Despite a large literature investigating social cognition in schizophrenia, little attention has been paid to capacities for moral judgment in this disorder. Understanding capacities for moral judgment is important for legal purposes, but will also offer insights concerning how people with schizophrenia negotiate moral dilemmas in a complex social world.
To conduct a preliminary investigation of moral judgment in schizophrenia. 27 patients and 21 controls completed: 1) a ‘moral/conventional transgressions’ task, in which participants rate the permissibility and severity of moral versus social transgressions; and 2) a ‘moral dilemmas’ task, in which participants judge the right or wrong of an act in a dilemma that pits the welfare of an individual against the common good. Pre-morbid IQ and neurocognition were also assessed, as well as reactive and proactive aggression and experiences of victimisation.
Patients and controls responded similarly to moral and social violations, being just as likely to judge them impermissible. In contrast, patients were more ‘utilitarian’ than controls on the moral dilemmas task. That is, they were more likely to endorse acting for the greater good, even at the cost of harming another, than controls. This increased tendency to moral utilitarianism in the patients was not explained by group differences in IQ or neurocognition. Utilitarian tendencies did, however, associate with higher levels of reactive aggression and experiences of victimisation in patients. Experiences of victimisation mediated the relation between utilitarian moral tendencies and reactive aggression.
Results indicate that the tendency towards utilitarian moral judgments displayed by people with schizophrenia is not explained by individual differences in basic moral-cognitive or neurocognitive ability. Implications of the findings concerning utilitarianism are discussed in relation to possible triggers of reactive aggression in schizophrenia.