indexed: 08/15/2024]
Abstract
BACKGROUND Emotion categorization has often been studied in the relapsing-remitting form of multiple sclerosis (RR-MS), suggesting an impairment in the recognition of emotions. The production of facial emotional expressions in RR-MS has not been considered, despite their importance in non-verbal communication. METHOD Twenty-five RR-MS patients and twenty-five matched controls completed a task of emotional categorization during which their faces were filmed. The stimuli were dynamic (sound or visual), expressed by adults (women or men), and expressing happy (laughing or smiling) or negative emotion. Two independent blinded raters quantified the happy facial expressions produced. The categorization task was used as a proxy for emotional categorization, while the happy facial expressions produced assessed the production of emotions. RESULTS The main analysis indicated impaired categorization of RR-MS for happy stimuli selectively, whereas their happy facial expressions were not statistically different from those of the control group. More specifically, this group effect was found for smiles (and not laughter) and for happy stimuli produced by men. Analysis of individual patient profiles suggested that 77% of patients with impaired judgments produced normal facial expressions, suggesting a high prevalence of this dissociation. Only 8% of our samples showed reverse dissociation, with happy facial expressions significantly different from those of the control group and normal emotional judgments. CONCLUSION These results corroborated the high prevalence of emotional categorization impairment in RR-MS but not for negative stimuli, which can probably be explained by the methodological specificities of the present work. The unusual impairment found for happy stimuli (for both emotional categorization and facial congruence) may be linked to the intensity of the perceived happy expressions but not to the emotional valence. Our results also indicated a mainly preserved production of facial emotions, which may be used in the future sociocognitive care of RR-MS patients with impaired emotional judgments.
Collapse
Affiliation(s)
- Pauline Gury
- Neurology Department, Maison-Blanche Hospital, Reims, France
- Laboratoire Mémoire Cerveau et Cognition (UR 7536), Université Paris Cité, Boulogne-Billancourt, France
| | | | | | - Marine Trachino
- Neurology Department, Maison-Blanche Hospital, Reims, France
| | - Marine Montazel
- Neurology Department, Maison-Blanche Hospital, Reims, France
| | - Pauline Narme
- Laboratoire Mémoire Cerveau et Cognition (UR 7536), Université Paris Cité, Boulogne-Billancourt, France
| | - Nathalie Ehrlé
- Neurology Department, Maison-Blanche Hospital, Reims, France
- Laboratoire Mémoire Cerveau et Cognition (UR 7536), Université Paris Cité, Boulogne-Billancourt, France
| |
Collapse
|
2
|
Zikos L, Degraeve B, Pinti A, Poupart J, Norberciak L, Kwiatkowski A, Donze C, Lenne B. Distinguishing the role of positivity bias, cognitive impairment and emotional reactivity in the deontological preference in multiple sclerosis during moral dilemmas: a social cognition study protocol. Front Psychol 2024; 15:1404876. [PMID: 39091703 PMCID: PMC11291456 DOI: 10.3389/fpsyg.2024.1404876] [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: 03/22/2024] [Accepted: 07/05/2024] [Indexed: 08/04/2024] Open
Abstract
Background Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease of the central nervous system characterized by a broad and unpredictable range of symptoms, including cognitive and sociocognitive dysfunction. Among these social-cognitive functions, moral judgment has been explored in persons with MS (PwMS) using moral dilemmas, where participants must decide whether to sacrifice one person to save a greater number. Opting for such a sacrifice reflects utilitarian reasoning (sacrificing one for the benefit of many is deemed acceptable), while refusing reflects deontological reasoning (such sacrifice is considered morally wrong). Compared to controls, PwMS have been shown to make greater deontological moral choices in such dilemmas. Objectives While PwMS have demonstrated a higher tendency for deontological moral choices in moral dilemmas compared to controls, the underlying determinants of this reasoning pattern remain unclear. In this project, we aim to investigate cognitive, emotional, and motivational factors that may explain deontological decision-making in MS. Methods and analysis We will recruit a sample of 45 PwMS and 45 controls aged 18-55 years. The type of response, deontological or utilitarian, to a series of 20 vignettes of moral dilemmas will constitute the primary outcomes. Global cognitive performance, positivity bias, alexithymia and empathy levels as well as emotional reactivity measured by electrodermal activity (EDA) during moral dilemmas will be secondary outcomes. Ethics and dissemination Ethics approval was granted by a national ethical committee (CPP Ouest III, national number 2023-A00447-38). The project is sponsored by the ARSEP Foundation. Findings will be presented at national and international conferences, as well as published in peer-reviewed scientific journals.
Collapse
Affiliation(s)
- Laurent Zikos
- Experience, Transhumanism, Human Interactions, Care & Society (ETHICS - EA7446), Lille Catholic University, Lille, France
| | - Béatrice Degraeve
- Experience, Transhumanism, Human Interactions, Care & Society (ETHICS - EA7446), Lille Catholic University, Lille, France
| | - Antonio Pinti
- Laboratoire Science de l’Information-Communication (LSC/DeVisu), Université Polytechnique Hauts-de-France, Valenciennes, France
| | - Julien Poupart
- Neurology Department, Groupement des Hôpitaux de l’Institut Catholique de Lille (GHICL), Lille Catholic University, Lille, France
| | - Laurène Norberciak
- Neurology Department, Groupement des Hôpitaux de l’Institut Catholique de Lille (GHICL), Lille Catholic University, Lille, France
| | - Arnaud Kwiatkowski
- Neurology Department, Groupement des Hôpitaux de l’Institut Catholique de Lille (GHICL), Lille Catholic University, Lille, France
| | - Cécile Donze
- Rehabilitation Department, Groupement des Hôpitaux de l’Institut Catholique de Lille (GHICL), Lille Catholic University, Lille, France
| | - Bruno Lenne
- Neurology Department, Groupement des Hôpitaux de l’Institut Catholique de Lille (GHICL), Lille Catholic University, Lille, France
| |
Collapse
|
3
|
Sever Aktuna YS, Koskderelioglu A, Eskut N, Aktuna A. Is impairment of facial emotion recognition independent of cognitive dysfunction in multiple sclerosis? Neurol Sci 2024; 45:2791-2800. [PMID: 38246940 PMCID: PMC11081977 DOI: 10.1007/s10072-024-07314-0] [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] [Received: 07/12/2023] [Accepted: 01/07/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Emotions expressed on the face play a key role in social cognition and communication by providing inner emotional experiences. This study aimed to evaluate facial emotion identification and discrimination and empathy abilities in patients with MS and whether it is related to cognitive dysfunction. METHODS One hundred twenty patients with relapsing-remitting MS and age- and sex-matched 120 healthy controls were enrolled in the study. All the subjects were evaluated with the Facial Emotion Identification Test (FEIT), Facial Emotion Discrimination Test (FEIDT), and Empathy Quotient (EQ). We used the Beck Depression Inventory (BDI) for depression and detailed cognitive tests, including the Montreal Cognitive Assessment (MoCA), the Symbol Digit Modalities Test (SDMT), and the Paced Auditory Serial Addition Test (PASAT). The quality of life was assessed with Multiple Sclerosis Quality of Life-54 (MSQL-54). RESULTS Patients with MS were 37.6 ± 9.5 years old, had a mean disease duration of 8.8 ± 6.6 (8-28) years, and a mean EDSS score of 1.6 ± 1.3 (0-4.5). We found significant differences in the identification of facial emotions, discrimination of facial emotions, and empathy in MS patients compared to controls (p < 0.05). Especially the recognition of feelings of sadness, fear, and shame was significantly lower in MS patients. The multivariate logistic regression analysis showed low SDMT and FEIDT scores which showed an independent association with MS. CONCLUSIONS Our findings indicate that facial emotion recognition and identification deficits are remarkable among patients with MS and emotion recognition is impaired together with and independently of cognitive dysfunction in MS patients.
Collapse
Affiliation(s)
- Yagmur Simge Sever Aktuna
- Neurology Department, University of Health Sciences, Izmir Bozyaka Education and Research Hospital, 35170, Izmir, Turkey.
| | - Asli Koskderelioglu
- Neurology Department, University of Health Sciences, Izmir Bozyaka Education and Research Hospital, 35170, Izmir, Turkey
| | - Neslihan Eskut
- Neurology Department, University of Health Sciences, Izmir Bozyaka Education and Research Hospital, 35170, Izmir, Turkey
| | - Atalay Aktuna
- Department of Public Health, Ministry of Health, Bornova District Health Directorate, 35030, Bornova, Izmir, Turkey
| |
Collapse
|
4
|
Burghart M, Sahm AHJ, Schmidt S, Bulla J, Mier D. Understanding empathy deficits and emotion dysregulation in psychopathy: The mediating role of alexithymia. PLoS One 2024; 19:e0301085. [PMID: 38718018 PMCID: PMC11078418 DOI: 10.1371/journal.pone.0301085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 03/09/2024] [Indexed: 05/12/2024] Open
Abstract
Psychopathy is a severe personality disorder marked by a wide range of emotional deficits, including a lack of empathy, emotion dysregulation, and alexithymia. Previous research has largely examined these emotional impairments in isolation, ignoring their influence on each other. Thus, we examined the concurrent interrelationship between emotional impairments in psychopathy, with a particular focus on the mediating role of alexithymia. Using path analyses with cross-sectional data from a community sample (N = 315) and a forensic sample (N = 50), our results yielded a statistically significant mediating effect of alexithymia on the relationship between psychopathy and empathy (community and forensic) and between psychopathy and emotion dysregulation (community). Moreover, replacing psychopathy with its three dimensions (i.e., meanness, disinhibition, and boldness) in the community sample revealed that boldness may function as an adaptive trait, with lower levels of alexithymia counteracting deficits in empathy and emotion dysregulation. Overall, our findings indicate that psychopathic individuals' limited understanding of their own emotions contributes to their lack of empathy and emotion dysregulation. This underscores the potential benefits of improving emotional awareness in the treatment of individuals with psychopathy.
Collapse
Affiliation(s)
- Matthias Burghart
- Department of Psychology and Psychotherapy, University of Konstanz, Konstanz, Germany
| | - Alexander H. J. Sahm
- Department of Psychology and Psychotherapy, University of Konstanz, Konstanz, Germany
| | - Sergej Schmidt
- Department of Psychology and Psychotherapy, University of Konstanz, Konstanz, Germany
| | - Jan Bulla
- Forensic Psychiatry and Psychotherapy, Reichenau Psychiatric Center, Reichenau, Germany
- Department of Forensic Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany
| | - Daniela Mier
- Department of Psychology and Psychotherapy, University of Konstanz, Konstanz, Germany
| |
Collapse
|
5
|
Roheger M, Grothe L, Hasselberg L, Grothe M, Meinzer M. A systematic review and meta-analysis of socio-cognitive impairments in multiple sclerosis. Sci Rep 2024; 14:7096. [PMID: 38528009 PMCID: PMC10963773 DOI: 10.1038/s41598-024-53750-5] [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] [Received: 06/23/2023] [Accepted: 02/05/2024] [Indexed: 03/27/2024] Open
Abstract
Socio-cognitive impairment is frequent in multiple sclerosis (MS). However, little is known about the relationship between other potentially relevant clinical symptoms (i.e., cognition, depression, fatigue) and the degree of socio-cognitive impairment, and neural mechanisms underlying socio-cognitive deficits in MS. Therefore, we meta-analytically quantified socio-cognitive impairment in MS. A systematic literature search in MEDLINE Ovid, Web of Science Core Collection, CENTRAL, and PsycInfo was conducted until December 2022. Studies investigating affective or cognitive theory of mind (a/cToM), visual perspective taking (VPT) and social decision making (SDM) in MS patients relative to healthy controls were included. Risk-of-bias (RoB) was assessed using the CLARITY group "Tool for Assessing RoB in Cohort Studies". Mediation analysis investigated the contribution of clinical symptoms to socio-cognitive impairment. In total, n = 8534 studies were screened, 58 were included in the systematic review, 27 in the meta-analyses. Most studies were rated with a moderate RoB. Meta-analyses confirmed impairment of both aToM and cToM in MS patients, with larger effect sizes for aToM. Mediation analysis demonstrated that higher levels of fatigue selectively predicted the degree of cToM impairment. There was insufficient data available to quantify impairment in other socio-cognitive domains. Fourteen structural and functional imaging studies were identified and characterized by substantial heterogeneity. Summarized, this study confirmed substantial socio-cognitive impairment in MS and highlights the potential exacerbating role of comorbid clinical symptoms. We identify several evidence gaps that need to be addressed in future large-scale studies using comprehensive and coordinated assessments of socio-cognitive parameters, potential mediators, and neural correlates.Trial registration: The pre-registered review protocol can be assessed at www.crd.york.ac.uk/PROSPERO/ (ID: CRD42020206225).
Collapse
Affiliation(s)
- Mandy Roheger
- Department of Neurology, University Medicine Greifswald, Walther Rathenau Str. 49, 17489, Greifswald, Germany
- Ambulatory Assessment in Psychology, Department of Psychology, Carl Von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Lydia Grothe
- Department of Neurology, University Medicine Greifswald, Walther Rathenau Str. 49, 17489, Greifswald, Germany
| | - Laura Hasselberg
- Department of Neurology, University Medicine Greifswald, Walther Rathenau Str. 49, 17489, Greifswald, Germany
| | - Matthias Grothe
- Department of Neurology, University Medicine Greifswald, Walther Rathenau Str. 49, 17489, Greifswald, Germany.
| | - Marcus Meinzer
- Department of Neurology, University Medicine Greifswald, Walther Rathenau Str. 49, 17489, Greifswald, Germany
| |
Collapse
|
6
|
Gury P, Moulin M, Laroye R, Montazel M, Trachino M, Narme P, Ehrlé N. Explicit and implicit abilities in humor processing in patients with relapsing-remitting multiple sclerosis. Soc Neurosci 2024; 19:1-13. [PMID: 38424715 DOI: 10.1080/17470919.2024.2315817] [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] [Received: 06/11/2023] [Accepted: 11/28/2023] [Indexed: 03/02/2024]
Abstract
Sociocognitive impairment is well known in the relapsing-remitting form of multiple sclerosis (RR-MS). The purpose of the present study was to assess explicit and implicit humor abilities in this population. Based on clinical observation and contrary to the current cognitive model, we hypothesized that implicit performances (happy facial expressions) would be better than explicit ones (humor judgment assessed by explicit humor comprehension, subjective feeling of amusement as a conscious appreciation of funniness, and verbal justifications of funniness). Twenty-five RR-MS patients and twenty-five healthy participants completed the tasks. Their face was filmed during humor ratings. Patients' results suggest that 32% of them showed an impairment in explicit humor comprehension, with normal facial expressions. Both groups found great difficulty in justifying the cause of their amusement. All these results may suggest the existence of a supplementary implicit pathway in humor processing. The preservation of this implicit pathway may be advantageous for future remediation. Contrary to the current model, we found that the subjective feeling of amusement was preserved when comprehension was impaired. Further studies will be needed to clarify this component, and adjust the theoretical modeling.
Collapse
Affiliation(s)
- Pauline Gury
- Neurology department, Maison-Blanche hospital, Reims, France
- Laboratoire Mémoire Cerveau et Cognition (UR 7536), University Paris Cité, Boulogne-Billancourt, France
| | | | | | - Marine Montazel
- Neurology department, Maison-Blanche hospital, Reims, France
| | - Marine Trachino
- Neurology department, Maison-Blanche hospital, Reims, France
| | - Pauline Narme
- Laboratoire Mémoire Cerveau et Cognition (UR 7536), University Paris Cité, Boulogne-Billancourt, France
| | - Nathalie Ehrlé
- Laboratoire Mémoire Cerveau et Cognition (UR 7536), University Paris Cité, Boulogne-Billancourt, France
| |
Collapse
|
7
|
Grigorescu C, Chalah MA, Ayache SS, Palm U. [Alexithymia in Multiple Sclerosis - Narrative Review]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2023; 91:404-413. [PMID: 35948023 DOI: 10.1055/a-1882-6544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Alexithymia is a multidimensional construct of personality implicating difficulties in identifying and describing another's feelings, and externally oriented thinking. It is broadly reported in psychiatric patients but has gained little attention regarding its occurrence and pathophysiology in multiple sclerosis (MS). This narrative review aims to address prevalence, etiology, neurobiological, and clinical findings of alexithymia. The prevalence of alexithymia in MS ranges from 10 to 53%. There seems to be an association with anxiety, depression, fatigue, and some aspects of social cognition, while the relationship with clinical and classical cognitive variables was rarely evaluated. Only a few studies referred to its pathophysiology assuming an aberrant interhemispheric transfer or regional cerebral abnormalities. The prevalence of alexithymia in MS and the potential negative impact on quality of life and interpersonal communication could severely impact clinical MS management and a screnning for these factors should be mandatory. Thus, further evaluation is needed concerning its relationship with clinical, emotional, and cognitive confounders. Large-scale studies employing neuroimaging techniques are needed for a better understanding of the neural underpinnings of this MS feature.
Collapse
Affiliation(s)
- Christina Grigorescu
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, München
| | - Moussa A Chalah
- EA 4391, Excitabilité Nerveuse et Thérapeutique, Université Paris-Est-Créteil, Créteil, France
- Service de Physiologie - Explorations Fonctionnelles, Hôpital Henri Mondor, Assistance Publique - Hôpitaux de Paris, Créteil, France
| | - Samar S Ayache
- EA 4391, Excitabilité Nerveuse et Thérapeutique, Université Paris-Est-Créteil, Créteil, France
- Service de Physiologie - Explorations Fonctionnelles, Hôpital Henri Mondor, Assistance Publique - Hôpitaux de Paris, Créteil, France
| | - Ulrich Palm
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, München
- Medical Park Chiemseeblick, Bernau a. Chiemsee
| |
Collapse
|
8
|
Doskas TK, Christidi F, Spiliopoulos KC, Tsiptsios D, Vavougios GD, Tsiakiri A, Vorvolakos T, Kokkotis C, Iliopoulos I, Aggelousis N, Vadikolias K. Social Cognition Impairments in Association to Clinical, Cognitive, Mood, and Fatigue Features in Multiple Sclerosis: A Study Protocol. Neurol Int 2023; 15:1106-1116. [PMID: 37755359 PMCID: PMC10536405 DOI: 10.3390/neurolint15030068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/28/2023] Open
Abstract
Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system (CNS), characterized by the diffuse grey and white matter damage. Cognitive impairment (CI) is a frequent clinical feature in patients with MS (PwMS) that can be prevalent even in early disease stages, affecting the physical activity and active social participation of PwMS. Limited information is available regarding the influence of MS in social cognition (SC), which may occur independently from the overall neurocognitive dysfunction. In addition, the available information regarding the factors that influence SC in PwMS is limited, e.g., factors such as a patient's physical disability, different cognitive phenotypes, mood status, fatigue. Considering that SC is an important domain of CI in MS and may contribute to subjects' social participation and quality of life, we herein conceptualize and present the methodological design of a cross-sectional study in 100 PwMS of different disease subtypes. The study aims (a) to characterize SC impairment in PwMS in the Greek population and (b) to unveil the relationship between clinical symptoms, phenotypes of CI, mood status and fatigue in PwMS and the potential underlying impairment on tasks of SC.
Collapse
Affiliation(s)
- Triantafyllos K. Doskas
- Neurology Department, Athens Naval Hospital, 11521 Athens, Greece; (T.K.D.); (K.C.S.)
- Neurology Department, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (F.C.); (A.T.); (I.I.); (K.V.)
| | - Foteini Christidi
- Neurology Department, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (F.C.); (A.T.); (I.I.); (K.V.)
| | - Kanellos C. Spiliopoulos
- Neurology Department, Athens Naval Hospital, 11521 Athens, Greece; (T.K.D.); (K.C.S.)
- Neurology Department, University of Patras, 26504 Patras, Greece
| | - Dimitrios Tsiptsios
- Neurology Department, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (F.C.); (A.T.); (I.I.); (K.V.)
| | | | - Anna Tsiakiri
- Neurology Department, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (F.C.); (A.T.); (I.I.); (K.V.)
| | - Theofanis Vorvolakos
- Psychiatry Department, Democritus University of Thrace, 68100 Alexandroupolis, Greece;
| | - Christos Kokkotis
- Department of Physical Education and Sport Science, Democritus University of Thrace, 69100 Komotini, Greece; (C.K.); (N.A.)
| | - Ioannis Iliopoulos
- Neurology Department, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (F.C.); (A.T.); (I.I.); (K.V.)
| | - Nikolaos Aggelousis
- Department of Physical Education and Sport Science, Democritus University of Thrace, 69100 Komotini, Greece; (C.K.); (N.A.)
| | - Konstantinos Vadikolias
- Neurology Department, Democritus University of Thrace, 68100 Alexandroupolis, Greece; (F.C.); (A.T.); (I.I.); (K.V.)
| |
Collapse
|
9
|
Weddell RA, Fisher-Hicks S. Comparison of spouse and patient personality change judgments following MS onset. Neuropsychol Rehabil 2023; 33:1384-1410. [PMID: 35857651 DOI: 10.1080/09602011.2022.2101478] [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: 03/22/2022] [Accepted: 07/08/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVES This is the first study to estimate the prevalence and predictors of spouse and patient perceptions of global/overall personality change (PC) in patients with multiple sclerosis (MS). METHODS 69 clinic patients and their spouses completed parallel measures of perceived PC and semantic differential scales measuring pre-MS and current specific behaviours. We correlated perceived personality changes with the following measures of perceived physical, cognitive, emotional, and social functioning: MS Impact Scale, MS Neuropsychological Questionnaire, Beck Depression Inventory-FastScreen; Hospital Anxiety and Depression Scale; Family Questionnaire, McMaster Assessment Device; and Social Provisions Scale. RESULTS Spouses and patients reported comparable levels of substantial change. Both associated PC with patient distress, perceived cognitive impairment, spouse distress, and poorer family functioning. Spouse, but not patient, PC ratings predicted severity of physical symptoms and social support. Principal component analysis of semantic differential ratings yielded a Compassionate Empathy component correlating with PC within spouse, but not patient, data. CONCLUSIONS These partially overlapping potential triggers for spouse and patient PC judgments raise questions about the extent they overlap with clinicians' criteria for PC, since spouses did not link impulsivity with PC. It is also suggested that the initial focus of treatment of PC should focus on partner-agreed changes.
Collapse
Affiliation(s)
- Rodger A Weddell
- Neuropsychology Department, Morriston Hospital, Swansea, UK
- Brain Injury Research Group, Swansea University, Swansea, UK
| | | |
Collapse
|
10
|
Chen X, Wu Z, Zhan B, Ding D, Zhang X. Effects of Alexithymia on Moral Decision-Making in Sacrificial Dilemmas: High Alexithymia is Associated with Weaker Sensitivity to Moral Norms. Psychol Res Behav Manag 2023; 16:2315-2325. [PMID: 37396404 PMCID: PMC10314773 DOI: 10.2147/prbm.s407744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/13/2023] [Indexed: 07/04/2023] Open
Abstract
Purpose Although several studies have investigated the association between alexithymia and moral decision-making in sacrificial dilemmas, the evidence remains mixed. The current work investigated this association and how alexithymia affects moral choice in such dilemmas. Methods The current research used a multinomial model (ie, CNI model) to disentangle (a) sensitivity to consequences, (b) sensitivity to moral norms, and (c) general preference for inaction versus action irrespective of consequences and norms in responses to moral dilemmas. Results Higher levels of alexithymia were associated with a greater preference for utilitarian judgments in sacrificial dilemmas (Study 1). Furthermore, individuals with high alexithymia showed significantly weaker sensitivity to moral norms than did those with low alexithymia, whereas there were no significant differences in sensitivity to consequences or a general preference for inaction versus action (Study 2). Conclusion The findings suggest that alexithymia affects moral choice in sacrificial dilemmas by blunting emotional reactions to causing harm, rather than through increased deliberative cost-benefit reasoning or general preference for inaction.
Collapse
Affiliation(s)
- Xiyou Chen
- Department of Psychology, School of Education Science, Hunan Normal University, Changsha, People’s Republic of China
- Center for Mind and Brain Science, Hunan Normal University, Changsha, People’s Republic of China
| | - Zhihui Wu
- Department of Psychology, School of Education Science, Hunan Normal University, Changsha, People’s Republic of China
- Center for Mind and Brain Science, Hunan Normal University, Changsha, People’s Republic of China
| | - Bin Zhan
- State Key Laboratory of Brain and Cognitive Sciences, CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Psychology, Chinese Academy of Sciences, Beijing, People’s Republic of China
| | - Daoqun Ding
- Department of Psychology, School of Education Science, Hunan Normal University, Changsha, People’s Republic of China
- Center for Mind and Brain Science, Hunan Normal University, Changsha, People’s Republic of China
| | - Xiangyi Zhang
- Department of Psychology, School of Education Science, Hunan Normal University, Changsha, People’s Republic of China
- Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, People’s Republic of China
| |
Collapse
|
11
|
Piacentini C, Argento O, Nocentini U. Cognitive impairment in multiple sclerosis: "classic" knowledge and recent acquisitions. ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:585-596. [PMID: 37379870 PMCID: PMC10658666 DOI: 10.1055/s-0043-1763485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/11/2022] [Indexed: 06/30/2023]
Abstract
Multiple sclerosis (MS) is a central nervous system (CNS) disease characterized by inflammation, axonal demyelination, and neurodegeneration, which can have a strong impact on all aspects of the life of the patient. Multiple sclerosis causes motor, sensory, cerebellar, and autonomic dysfunctions, as well as cognitive and psychoemotional impairment. The most frequently compromised cognitive domains are complex attention/information processing, memory, executive and visuospatial functions. Recently, alterations have also been evidenced in complex cognitive functions, such as social cognition, moral judgment, and decision-making. Cognitive impairment is characterized by high variability and can affect work skills, social interactions, coping strategies and more generally the quality of life of patients and their families. With the use of sensitive and easy-to-administer test batteries, an increasingly accurate and early diagnosis is feasible: this allows to determine the effectiveness of possible preventive measures, to predict the future progression of the disease and to improve the quality of life of patients. There is currently limited evidence regarding the efficacy, on cognitive impairment, of disease-modifying therapies. The most promising approach, which has received strong empirical support, is cognitive rehabilitation.
Collapse
Affiliation(s)
- Chiara Piacentini
- Institute of Hospitalization and Care of a Scientific Character “Santa Lucia”
Foundation, Behavioral Neuropsychology, Rome, Italy.
| | - Ornella Argento
- Institute of Hospitalization and Care of a Scientific Character “Santa Lucia”
Foundation, Behavioral Neuropsychology, Rome, Italy.
| | - Ugo Nocentini
- Institute of Hospitalization and Care of a Scientific Character “Santa Lucia”
Foundation, Behavioral Neuropsychology, Rome, Italy.
- University of Rome “Tor Vergata”, Department of Clinical Sciences and
Translational Medicine, Rome, Italy.
| |
Collapse
|
12
|
Alexithymia and Coping With Stress in Patients With Multiple Sclerosis: A Comparative Study. J Neurosci Nurs 2023; 55:24-29. [PMID: 36579898 DOI: 10.1097/jnn.0000000000000684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
ABSTRACT BACKGROUND: Multiple sclerosis (MS), which is frequently seen in young adults, affects mental health because of disease symptoms and cognitive disorders. This study was conducted to evaluate the presence of alexithymia and problem- or emotion-focused coping strategies with stress in MS patients, determine the relationship between these variables, and compare the results of MS patients with those of healthy individuals. METHODS: This descriptive, cross-sectional, and comparative study was carried out with the participation of 120 MS patients presenting to a neurology clinic and outpatient clinic of a university hospital and 120 healthy individuals. Data were collected using a personal information form, the Toronto Alexithymia Scale, and the Ways of Coping Scale. RESULTS: The 40.8% rate of alexithymia in the MS patients was higher than that in the healthy individuals (21.7%). Compared with healthy individuals, MS patients use emotion-focused coping methods, such as a lack of self-confidence approach and a submissive approach, more frequently ( P < .05). A significant negative correlation was found between the alexithymia and problem-focused coping strategies of MS patients ( P < .01). CONCLUSION: Alexithymia is more common in MS patients than in healthy individuals. Alexithymia negatively affects the methods patients use to cope with stress. In the treatment and care of MS patients, nurses should plan interventions for the ability of these patients to recognize and express their emotions and develop positive coping methods.
Collapse
|
13
|
Karpuz Seren B, Acikgoz M, Piri Cinar B, Aciman Demirel E, Celebi U, Atasoy HT. The relationship between alexithymia, reading the mind in the eyes and cognition in patients with multiple sclerosis. Mult Scler Relat Disord 2022; 68:104196. [PMID: 36223703 DOI: 10.1016/j.msard.2022.104196] [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: 12/24/2021] [Revised: 08/29/2022] [Accepted: 09/25/2022] [Indexed: 12/15/2022]
Abstract
AIM The purpose of this study was to determine the frequency of alexithymia, difficulty in recognizing one's own and others' emotions, to determine the ability to read the mind in the eyes that evaluates the emotions of others, and to assess the relationship between these parameters and demographic characteristics, cognition, anxiety and depression in people with multiple sclerosis (PwMS). MATERIAL AND METHOD Seventy patients presenting to the neurology clinic and diagnosed with MS and 70 healthy volunteers with similar demographic characteristics were included in the study. The California Verbal Learning Test II (CVLT II), Symbol Digit Modalities Test (SDMT), Revised Brief Visuospatial Memory Test (BVMT-R), and Trail-Making Test (TMT) were applied to determine all participants' cognitive status. All participants were also administered Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Toronto Alexithymia Scale-20 (TAS-20), Reading the Mind in the Eyes Test (RMET), Fatigue Impact Scale (FIS) and Short Form 36 Health Survey (SF-36) for quality of life. RESULTS Alexithymia levels were higher in the PwMS than in the control group, 24.2% of the PwMS and 4.2% of the control group being alexithymic. The PwMS group exhibited poorer performance on all cognitive tests and in BDI, BAI, FIS and SF-36 scale scores than the control group. No difference was determined between the groups' RMET scores. Depression and anxiety levels increased in line with alexithymia levels in the PwMS group, while RMET scores decreased. No association was determined between alexithymia levels and age, sex, duration of disease, degree of disability, cognition, or fatigue. RMET scores were not affected by age, sex, duration of disease, degree of disability, anxiety, or fatigue, but were lower among individuals with poor cognition and in depressive patients. CONCLUSION Neuropsychiatric symptoms have been the subject of considerable research in MS in recent years and these clinical characteristics in patients have begun being closely monitored. PwMS are capable of experiencing difficulty in identifying emotions in themselves and others, and their social lives can be affected. In addition, the fact that this exhibits an association with cognition based on RMET is particularly noteworthy.
Collapse
Affiliation(s)
- Burcu Karpuz Seren
- Zonguldak Bulent Ecevit University Faculty of Medicine Neurology Department, Zonguldak, Turkey
| | - Mustafa Acikgoz
- Zonguldak Bulent Ecevit University Faculty of Medicine Neurology Department, Zonguldak, Turkey.
| | - Bilge Piri Cinar
- Zonguldak Bulent Ecevit University Faculty of Medicine Neurology Department, Zonguldak, Turkey
| | - Esra Aciman Demirel
- Zonguldak Bulent Ecevit University Faculty of Medicine Neurology Department, Zonguldak, Turkey
| | - Ulufer Celebi
- Zonguldak Bulent Ecevit University Faculty of Medicine Neurology Department, Zonguldak, Turkey
| | - Hüseyin Tugrul Atasoy
- Zonguldak Bulent Ecevit University Faculty of Medicine Neurology Department, Zonguldak, Turkey
| |
Collapse
|
14
|
Yin X, Hong Z, Zheng Y, Ni Y. Effect of subclinical depression on moral judgment dilemmas: a process dissociation approach. Sci Rep 2022; 12:20065. [PMID: 36414675 PMCID: PMC9681861 DOI: 10.1038/s41598-022-24473-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 11/15/2022] [Indexed: 11/23/2022] Open
Abstract
Dual-process theory of moral judgment indicates that moral decision-making is guided by emotional or cognitive processing, competing with each other. While emotional processing overwhelms cognitive processing, individuals preferentially make deontological judgments. Further, while cognitive processing dominates emotional processing, individuals preferentially make utilitarian judgments. This theory predicts that individuals with subclinical depression associated with emotion regulation deficits may deliver more utilitarian judgments. Experiment 1 indicated that higher depressive symptoms predicted utilitarian judgment. However, previous studies have not determined why individuals with subclinical depression make a utilitarian judgment. Thus, Experiment 2 employed the process-dissociation approach, which can separately measure the relative strength of individual deontological and utilitarian inclinations. Deontological inclination (parameter D) was associated with emotional processing, whereas utilitarian inclination (parameter U) was related to cognitive processing. In Experiment 2, the two groups (higher depressive symptoms/minimal depressive symptoms) completed the moral task of the process-dissociation approach to investigate the underlying mechanism. There was a significant interaction effect between the group and parameter of process dissociation. Parameter D in the higher depressive symptoms group was weaker than in the minimal depressive symptoms group. Individuals with subclinical depression bias their utilitarian judgments by making fewer deontological moral judgments.
Collapse
Affiliation(s)
- Xiyang Yin
- Guangzhou Huashang Vocational College, Center of Mental Health Education and Counseling, Guangzhou, 511300, People's Republic of China.
| | - Zijing Hong
- Jinan University, School of Management, Guangzhou, 510632, People's Republic of China
| | - Yinjia Zheng
- Department of Psychology, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510170, People's Republic of China
| | - Yali Ni
- Guangzhou Huashang Vocational College, Center of Mental Health Education and Counseling, Guangzhou, 511300, People's Republic of China.
| |
Collapse
|
15
|
Wang H, Zhao P, Zhao J, Zhong J, Pan P, Wang G, Yi Z. Theory of Mind and Empathy in Adults With Epilepsy: A Meta-Analysis. Front Psychiatry 2022; 13:877957. [PMID: 35573343 PMCID: PMC9093035 DOI: 10.3389/fpsyt.2022.877957] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/04/2022] [Indexed: 12/18/2022] Open
Abstract
Mounting evidence suggests that social cognitive abilities [including theory of mind (ToM) and empathy] are impaired in adult patients with epilepsy. Although the deficits in overall ToM in epilepsy have been documented well, the effects of epilepsy on empathic ability and specific subcomponents of ToM remain unclear. The primary aim of this study was to provide the first meta-analytic integration of ToM and empathy in adult patients with epilepsy, and to decompose these constructs to clearly differentiate their distinct (cognitive ToM and affective empathy) and overlapping (affective ToM/cognitive empathy) components. This meta-analysis included 28 studies. Adult patients with temporal lobe epilepsy (TLE) and frontal lobe epilepsy (FLE) showed impairments in cognitive ToM and affective ToM/cognitive empathy compared to the healthy controls (HCs); no group differences were identified for affective empathy. Besides, cognitive ToM was impaired in adult patients with idiopathic generalized epilepsy (IGE) and focal seizures (caused by epileptogenic foci) outside the temporal and frontal lobes (extra-TLE/FLE) and no group differences were evident for affective ToM/cognitive empathy compared to the HCs. Moreover, relative to the HCs, no group differences were identified for affective empathy in adult patients with IGE. Additionally, no (statistically) significant difference was observed between the magnitude of ToM/empathy impairment in adult patients who underwent and those who did not undergo epilepsy surgery. These quantitative findings suggest differential impairment of the core aspects of social cognitive processing in adult patients with epilepsy, which may contribute to the development of structured cognitive interventions (i.e., social cognitive training) for adult patients with epilepsy.
Collapse
Affiliation(s)
- HongZhou Wang
- Department of Neurology, Anting Hospital, Shanghai, China
| | - PanWen Zhao
- Department of Central Laboratory, Yancheng Third People's Hospital, The Sixth Affiliated Hospital of Nantong University, Yancheng, China
| | - Jing Zhao
- Department of Central Laboratory, Yancheng Third People's Hospital, The Sixth Affiliated Hospital of Nantong University, Yancheng, China
| | - JianGuo Zhong
- Department of Neurology, Yancheng Third People's Hospital, The Sixth Affiliated Hospital of Nantong University, Yancheng, China
| | - PingLei Pan
- Department of Central Laboratory, Yancheng Third People's Hospital, The Sixth Affiliated Hospital of Nantong University, Yancheng, China.,Department of Neurology, Yancheng Third People's Hospital, The Sixth Affiliated Hospital of Nantong University, Yancheng, China
| | - GenDi Wang
- Department of Neurology, Yancheng Third People's Hospital, The Sixth Affiliated Hospital of Nantong University, Yancheng, China
| | - ZhongQuan Yi
- Department of Central Laboratory, Yancheng Third People's Hospital, The Sixth Affiliated Hospital of Nantong University, Yancheng, China
| |
Collapse
|
16
|
Brewer R, Murphy J, Bird G. Atypical interoception as a common risk factor for psychopathology: A review. Neurosci Biobehav Rev 2021; 130:470-508. [PMID: 34358578 PMCID: PMC8522807 DOI: 10.1016/j.neubiorev.2021.07.036] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 07/09/2021] [Accepted: 07/31/2021] [Indexed: 02/06/2023]
Abstract
The inadequacy of a categorial approach to mental health diagnosis is now well-recognised, with many authors, diagnostic manuals and funding bodies advocating a dimensional, trans-diagnostic approach to mental health research. Variance in interoception, the ability to perceive one's internal bodily state, is reported across diagnostic boundaries, and is associated with atypical functioning across symptom categories. Drawing on behavioural and neuroscientific evidence, we outline current research on the contribution of interoception to numerous cognitive and affective abilities (in both typical and clinical populations), and describe the interoceptive atypicalities seen in a range of psychiatric conditions. We discuss the role that interoception may play in the development and maintenance of psychopathology, as well as the ways in which interoception may differ across clinical presentations. A number of important areas for further research on the role of interoception in psychopathology are highlighted.
Collapse
Affiliation(s)
- Rebecca Brewer
- Department of Psychology, Royal Holloway, University of London, United Kingdom
| | - Jennifer Murphy
- Department of Psychology, Royal Holloway, University of London, United Kingdom.
| | - Geoffrey Bird
- Department of Experimental Psychology, University of Oxford, United Kingdom; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| |
Collapse
|
17
|
The relationship between alexithymia and theory of mind: A systematic review. Neurosci Biobehav Rev 2021; 131:497-524. [PMID: 34599917 DOI: 10.1016/j.neubiorev.2021.09.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 09/16/2021] [Accepted: 09/19/2021] [Indexed: 12/19/2022]
Abstract
Theory of Mind (ToM), the ability to represent the mental states of oneself and others, is an essential social skill disrupted across many psychiatric conditions. The transdiagnostic nature of ToM impairment means it is plausible that ToM impairment is related to alexithymia (difficulties identifying and describing one's own emotions), as alexithymia is seen across psychiatric conditions. Whilst many studies have examined links between alexithymia and ToM, results are mixed. Therefore, the purpose of this systematic review is to provide a taxonomy of ToM tests and assess their relationship with alexithymia. Tests are grouped according to whether they assess propensity to engage spontaneously in ToM or accuracy of ToM inferences, with tests further subdivided into those that do, and do not, require emotion recognition. A review of 63 suitable studies suggests that alexithymia is often associated with reduced ToM, and inaccurate ToM when tasks require emotion recognition. This latter finding appears due to impaired emotion recognition, rather than ToM impairment per se. Further directions and considerations for future research are discussed.
Collapse
|
18
|
Jougleux C, Hennion S, Outteryck O, Vermersch P, Zéphir H. Characterization of alexithymia in clinically isolated syndrome. Rev Neurol (Paris) 2021; 177:1145-1150. [PMID: 34187691 DOI: 10.1016/j.neurol.2021.01.017] [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: 12/15/2020] [Revised: 01/19/2021] [Accepted: 01/26/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND In multiple sclerosis (MS), the prevalence of alexithymia, defined as an inability to identify and describe emotions, is close to 50% but the prevalence of this symptom in clinically isolated syndrome (CIS) is unknown. Characterizing alexithymia at an early stage of the disease can help to clarify psychobehavioural disturbances in CIS patients. METHODS Forty CIS patients, who fulfilled the MRI criteria for dissemination in space, were matched with 40 healthy subjects. They completed self-assessment scales for alexithymia, depression, anxiety, apathy and empathy. Cognitive functions were assessed using a battery of neuropsychological tests. RESULTS The mean delay (± standard deviation) between the occurrence of CIS and inclusion in the study was 3.9 (2.8) months. The frequency of alexithymia was higher in CIS patients than in controls, with a prevalence of 42% (P<0.0001). Alexithymia correlated with anxiety and depression but not with cognition. Alexithymia was dependent only on depression (P=0.003). CONCLUSION Alexithymia, characterized by difficulty identifying feelings, is present in patients in the early stage of MS, and seems to be strongly associated with depression. Difficulty in social interaction could be a risk of future affective disorders.
Collapse
Affiliation(s)
| | - S Hennion
- CHU de Lille, France; Centre de référence épilepsie des maladies rares de Lille, France
| | - O Outteryck
- CHU de Lille, France; CHU de Lille. U1171 Université de Lille, France
| | - P Vermersch
- CHU de Lille, France; Université de Lille, U1172, Lille, France
| | - H Zéphir
- CHU de Lille, France; Université de Lille, U1172, Lille, France
| |
Collapse
|
19
|
Wright JKX, Grainger SA, Coundouris SP, Henry JD. Affective empathy in neurodegenerative disorders: The importance of measurement type. Neurosci Biobehav Rev 2021; 127:808-819. [PMID: 34098183 DOI: 10.1016/j.neubiorev.2021.05.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 04/09/2021] [Accepted: 05/22/2021] [Indexed: 01/02/2023]
Abstract
In recent years, there has been increasing attention focused on affective empathy in neurodegenerative disorders (NDs). However, prior studies have identified discrepancies not only between, but sometimes within, specific NDs. These discrepancies may reflect methodological differences in how affective empathy has been operationalized, with three quite distinct approaches to assessment possible (self-report, informant-report and performance-based). Therefore, we conducted the first meta-analytic review of affective empathy in people with NDs, that considered the potential moderating role of measurement type. Across 27 studies that included 1456 people with NDs and 832 controls, the results showed that most NDs are associated with impaired affective empathy, but that the magnitude of these difficulties differs meaningfully across disorders. However, most importantly, the results indicated that measurement type is a critical consideration in this literature, with substantive differences emerging for self- versus informant-rated measures. These results are discussed in relation to their practical implications for clinical assessment, as well as how they help to inform current theoretical understanding of affective empathic processing.
Collapse
Affiliation(s)
- Janet K X Wright
- School of Psychology, The University of Queensland, Brisbane, Australia
| | - Sarah A Grainger
- School of Psychology, The University of Queensland, Brisbane, Australia
| | | | - Julie D Henry
- School of Psychology, The University of Queensland, Brisbane, Australia.
| |
Collapse
|
20
|
Önal A, Rapp MA, Sebold M, Garbusow M, Chen H, Kuitunen-Paul S, Montag C, Kluge U, Smolka MN, Heinz A. Empathy and the ability to experience one's own emotions modify the expression of blatant and subtle prejudice among young male adults. J Psychiatr Res 2021; 137:471-479. [PMID: 33798974 DOI: 10.1016/j.jpsychires.2021.03.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 03/02/2021] [Accepted: 03/05/2021] [Indexed: 01/10/2023]
Abstract
Prejudices can lead to discrimination, social exclusion, and violence particularly among young male adults. Previous findings suggest that the degree of holding prejudices is linked to low levels of empathy, while low levels of empathy have been associated with alexithymia, the inability to experience one's own feelings. We tested the hypothesis that the impact of a lack of empathy on reporting blatant and subtle prejudices is moderated by the inability to identify one's own feelings. In a sample of n = 136 young male adults aged 21 years (mean = 21.5 years; sd = 0.3), we conducted correlation and moderator analyses to determine possible relationships between prejudices, empathy, and alexithymia as assessed by self-report questionnaires. Prejudices were assessed by the Blatant and Subtle Prejudice Scale (BSPS), empathy was assessed by the German modified version of the Interpersonal Reactivity Index (IRI), and alexithymia by the 20-item Toronto Alexithymia Scale (TAS-20). Self-reported empathy levels were correlated with the strength of subtle and blatant prejudices. The moderation analyses revealed that the negative association between empathy and subtle prejudice increased with decreasing alexithymia. The negative association between empathy and blatant prejudice, on the other hand, was significant only for participants with low levels of alexithymia. These results suggest that empathy can limit the expression of blatant and to some degree also subtle prejudice when subjects are capable to identify their own feelings in a group of young males.
Collapse
Affiliation(s)
- A Önal
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, And Berlin Institute of Health, Institute of Psychiatry and Psychotherapy, 10117, Berlin, Germany.
| | - M A Rapp
- Department for Social and Preventive Medicine, University of Potsdam, 14469, Potsdam, Germany.
| | - M Sebold
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, And Berlin Institute of Health, Institute of Psychiatry and Psychotherapy, 10117, Berlin, Germany.
| | - M Garbusow
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, And Berlin Institute of Health, Institute of Psychiatry and Psychotherapy, 10117, Berlin, Germany.
| | - H Chen
- Department of Psychiatry and Neuroimaging Centre, Technische Universität Dresden, 01307, Dresden, Germany.
| | - S Kuitunen-Paul
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, 01187, Dresden, Germany; Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, 01307, Dresden, Germany.
| | - C Montag
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, And Berlin Institute of Health, Institute of Psychiatry and Psychotherapy, 10117, Berlin, Germany.
| | - U Kluge
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, And Berlin Institute of Health, Institute of Psychiatry and Psychotherapy, 10117, Berlin, Germany.
| | - M N Smolka
- Department of Psychiatry and Neuroimaging Centre, Technische Universität Dresden, 01307, Dresden, Germany.
| | - A Heinz
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, And Berlin Institute of Health, Institute of Psychiatry and Psychotherapy, 10117, Berlin, Germany.
| |
Collapse
|
21
|
Doskas T, Vavougios GD, Karampetsou P, Kormas C, Synadinakis E, Stavrogianni K, Sionidou P, Serdari A, Vorvolakos T, Iliopoulos I, Vadikolias Κ. Neurocognitive impairment and social cognition in multiple sclerosis. Int J Neurosci 2021; 132:1229-1244. [PMID: 33527857 DOI: 10.1080/00207454.2021.1879066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE/AIM OF THE STUDY The impairment of neurocognitive functions occurs in all subtypes of multiple sclerosis, even from the earliest stages of the disease. Commonly reported manifestations of cognitive impairment include deficits in attention, conceptual reasoning, processing efficiency, information processing speed, memory (episodic and working), verbal fluency (language), and executive functions. Multiple sclerosis patients also suffer from social cognition impairment, which affects their social functioning. The objective of the current paper is to assess the effect of neurocognitive impairment and its potential correlation with social cognition performance and impairment in multiple sclerosis patients. MATERIALS AND METHODS An overview of the available-to-date literature on neurocognitive impairment and social cognition performance in multiple sclerosis patients by disease subtype was performed. RESULTS It is not clear if social cognition impairment occurs independently or secondarily to neurocognitive impairment. There are associations of variable strengths between neurocognitive and social cognition deficits and their neural basis is increasingly investigated. CONCLUSIONS The prompt detection of neurocognitive predictors of social cognition impairment that may be applicable to all multiple sclerosis subtypes and intervention are crucial to prevent further neural and social cognition decline in multiple sclerosis patients.
Collapse
Affiliation(s)
- Triantafyllos Doskas
- Department of Neurology, Athens Naval Hospital, Athens, Greece.,Department of Neurology, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | | | | | | | | | | | | | - Aspasia Serdari
- Department of Psychiatry, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Theofanis Vorvolakos
- Department of Psychiatry, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Ioannis Iliopoulos
- Department of Neurology, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | | |
Collapse
|
22
|
Weddell R, Fisher-Hicks S. Correlates of the personality change judgments of individuals who have MS. Brain Inj 2021; 35:345-355. [PMID: 33395314 DOI: 10.1080/02699052.2020.1865568] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objectives: This is the first study to estimate prevalence of self-reported personality change (PC) in people with multiple sclerosis (MS). Methods developed in traumatic brain injury studies explore physical, and psychosocial triggers for PC judgments.Participants: 69 MS clinic attendees living with their partner.Measures: Participants rated the degree of PC. 28 Current and pre-MS characteristics were rated. The Multiple Sclerosis Impact Scale, the MS Neuropsychological Questionnaire, the Beck Depression Inventory-FastScreen, and the Hospital Anxiety and Depression Scale quantified neuropsychological status. The Family Questionnaire, McMaster Assessment Device and the Social Provisions Scale sampled perceived social influences.Results: 54% perceived substantial PC. Current characteristics predicted PC better than perceived behavior changes. PC was associated with specific characteristics denoting stress reactions, emotional distress, perceived cognitive impairment and poorer family functioning. PC was not significantly related to severity of physical symptoms or social support. This study also suggested that the specific characteristics questionnaire probed at least 2 components of reconstructed identity: PC/Reactivity and Disability.Conclusions: This study raises methodological concerns about measures that simply sum ratings of characteristics related to self-identity. It also proposes possible ways of collaborating with individuals in their efforts to respond constructively to PC and other changes. .
Collapse
|
23
|
Lin X, Zhang X, Liu Q, Zhao P, Zhong J, Pan P, Wang G, Yi Z. Empathy and Theory of Mind in Multiple Sclerosis: A Meta-Analysis. Front Psychiatry 2021; 12:628110. [PMID: 33897490 PMCID: PMC8062809 DOI: 10.3389/fpsyt.2021.628110] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 03/18/2021] [Indexed: 12/25/2022] Open
Abstract
Multiple sclerosis (MS) is an immune-mediated demyelinating disease of the central nervous system. Studies have shown that MS disrupts several social cognitive abilities [including empathy and theory of mind (ToM)]. Overall ToM deficits in MS are well documented, but how the specific ToM subcomponents and empathic capacity are affected remains unclear. For this meta-analysis, we searched PubMed, Web of Science, and Embase from inception to July 2020. Effect sizes were calculated using Hedges g with a random-effects model. Thirty-three studies were included. Relative to healthy controls (HCs), patients with MS were moderately impaired in overall empathy (g = -0.67), overall ToM (g = -74), cognitive ToM (g = -0.72), and the overlapping domains of cognitive empathy/affective ToM (g = -0.79); no group differences were identified for affective empathy (g = -0.19). Compared with HCs, patients with relapsing-remitting MS (RRMS) and progressive MS were impaired in overall empathy, overall ToM, cognitive ToM, and cognitive empathy/affective ToM, without significant RRMS-progressive MS differences in impairment degree. We conducted the first meta-analytic review investigating the empathy and ToM functioning patterns in patients with MS and examined the overlapping and distinct subcomponents of these constructs. The findings suggest differential impairment of the core aspects of social cognitive processing in patients with MS, which may importantly inform the development of structured social cognitive MS interventions.
Collapse
Affiliation(s)
- XiaoGuang Lin
- Department of Neurology, Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China
| | - XueLing Zhang
- Department of Neurology, Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China
| | - QinQin Liu
- Department of Neurology, Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China
| | - PanWen Zhao
- Department of Central Laboratory, Affiliated Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng, China
| | - JianGuo Zhong
- Department of Neurology, Affiliated Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng, China
| | - PingLei Pan
- Department of Neurology and Department of Central Laboratory, Affiliated Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng, China
| | - GenDi Wang
- Department of Neurology, Affiliated Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng, China
| | - ZhongQuan Yi
- Department of Central Laboratory, Affiliated Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng, China
| |
Collapse
|
24
|
Stojanov J, Stojanov A. A cross-sectional study of alexithymia in patients with relapse remitting form of multiple sclerosis. J Postgrad Med 2020; 66:23-27. [PMID: 31929308 PMCID: PMC6970317 DOI: 10.4103/jpgm.jpgm_499_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background: Alexithymia is one's incapacity to identify, comprehend, and describe emotions. There is almost no literature data about the levels of alexithymia among patients with relapse remitting type of multiple sclerosis. Aim: The objective of the present study was to assess the levels of alexithymia in patients with relapse remitting type of multiple sclerosis in relation to their sociodemographic variables and clinical characteristics of the disease. Methods: This cross-sectional study included 106 consecutively assessed patients with relapse remitting type of multiple sclerosis. In addition to the data regarding disease duration, number of demyelinating relapses, and degree of neurological disability, assessed by the expanded disability scale score (EDSS), we used Toronto alexithymia scale (TAS), fatigue severity scale (FSS) and, Hamilton scale for the assessment of anxiety and depression and sociodemographic questionnaire. Results: Study included 74 female and 32 male patients, with a median age of 44 years, median disease duration 90 months, and median EDSS 4. About 29.55% of patients had alexithymia and borderline alexithymia was observed in 31.15% patients. Alexithymia correlated with anxiety and depression (P < 0.01) on all TAS subscales. Higher levels of neurological disability based on EDSS, severe fatigue based on FSS scores, and severe relapse remitting type of multiple sclerosis with more relapses and longer disease duration correlated with alexithymia (P < 0.01), depression (P < 0.01), and anxiety (P < 0.01). Higher rates of alexithymia were noticed in older, unemployed, single patients, and those having fewer children. Conclusions: Alexithymia was found in a relatively high percentage in patients with relapse remitting type of multiple sclerosis.
Collapse
Affiliation(s)
- J Stojanov
- Special Hospital for Psychiatric Illness "Gornja Toponica", Gornja Toponica, Serbia
| | - A Stojanov
- Clinic of Neurology, Clinical Center of Nis, Nis, Serbia
| |
Collapse
|
25
|
The relationship between dimensions of mental health and alexithymia in multiple sclerosis patients. Mult Scler Relat Disord 2020; 46:102525. [DOI: 10.1016/j.msard.2020.102525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 09/15/2020] [Accepted: 09/18/2020] [Indexed: 11/18/2022]
|
26
|
Patil I, Larsen EM, Kichic R, Gleichgerrcht E. Moral Cognition About Harm in Anxiety Disorders: The Importance of Experienced Emotion. Psychol Rep 2020; 124:2501-2523. [PMID: 33028157 DOI: 10.1177/0033294120964134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Recent work has shown that emotional arousal influences decision-making in sacrificial moral dilemmas, with heightened levels of arousal associated with increased aversion to committing moral transgressions to maximize utilitarian outcomes. Patients with anxiety disorders experience pathologically heightened states of arousal and thus may be expected to exhibit reduced utilitarian responding on such dilemmas. Extant evidence has been mixed, however, regarding whether anxious patients differ in their moral decisions from controls, and no study has conducted a careful examination of emotions experienced during decision-making. We administered sacrificial moral dilemmas to a cohort of 95 patients from across the spectrum of anxiety disorders to test whether they differed from matched controls on a) utilitarian decision-making, and b) ratings of experienced emotion during the moral deliberative process. Results showed no group differences between patients and controls on endorsement of utilitarian sacrificial action or on reported experience of emotionality during the experiment. Additionally, exploratory analysis revealed that specific emotions were correlated with utilitarian judgments. These results are in line with the Dual Process Theory model's prediction that decreased utilitarian responding will be concomitant with an increased emotional arousal. Our findings support past work indicating that moral cognition is intact in anxiety disorders despite the emotional dysregulation characteristic of anxious psychopathology. Future work would benefit from the use of process-dissociation techniques to further clarify whether emotional or cognitive processes may differ in anxiety disorders during moral cognition.
Collapse
Affiliation(s)
- Indrajeet Patil
- Department of Psychology, Harvard University, Cambridge, MA, USA; Center for Humans and Machines, Max Planck Institute for Human Development, Berlin, Germany
| | - Emmett M Larsen
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Rafael Kichic
- Institute of Cognitive Neurology, Buenos Aires, Argentina
| | | |
Collapse
|
27
|
Ehrlé N, Hody A, Lecrique M, Gury P, Bakchine S. Social norms in patients with relapsing-remitting multiple sclerosis: Impairment of the moral/conventional distinction? Soc Neurosci 2020; 15:630-640. [PMID: 33026971 DOI: 10.1080/17470919.2020.1834449] [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: 10/23/2022]
Abstract
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.
Collapse
Affiliation(s)
- Nathalie Ehrlé
- Hôpital Maison-Blanche, Service de neurologie , Reims cedex, France.,Laboratoire Mémoire, Cerveau & Cognition (MC²Lab URP 7536) , Boulogne-Billancourt, France
| | | | - Maud Lecrique
- Hôpital Maison-Blanche, Service de neurologie , Reims cedex, France
| | - Pauline Gury
- Hôpital Maison-Blanche, Service de neurologie , Reims cedex, France
| | - Serge Bakchine
- Hôpital Maison-Blanche, Service de neurologie , Reims cedex, France
| |
Collapse
|
28
|
Zhang X, Wu Z, Li S, Lai J, Han M, Chen X, Liu C, Ding D. Why People With High Alexithymia Make More Utilitarian Judgments. Exp Psychol 2020; 67:23-30. [PMID: 32520665 DOI: 10.1027/1618-3169/a000474] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Although recent studies have investigated the effect of alexithymia on moral judgments, such an effect remains elusive. Furthermore, moral judgments have been conflated with the moral inclinations underlying those judgments in previous studies. Using a process dissociation approach to independently quantify the strength of utilitarian and deontological inclinations, the present study investigated the effect of alexithymia on moral judgments. We found that deontological inclinations were significantly lower in the high alexithymia group than in the low alexithymia group, whereas the difference in the utilitarian inclinations between the two groups was nonsignificant. Furthermore, empathic concern and deontological inclinations mediated the association between alexithymia and conventional relative judgments (i.e., more utilitarian judgments over deontological judgments), showing that people with high alexithymia have low empathic concern, which, in turn, decreases deontological inclinations and contributes to conventional relative judgments. These findings underscore the importance of empathy and deontological inclinations in moral judgments and indicate that individuals with high alexithymia make more utilitarian judgments over deontological judgments possibly due to a deficit in affective processing.
Collapse
Affiliation(s)
- Xiangyi Zhang
- Department of Psychology, School of Education Science, Hunan Normal University, Changsha, PR China.,Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, PR China
| | - Zhihui Wu
- Department of Psychology, School of Education Science, Hunan Normal University, Changsha, PR China
| | - Shenglan Li
- Department of Psychology, School of Education Science, Hunan Normal University, Changsha, PR China
| | - Ji Lai
- Department of Psychology, School of Education Science, Hunan Normal University, Changsha, PR China
| | - Meng Han
- Department of Psychology, School of Education Science, Hunan Normal University, Changsha, PR China
| | - Xiyou Chen
- Changsha Experimental High School, Changsha, PR China
| | - Chang Liu
- Department of Criminal Justice, Ningxia Police Vocational College, Ningxia, PR China
| | - Daoqun Ding
- Department of Psychology, School of Education Science, Hunan Normal University, Changsha, PR China.,Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, PR China
| |
Collapse
|
29
|
Empathy in multiple sclerosis––Correlates with cognitive, psychological and occupational functioning. Mult Scler Relat Disord 2020; 41:102036. [DOI: 10.1016/j.msard.2020.102036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 02/25/2020] [Accepted: 03/01/2020] [Indexed: 01/10/2023]
|
30
|
Maresca G, Maggio MG, Latella D, Naro A, Portaro S, Calabrò RS. Understanding the role of social cognition in neurodegenerative Disease: A scoping review on an overlooked problem. J Clin Neurosci 2020; 77:17-24. [PMID: 32389547 DOI: 10.1016/j.jocn.2020.05.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 05/02/2020] [Indexed: 12/12/2022]
Abstract
Social cognition (SC) is the set of socio-cognitive processes that guide automatic and voluntary behaviors by modulating behavioral responses, it includes both cognitive (Theory of the mind - ToM) and affective aspects (Empathy). SC also includes representations of internal somatic states, self-knowledge, perception of others, communication with others and interpersonal motivations. SC is relevant in daily life and reflects the neural complexity of social processing. The purpose of this scoping review is to evaluate the role of SC in neurological disorders, also considering the pathophysiological mechanisms underlying SC and potential assessment tools. The included studies were carried out between 2010 and 2019 and were found on PubMed, Scopus, Cochrane, and Web of Sciences databases, using the combined terms "social cognition"; "dementia"; "multiple sclerosis"; "parkinson", "amyotrophic lateral sclerosis", "neurodegenerative disease". Our review has shown that different SC domains are affected by several neurological conditions, with regards to dementia and amyotrophic lateral sclerosis. Further studies are needed to investigate the association between cognitive and social deficits, for a better management of patients with neurological disorders.
Collapse
Affiliation(s)
| | | | | | - Antonino Naro
- IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | | | | |
Collapse
|
31
|
Li S, Ding D, Lai J, Zhang X, Wu Z, Liu C. The Characteristics of Moral Judgment of Psychopaths: The Mediating Effect of the Deontological Tendency. Psychol Res Behav Manag 2020; 13:257-266. [PMID: 32210648 PMCID: PMC7069607 DOI: 10.2147/prbm.s226722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 02/18/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Many studies explore the relationship between moral judgment and psychopathy in western culture, but the mechanism underlying this relationship remains unclear. By far, no research about this topic in the background of Chinese culture exists. In the current study, we adopt one of the creative process-dissociation approaches to explore the relationship between the psychopath and moral judgment. Methods Adopt the Levenson Self-Report Psychopathic Scale, the Chinese version of Interpersonal Reactivity and Process-dissociation approach to explore the relationship between the psychopath and moral judgment. Results Traditional utilitarian moral score of the high psychopathy group are significantly higher than that of low psychopathy group (t= 2.97, p<0.05), people with high psychopathy utilitarian tendency U factor score and people with low psychopathy have no significant difference (F= 0.85, p = 0.36). Conclusion Individuals with high psychopathy tend to make fewer deontological moral judgments because of their decreased deontological tendencies rather than their increased utilitarian tendencies. They may make more acceptance choices not to increase the well-being of the majority of people, but because of their increased acceptance of hurting others in the moral dilemma.
Collapse
Affiliation(s)
- Shenglan Li
- Department of Psychology, School of Education Science, Hunan Normal University, Changsha, People's Republic of China.,Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, People's Republic of China
| | - Daoqun Ding
- Department of Psychology, School of Education Science, Hunan Normal University, Changsha, People's Republic of China.,Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, People's Republic of China
| | - Ji Lai
- Department of Psychology, School of Education Science, Hunan Normal University, Changsha, People's Republic of China
| | - Xiangyi Zhang
- Department of Psychology, School of Education Science, Hunan Normal University, Changsha, People's Republic of China.,Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, People's Republic of China
| | - Zhihui Wu
- Department of Psychology, School of Education Science, Hunan Normal University, Changsha, People's Republic of China
| | - Chang Liu
- Department of Criminal Justice, Ningxia Police Vocational College, Ningxia, People's Republic of China
| |
Collapse
|
32
|
Chalah MA, Kauv P, Palm U, Lefaucheur JP, Hodel J, Créange A, Ayache SS. Deciphering the neural underpinnings of alexithymia in multiple sclerosis. Neurosci Lett 2020; 725:134894. [PMID: 32147502 DOI: 10.1016/j.neulet.2020.134894] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/01/2020] [Accepted: 03/04/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Alexithymia is a personality construct that could occur in up to 53 % of patients with multiple sclerosis (MS). It entails difficulties in identifying and describing one's feelings and an externally oriented thinking. The current work aims to assess the neural underpinnings of alexithymia in this population. METHODS Forty-five patients with MS filled in the Toronto Alexithymia Scale (n = 17 with high alexithymia and n = 28 with low alexithymia). Brain magnetic resonance imaging was obtained for each patient and a morphometry algorithm (MorphoBox) was applied to calculate regional brain volumes. All patients underwent a clinical and neuropsychological evaluation which included measures for anxiety, depression, fatigue, daytime sleepiness, and basic and social cognition. RESULTS Compared to patients with low alexithymia, patients with high alexithymia had significantly higher fatigue and depression ratings, and lower empathy scores. In addition, they had lower volumes of corpus callosum, deep white matter, pallidum bilaterally, and left thalamus. In the whole cohort, alexithymia scores were inversely correlated with gray matter (thalamus and pallidum bilaterally) and white matter volumes (corpus callosum and bilateral deep white matter) after controlling for covariates (ps<0.05). CONCLUSION This study offers insights on the neuropsychological and neural substrates of alexithymia in MS. The current findings are consistent with alexithymia reports in other clinical populations, and suggest an association between alexithymia and atrophy of thalami, pallidum, corpus callosum and deep white matter in MS. Further research is needed to enhance the understanding of alexithymia mechanisms in this clinical context.
Collapse
Affiliation(s)
- Moussa A Chalah
- EA 4391, Excitabilité Nerveuse et Thérapeutique, Université Paris-Est-Créteil, Créteil, France; Service de Physiologie - Explorations Fonctionnelles, Hôpital Henri Mondor, Assistance Publique - Hôpitaux de Paris, Créteil, France
| | - Paul Kauv
- EA 4391, Excitabilité Nerveuse et Thérapeutique, Université Paris-Est-Créteil, Créteil, France; Service de Neuroradiologie, Hôpital Henri-Mondor, Assistance Publique - Hôpitaux de Paris, Créteil, France
| | - Ulrich Palm
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany; Medical Park Chiemseeblick, Bernau, Germany
| | - Jean-Pascal Lefaucheur
- EA 4391, Excitabilité Nerveuse et Thérapeutique, Université Paris-Est-Créteil, Créteil, France; Service de Physiologie - Explorations Fonctionnelles, Hôpital Henri Mondor, Assistance Publique - Hôpitaux de Paris, Créteil, France
| | - Jérôme Hodel
- EA 4391, Excitabilité Nerveuse et Thérapeutique, Université Paris-Est-Créteil, Créteil, France; Service de Neuroradiologie, Hôpital Henri-Mondor, Assistance Publique - Hôpitaux de Paris, Créteil, France
| | - Alain Créange
- EA 4391, Excitabilité Nerveuse et Thérapeutique, Université Paris-Est-Créteil, Créteil, France; Service de Neurologie, Hôpital Henri Mondor, Assistance Publique - Hôpitaux de Paris, Créteil, France
| | - Samar S Ayache
- EA 4391, Excitabilité Nerveuse et Thérapeutique, Université Paris-Est-Créteil, Créteil, France; Service de Physiologie - Explorations Fonctionnelles, Hôpital Henri Mondor, Assistance Publique - Hôpitaux de Paris, Créteil, France.
| |
Collapse
|
33
|
Eddy CM. What Do You Have in Mind? Measures to Assess Mental State Reasoning in Neuropsychiatric Populations. Front Psychiatry 2019; 10:425. [PMID: 31354534 PMCID: PMC6636467 DOI: 10.3389/fpsyt.2019.00425] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 05/29/2019] [Indexed: 12/12/2022] Open
Abstract
Social interaction is closely associated with both functional capacity and well-being. Previous research has not only revealed evidence of social dysfunction in individuals with a wide range of psychiatric and neurological disorders but also generated an abundance of potential measures for assessing social cognition. This review explores the most popular measures used within neuropsychiatric populations to investigate the ability to recognize or reason about the mental states of others. Measures are also critically analyzed in terms of strengths and limitations to aid task selection in future clinical studies. The most frequently applied assessment tools use verbal, visual or audiovisual forms of presentation and assess recognition of mental states from facial features, self-rated empathy, the understanding of other's cognitive mental states such as beliefs and intentions, or the ability to combine knowledge of other's thoughts and emotions in order to understand subtle communications or socially inappropriate behavior. Key weaknesses of previous research include limited investigation of relationships with clinical symptoms, and underutilization of measures of everyday social functioning that offer a useful counterpart to traditional "lab" tasks. Future studies should aim to carefully select measures not only based on the range of skills to be assessed but also taking into account potential difficulties with interpretation and the need to gain insight into the application of social cognitive skills as well as ability per se. Some of the best measures include those with well-matched control trials (e.g., Yoni Task) or those that restrict the influence of verbal deficits (e.g., intentions comic strip task), elicit spontaneous mentalizing (e.g., Animations Task), and possess greater ecological validity (e.g., Movie for the Assessment of Social Cognition). Social cognitive research within psychiatric populations will be further enhanced through the development of more closely matched control tasks, and the exploration of relationships between task performance, medication, strategy use, and broader emotional and motor functions.
Collapse
Affiliation(s)
- Clare M. Eddy
- Research and Innovation, BSMHFT National Centre for Mental Health, Birmingham, United Kingdom
- Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| |
Collapse
|
34
|
Moral Judgment: An Overlooked Deficient Domain in Multiple Sclerosis? Behav Sci (Basel) 2018; 8:bs8110105. [PMID: 30453483 PMCID: PMC6262463 DOI: 10.3390/bs8110105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 11/02/2018] [Accepted: 11/13/2018] [Indexed: 12/17/2022] Open
Abstract
Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease of the central nervous system through which patients can suffer from sensory, motor, cerebellar, emotional, and cognitive symptoms. Although cognitive and behavioral dysfunctions are frequently encountered in MS patients, they have previously received little attention. Among the most frequently impaired cognitive domains are attention, information processing speed, and working memory, which have been extensively addressed in this population. However, less emphasis has been placed on other domains like moral judgment. The latter is a complex cognitive sphere that implies the individuals’ ability to judge others’ actions and relies on numerous affective and cognitive processes. Moral cognition is crucial for healthy and adequate interpersonal relationships, and its alteration might have drastic impacts on patients’ quality of life. This work aims to analyze the studies that have addressed moral cognition in MS. Only three works have previously addressed moral judgement in this clinical population compared to healthy controls, and none included neuroimaging or physiological measures. Although scarce, the available data suggest a complex pattern of moral judgments that deviate from normal response. This finding was accompanied by socio-emotional and cognitive deficits. Only preliminary data are available on moral cognition in MS, and its neurobiological foundations are still needing to be explored. Future studies would benefit from combining moral cognitive measures with comprehensive neuropsychological batteries and neuroimaging/neurophysiological modalities (e.g., functional magnetic resonance imaging, tractography, evoked potentials, electroencephalography) aiming to decipher the neural underpinning of moral judgement deficits and subsequently conceive potential interventions in MS patients.
Collapse
|
35
|
Koelkebeck K, Kuegler L, Kohl W, Engell A, Lencer R. Social cognition in schizophrenia: The role of mentalizing in moral dilemma decision-making. Compr Psychiatry 2018; 87:171-178. [PMID: 30415199 DOI: 10.1016/j.comppsych.2018.10.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 10/02/2018] [Accepted: 10/28/2018] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Patients with schizophrenia have difficulties in several aspects of social cognition, e.g. emotion recognition and mentalizing. It is yet unclear if patients also show deficits in moral decision-making and whether the two aspects interact. Deficits in moral decision-making abilities might put patients in disadvantageous positions in every-day interactions. METHOD Twenty-five patients with schizophrenia and twenty-five matched healthy controls participated in six moral dilemma tasks, a standard moral competency test and two mentalizing tasks. In addition, we assessed psychopathology and empathy abilities. In a brief intervention patients were asked to empathize with characters in the moral dilemmas. We expected that the decisions made by patients with schizophrenia would be more out-come-oriented, i.e. utilitarian, as compared to those made by healthy controls. RESULTS Patients and healthy controls did not decide significantly differently on the moral dilemmas and patients showed normal moral competencies. Deficits in mentalizing in patients were replicated. Only in a regression analysis, however, we were able to show that PANSS positive scores and the Comic Strip task scores contributed to the moral decisions. Empathy training did not have an altering influence on decision-making. DISCUSSION Although an overlap between social cognition and moral decision-making networks has been proposed, deficits in moral decision-making and explicit associations with mentalizing were not present in patients. Psychopathology together with mentalizing abilities, however, contributed to decision-making in patients. Our findings suggest that in schizophrenia some aspects, e.g. mentalizing, are more strongly impaired while other aspects, e.g. moral decision-making, are preserved. Further research is needed to elucidate the different aspects forming social cognition and their mutual contributions, specifically in schizophrenia.
Collapse
Affiliation(s)
- Katja Koelkebeck
- University of Muenster, School of Medicine, Department of Psychiatry and Psychotherapy, Muenster, Germany.
| | - Lisa Kuegler
- University of Muenster, School of Medicine, Department of Psychiatry and Psychotherapy, Muenster, Germany.
| | - Waldemar Kohl
- University of Muenster, School of Medicine, Department of Psychiatry and Psychotherapy, Muenster, Germany.
| | - Alva Engell
- University of Muenster, School of Medicine, Department of Psychiatry and Psychotherapy, Muenster, Germany.
| | - Rebekka Lencer
- University of Muenster, School of Medicine, Department of Psychiatry and Psychotherapy, Muenster, Germany.
| |
Collapse
|
36
|
Takamatsu R. Turning off the empathy switch: Lower empathic concern for the victim leads to utilitarian choices of action. PLoS One 2018; 13:e0203826. [PMID: 30212541 PMCID: PMC6136766 DOI: 10.1371/journal.pone.0203826] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 08/28/2018] [Indexed: 11/24/2022] Open
Abstract
Empathy enables people to vicariously experience the other’s pain. At the same time, the focus of empathy can be narrow and reserved for a limited number of people. In sacrificial dilemmas, non-empathic people are more likely to sacrifice one person for greater good. However, no study has investigated the role of diminished empathic concern for the victim in utilitarian choices of action. In two studies, we investigated how empathy actually experienced in sacrificial dilemmas affects a decision to perform a harmful action onto the victim. In Study 1 (N = 275), participants were asked to rate the extent to which they were feeling two divergent tropes of affective empathy: other-oriented empathy (empathic concern) and self-oriented empathy (personal distress). Results showed that lower levels of other-focused empathy for the victim predicted utilitarian choices of action. In Study 2 (N = 170), participants were asked to rate the extent to which they empathized with the victim and the saved. We also assessed dispositional empathy and psychopathy to test a hypothesis that psychopathy mediates the relationship between lower empathy for the victim and utilitarian choices of action. Results supported this hypothesis, whereas dispositional empathy was not significantly correlated with utilitarian choices of action. Overall, lower empathy experienced in the dilemma situation was associated with utilitarian choices of action, and this was specific to reduced empathic concern for the victim. People choose to pursue the utilitarian end that accompanies harm onto the other as a mean when the victim is out of their empathic focus.
Collapse
Affiliation(s)
- Reina Takamatsu
- Department of Psychology and Human Developmental Sciences, Nagoya University, Aichi, Japan
- * E-mail:
| |
Collapse
|
37
|
Realmuto S, Dodich A, Meli R, Canessa N, Ragonese P, Salemi G, Cerami C. Moral Cognition and Multiple Sclerosis: A Neuropsychological Study. Arch Clin Neuropsychol 2018; 34:319-326. [DOI: 10.1093/arclin/acy047] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 03/16/2018] [Accepted: 05/08/2018] [Indexed: 01/28/2023] Open
Affiliation(s)
- Sabrina Realmuto
- Experimental Biomedicine and Clinical Neuroscience Department (BioNeC), University of Palermo, Palermo, Italy
| | - Alessandra Dodich
- Clinical Neuroscience Department, San Raffaele Hospital and Scientific Institute, Milan, Italy
| | - Riccardo Meli
- Experimental Biomedicine and Clinical Neuroscience Department (BioNeC), University of Palermo, Palermo, Italy
| | - Nicola Canessa
- NEtS Center, Istituto Universitario di Studi Superiori, Pavia, Italy
| | - Paolo Ragonese
- Experimental Biomedicine and Clinical Neuroscience Department (BioNeC), University of Palermo, Palermo, Italy
| | - Giuseppe Salemi
- Experimental Biomedicine and Clinical Neuroscience Department (BioNeC), University of Palermo, Palermo, Italy
| | - Chiara Cerami
- Clinical Neuroscience Department, San Raffaele Hospital and Scientific Institute, Milan, Italy
| |
Collapse
|
38
|
Fortier J, Besnard J, Allain P. Theory of mind, empathy and emotion perception in cortical and subcortical neurodegenerative diseases. Rev Neurol (Paris) 2018; 174:237-246. [DOI: 10.1016/j.neurol.2017.07.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 06/15/2017] [Accepted: 07/04/2017] [Indexed: 12/13/2022]
|
39
|
Vanotti S, Caceres FJ. Cognitive and neuropsychiatric disorders among MS patients from Latin America. Mult Scler J Exp Transl Clin 2017; 3:2055217317717508. [PMID: 28979791 PMCID: PMC5617097 DOI: 10.1177/2055217317717508] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 06/04/2017] [Indexed: 11/20/2022] Open
Abstract
Cognitive and neuropsychiatric disorders in patients with multiple sclerosis have been extensively documented. The focus of this review will be on cognitive and neuropsychiatric disorders in multiple sclerosis patients from Latin America, in the context of international literature. Multicentre studies carried out in Latin America have shown that 43% of the patients have cognitive impairment and 34.5% in early stages of the disease, 29% depression and 20.9% neuropsychiatric disorders. The profile of cognitive impairment corresponds to alterations in visual and verbal memory, in attention, in information processing speed and in verbal fluency. The neuropsychiatric profile showed disorders in anxiety, depression, apathy and irritability domains. In the region, there exist validations of the multiple sclerosis neuropsychological screening questionnaire (MSNQ), the brief repeatable battery of neuropsychological tests (BRB-N) and the brief international cognitive assessment for multiple sclerosis (BICAMS), as well as of the paced auditory serial addition test (PASAT) and the symbol digit modalities test (SDMT). A study showed that 53% of the patients who met the NEDA3 condition had cognitive impairment. This finding highlights the need for taking cognitive assessment into account when determining therapeutic efficacy.
Collapse
Affiliation(s)
| | - Fernando J Caceres
- Multiple Sclerosis Clinic, INEBA - Neurosciences Institute of Buenos Aires, Argentina
| |
Collapse
|
40
|
Takamatsu R, Takai J. With or Without Empathy: Primary Psychopathy and Difficulty in Identifying Feelings Predict Utilitarian Judgment in Sacrificial Dilemmas. ETHICS & BEHAVIOR 2017. [DOI: 10.1080/10508422.2017.1367684] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Reina Takamatsu
- Department of Psychology and Developmental Sciences, Nagoya University
| | - Jiro Takai
- Department of Psychology and Developmental Sciences, Nagoya University
| |
Collapse
|
41
|
Chalah MA, Ayache SS. Alexithymia in multiple sclerosis: A systematic review of literature. Neuropsychologia 2017; 104:31-47. [DOI: 10.1016/j.neuropsychologia.2017.07.034] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 07/28/2017] [Accepted: 07/29/2017] [Indexed: 02/07/2023]
|
42
|
Abstract
BACKGROUND AND OBJECTIVES Multiple sclerosis (MS) is a chronic progressive inflammatory disease of the central nervous system, representing the primary cause of non-traumatic disability in young adults. Cognitive dysfunction can affect patients at any time during the disease process and might alter the six core functional domains. Social cognition is a multi-component construct that includes the theory of mind, empathy and social perception of emotions from facial, bodily and vocal cues. Deficits in this cognitive faculty might have a drastic impact on interpersonal relationships and quality of life (QoL). Although exhaustive data exist for non-social cognitive functions in MS, only a little attention has been paid for social cognition. The objectives of the present work are to reappraise the definition and anatomy of social cognition and evaluate the integrity of this domain across MS studies. We will put special emphasis on neuropsychological and neuroimaging studies concerning social cognitive performance in MS. METHODS Studies were selected in conformity with PRISMA guidelines. We looked for computerized databases (PubMed, Medline, and Scopus) that index peer-reviewed journals to identify published reports in English and French languages that mention social cognition and multiple sclerosis, regardless of publication year. We combined keywords as follows: (facial emotion or facial expression or emotional facial expressions or theory of mind or social cognition or empathy or affective prosody) AND multiple sclerosis AND (MRI or functional MRI or positron emission tomography or functional imaging or structural imaging). We also scanned references from articles aiming to get additional relevant studies. RESULTS In total, 26 studies matched the abovementioned criteria (26 neuropsychological studies including five neuroimaging studies). Available data support the presence of social cognitive deficits even at early stages of MS. The increase in disease burden along with the "multiple disconnection syndrome" resulting from gray and white matters pathology might exceed the "threshold for cerebral tolerance" and can manifest as deficits in social cognition. Admitting the impact of the latter on patients' social functioning, a thorough screening for such deficits is crucial to improving patients' QoL. (JINS, 2017, 23, 266-286).
Collapse
|
43
|
Almeida MBD, Going LC, Fragoso YD. Patients with multiple sclerosis present low levels of empathy. ARQUIVOS DE NEURO-PSIQUIATRIA 2016; 74:982-985. [DOI: 10.1590/0004-282x20160154] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 09/01/2016] [Indexed: 11/22/2022]
Abstract
ABSTRACT Multiple sclerosis (MS) is a chronic neuroimmunological disease that mainly affects young adults, leading to neurological disabilities over the course of their lives. Many psychiatric conditions have been reported in patients with MS, but there are remarkably few studies assessing empathy among these patients. Methods This is a single center, cross-sectional study, of 34 patients with MS and 34 matched control subjects. A specific questionnaire (empathy quotient) was used. Results Patients with MS showed significantly lower levels of empathy. This finding was not correlated with disease duration, degree of disability, drugs for treating MS or lesion load on resonance magnetic imaging. Conclusion Decreased empathy is a frequent condition in patients with MS and should be addressed in order to diminish the psychosocial burden of this neurological disease.
Collapse
Affiliation(s)
| | - Luana Carramilo Going
- Universidade Católica de Santos, Brasil; Universidade Metropolitana de Santos, Brasil
| | - Yara Dadalti Fragoso
- Universidade Metropolitana de Santos, Brasil; Universidade Metropolitana de Santos, Brasil
| |
Collapse
|
44
|
Affiliation(s)
- A H V Schapira
- Clinical Neurosciences, UCL Institute of Neurology, London, UK
| |
Collapse
|
45
|
Bora E, Özakbaş S, Velakoulis D, Walterfang M. Social Cognition in Multiple Sclerosis: a Meta-Analysis. Neuropsychol Rev 2016; 26:160-72. [DOI: 10.1007/s11065-016-9320-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Accepted: 05/12/2016] [Indexed: 12/16/2022]
|
46
|
Patil I, Young L, Sinay V, Gleichgerrcht E. Elevated moral condemnation of third-party violations in multiple sclerosis patients. Soc Neurosci 2016; 12:308-329. [DOI: 10.1080/17470919.2016.1175380] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
|
47
|
Divergent roles of autistic and alexithymic traits in utilitarian moral judgments in adults with autism. Sci Rep 2016; 6:23637. [PMID: 27020307 PMCID: PMC4810325 DOI: 10.1038/srep23637] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 03/10/2016] [Indexed: 11/08/2022] Open
Abstract
This study investigated hypothetical moral choices in adults with high-functioning autism and the role of empathy and alexithymia in such choices. We used a highly emotionally salient moral dilemma task to investigate autistics' hypothetical moral evaluations about personally carrying out harmful utilitarian behaviours aimed at maximizing welfare. Results showed that they exhibited a normal pattern of moral judgments despite the deficits in social cognition and emotional processing. Further analyses revealed that this was due to mutually conflicting biases associated with autistic and alexithymic traits after accounting for shared variance: (a) autistic traits were associated with reduced utilitarian bias due to elevated personal distress of demanding social situations, while (b) alexithymic traits were associated with increased utilitarian bias on account of reduced empathic concern for the victim. Additionally, autistics relied on their non-verbal reasoning skills to rigidly abide by harm-norms. Thus, utilitarian moral judgments in autism were spared due to opposite influences of autistic and alexithymic traits and compensatory intellectual strategies. These findings demonstrate the importance of empathy and alexithymia in autistic moral cognition and have methodological implications for studying moral judgments in several other clinical populations.
Collapse
|