title: Manic patients exhibit more utilitarian moral judgments in comparison with euthymic bipolar and healthy persons.
abstract: Both emotional and cognitive processes are involved in moral judgments. Ventromedial prefrontal lesions are related to impaired prosocial emotions and emotional dysregulation, and patients with these lesions exhibit increased utilitarian judgments of emotionally salient personal moral dilemmas. Bipolar patients experiencing manic episode also have impaired emotional regulation and behavioral control. We investigated the characteristics of moral judgment in manic and euthymic patients with bipolar disorder using the 50 hypothetical moral dilemma task (17 non-moral, 20 personal, and 13 impersonal). Our study included 27 manic bipolar patients, 26 euthymic bipolar patients, and 42 healthy controls. Subjects were instructed to determine whether or not each dilemma was morally acceptable, and their reaction times were recorded. Manic patients showed significantly greater utilitarian judgment than euthymic patients and normal controls for personal moral dilemmas. However, there were no significant between-group differences for the non-moral and impersonal moral dilemmas. Our results suggest that increased utilitarian judgments of personal moral dilemmas may be a state-related finding observed only in manic patients. This difference in moral judgment assessments may reflect the decision-making characteristics and underlying neurobiological mechanisms of bipolar disorder, especially during the manic state.
authors.affiliation: Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Sung Hwa
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Tae Young
authors.initials: TY
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, Seoul National Hospital, Seoul, Republic of Korea.
authors.forename: Vin
authors.initials: V
authors.lastname: Ryu
authors.affiliation: Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Ra Yeon
authors.initials: RY
authors.lastname: Ha
authors.affiliation: Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Su Jin
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, Seoul National Hospital, Seoul, Republic of Korea; Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea.
authors.forename: Kyooseob
authors.initials: K
authors.lastname: Ha
authors.affiliation: Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: chs0225@yuhs.ac.
authors.forename: Hyun-Sang
authors.initials: HS
authors.lastname: Cho
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D016022:Case-Control Studies; D005260:Female; D006262:Health; D006801:Humans; D007600:Judgment; D008297:Male; D009014:Morals; D011569:Psychiatric Status Rating Scales; D011930:Reaction Time / Q000502:physiology; D055815:Young Adult