Psychopaths Know Right from Wrong but Don't care

Maaike Cima; Franca Tonnaer; Marc D. Hauser

Disclosures

Soc Cogn Affect Neurosci. 2010;5(1):59-67. 

In This Article

Abstract and Introduction

Abstract

Adult psychopaths have deficits in emotional processing and inhibitory control, engage in morally inappropriate behavior, and generally fail to distinguish moral from conventional violations. These observations, together with a dominant tradition in the discipline which sees emotional processes as causally necessary for moral judgment, have led to the conclusion that psychopaths lack an understanding of moral rights and wrongs. We test an alternative explanation: psychopaths have normal understanding of right and wrong, but abnormal regulation of morally appropriate behavior. We presented psychopaths with moral dilemmas, contrasting their judgments with age- and sex-matched (i) healthy subjects and (ii) non-psychopathic, delinquents. Subjects in each group judged cases of personal harms (i.e. requiring physical contact) as less permissible than impersonal harms, even though both types of harms led to utilitarian gains. Importantly, however, psychopaths' pattern of judgments on different dilemmas was the same as those of the other subjects. These results force a rejection of the strong hypothesis that emotional processes are causally necessary for judgments of moral dilemmas, suggesting instead that psychopaths understand the distinction between right and wrong, but do not care about such knowledge, or the consequences that ensue from their morally inappropriate behavior.

Introduction

The behavior of psychopaths is, without doubt, morally inappropriate, including murder, sexual molestation, fraud, and arson. Further, clinical analyses show that they present abnormal emotional profiles, as well as problems with inhibitory control, often leading to both reactive and instrumental aggression (Blair, 1995, 1997, 2008; Blair and Cipolotti, 2000; Blair et al., 1995; Glenn and Raine, 2008; Kiehl, 2006; Kiehl et al., 2001; Raine and Yang, 2006). What is unclear is the extent to which psychopaths suffer from damage to morally-specific knowledge that, in healthy individuals, guides intuitive judgments of right and wrong independently of their moral actions. On the one hand, studies indicate that psychopaths, both adults and juveniles, show a diminished capacity to distinguish between conventional and moral transgressions (Blair, 1995, 1997, 2008; Smetana, 2005; Turiel, 1998, 2005). For example, unlike healthy adults, adult psychopaths will typically judge as equally forbidden transgressions in which a person wears pyjamas to a restaurant (conventional) and a person who gratuitously hits a waiter in the restaurant (moral). Psychopaths also show diminished inhibitory control, a deficit that may contribute to their impulsive behavior, especially in the context of violence (Blair, 2008; Blair and Cipolotti, 2000; Kiehl, 2006). This research has led to the view that because of their emotional deficits, psychopaths have corresponding deficits in moral knowledge which, coupled with poor inhibitory control, leads to morally inappropriate behavior (Blair, Mitchell, and Blair, 2005; Nichols, 2002; Prinz, 2008).

Further support for the idea that the deficit in moral psychology seen among psychopaths is due to the deficit in emotional processing, comes from the wealth of research showing a significant relationship between emotional experience and moral judgment. For example, dozens of studies now show that you can prime people's emotional state, and as a result, change their judgment of particular moral scenarios. For instance, putting people in a happy state is associated with a greater tendency to allow someone to be used as a means to some greater good (Valdesolo and DeSteno, 2006); associating a neutral word with disgust under hypnosis is associated with more severe moral condemnation (Wheatley and Haidt, 2006); inducing disgust is associated with more severe moral judgments (Schnall et al., 2008).

In addition to these behavioral studies, neuroscientific experiments also support the critical role of emotion in moral judgment. In particular, several imaging experiments reveal clear patterns of activation in emotionally-relevant areas when subjects read about moral dilemmas (Greene, 2003; Greene et al., 2003, 2004; Moll et al., 2002, 2005, 2007). And further, recent studies of patients with severe deficits in emotional processing [i.e. fronto-temporal dementia (FTD) and individuals with bilateral damage to the ventral medial prefrontal cortex (VMPC)], show a highly selective, but significant deficit in moral judgment (Ciaramelli et al., 2007; Koenigs et al., 2007). For example, whereas VMPC patients, like controls, judged actions involving impersonal harms (e.g., flipping the switch on the trolley to kill one person, but save five) as more permissible than actions involving personal harms (e.g., pushing the fat man off the footbridge to stop the trolley, killing the man, but saving the 5), VMPC patients were more likely to endorse these personal cases, including situations where aversive acts lead to significant benefits to others. Thus, for a broad range of moral dilemmas, emotions appear to play little to no role in guiding judgment; for dilemmas that pit highly aversive actions against significant utilitarian gains, these patients favour the outcome, providing evidence for the causal role of emotion for a specific class of moral problems.

The neuropsychological data are of particular interest because they provide a more causal account of the relationship between emotional processes and moral judgment. Further, and of special interest to the present paper, several authors have alluded to the similarity in profile between VMPC patients and psychopaths, especially their flat socio-emotional responses and their lack of inhibitory control (Anderson et al., 1999; Barrash et al., 2000). On this view, psychopaths and VMPC patients should show the same pattern of moral judgments.

Summarizing, a dominant perspective in the current literature sees intact emotional processes as essential to our moral psychology. Here, we consider an alternative framework, one that motivates the present studies of psychopaths. In particular, though we do not deny that emotions play some role in our moral psychology, it is possible that our emotional experiences follow from our moral judgments as opposed to preceding and guiding them (Huebner et al., 2008). If this view is correct, then psychopaths may well show normal patterns of moral judgments relative to control populations. Where psychopaths deviate is in both not caring about their judgments (i.e. what they know about morally forbidden and permissible cases) and in not engaging with the kinds of motivational systems that inspire morally appropriate behavior and inhibit morally inappropriate behavior.

The following study targets three issues at the core of current work in moral psychology: (i) To what extent is normal emotional regulation necessary for making normal moral judgments, especially in the context of moral dilemmas where there are no clear, societally-mandated or typical responses? (ii) To what extent are the systems that guide moral judgments dissociable from those that guide moral behavior? More specifically, do psychopaths show deficits in both moral knowledge and behavior, in knowledge, or in the link between knowledge and behavior? (iii) Given the parallels between psychopaths and VMPC patients with respect to their deficits in socio-emotional processing and self-control, do they show parallel patterns of moral judgments?

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