The obsessive-compulsive brain is more active with moral dilemmas

Grup recerca psiquiatria Dr Carlos Soriano (1)

Individuals with obsessive compulsive disorder are characterized by persistent thoughts that cause concern, and repetitive behaviours, called compulsions. A new study, led by researchers from IDIBELL, reveals that these people develop a significantly greater concern than the general population to such moral issues. The study was published in the Archives of General Psychiatry.

IDIBELL researchers at the Bellvitge University Hospital, in collaboration with experts from the Hospital del Mar and the University of Melbourne (Australia), have shown that patients with obsessive compulsive disorder have greater moral sensitivity.

“Faced with a problem of this type, people suffering from this type of anxiety disorder show that they worry considerably more”, said Carles Soriano-Mas, IDIBELL researcher and one of the authors.

Using functional magnetic resonance imaging, the researchers studied the neurophysiological basis of this increased moral sensitivity. Brain activity is measured in a group of 73 patients with obsessive compulsive disorder and in 73 healthy people (control group) when faced with different moral problems in which they had to choose between two alternatives both leading to very negative consequences.

For example, they were faced the dilemma of the crying baby, a classic in philosophy classes. They were asked to imagine themselves in a hypothetical war. Enemy soldiers lie in wait to attack and the entire village hides in a cellar. A baby starts to cry. If nobody makes the baby stop crying, the soldiers will discover them. Would it be justifiable to smother his crying running the risk of suffocating him to save everyone else?

Brain activations shown by participants to this moral question were compared with those shown to trivial choices, such as choosing between going to the countryside or the beach for a weekend. The results verified that subjects with obsessive compulsive disorder suffer higher activation than controls during situations of moral dilemma in orbitofrontal cortex regions, especially in the medial part, a region associated with decision-making processes and the development of a sense of morality.

“These data allows us for the first time to objectify the existence of brain dysfunctions related to alterations in complex cognitions, such as experiencing morality, and gives us insight into the characterization of altered brain mechanisms in obsessive compulsive disorders”, said Soriano-Mas.

Compulsions for anxiety
Obsessive-compulsive disorders affect 2% of the population and they can differentiate into different types of patients. There are some patients who need be surrounded by perfectly symmetrical objects in order or who accumulate different types of objects that they can later not get rid of. But, “the majority are characterised by being obsessed with dirt and compulsive cleaning or by doubting that they have carried out important actions properly, like turning off the gas. Such behaviour makes then repeatedly check whether they have performed such actions”, concluded Soriano -Mas.

Ben J. Harrison, Jesus Pujol, Carles Soriano-Mas, Rosa Hernández-Ribas, Marina López-Solà, Hector Ortiz, Pino Alonso, Joan Deus, José M. Menchon, Eva Real, Cinto Segalàs, Oren Contreras-Rodríguez, Laura Blanco-Hinojo, Narcís Cardoner. “Neural Correlates of Moral Sensitivity in Obsessive-Compulsive Disorder”. Arch Gen Psychiatry 2012; 69(7):741-749.

Source: SINC. November 7th, 2012.

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