Moral Judgment in Frontal Lobe Lesions

Comparing Moral Judgments of Patients With Frontotemporal Dementia and Frontal Stroke

Baez S, Couto B, Torralva T, et al
JAMA Neurol. 2014 Jul 21. [Epub ahead of print]

Study Summary

Social cognition is thought to be impaired in patients with prefrontal vascular lesions and in those with the behavioral variant of frontotemporal dementia, according to several clinical reports. Although both conditions are also thought to be associated with impairment of moral reasoning, little research has directly compared moral reasoning in these 2 groups of patients.

Participants in this study completed a test that aimed to differentiate the contributions of intentions and outcomes in moral judgment using scenarios with harmful intentions in the absence of harmful outcomes, and vice versa. In these scenarios, the protagonists intended to cause harm, but their actions did not actually result in harm; or, conversely, they caused harm without intending to do so.

Compared with neurologically healthy controls, patients with prefrontal lesions and those with the behavioral variant of frontotemporal dementia rated scenarios with harmful intentions in the absence of harmful outcomes as being more permissible. They also judged harmful outcomes in the absence of harmful intentions as less permissible than did the neurologically healthy controls, with no significant differences between the 2 conditions.

Viewpoint

This study appears to be the first to directly compare patients with 2 different causes of frontal lobe lesions: vascular vs neurodegenerative. Both pathologies were associated with impairments in moral judgment involving integration of information with respect to intentions and outcomes. Although this task did not differentiate the 2 conditions, further studies of this type may shed some light on the neuropsychological manifestations of differing etiologies of frontal lobe disease.

Cite this: Laurie L. Barclay. Moral Judgment in Frontal Lobe Lesions - Medscape - Aug 19, 2014.

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