Preserved intention understanding during moral judgments in schizophrenia

PLoS One. 2021 May 19;16(5):e0251180. doi: 10.1371/journal.pone.0251180. eCollection 2021.


Introduction: Although there is convincing evidence for socio-cognitive impairments in schizophrenia spectrum disorder (SSD), little evidence is found for deficient moral cognition. We investigated whether patients with SSD showed altered moral judgments in a story task where the protagonist either had a neutral or malicious intention towards another person. This paradigm examined whether SSD relates to altered moral cognition in general or specifically to impaired integration of prior information (such as beliefs) in moral judgments.

Methods: 23 patients and 32 healthy controls read vignettes created in a 2 x 2 design. The protagonist in each story either had a neutral or negative intention towards another person which, as a result, either died (negative outcome) or did not die (neutral outcome). Participants rated the moral permissibility of the protagonist's action. Standard null hypothesis significance testing and equivalent Bayes analyses are reported.

Results: Schizophrenia patients did not differ significantly in permissibility ratings from healthy controls. This finding was supported by the Bayes analyses which favoured the null hypothesis. Task performance was not related to symptom severity or medication.

Conclusions: The current findings do not support the notion that moral judgments are deficient in schizophrenia. Furthermore, the current study shows that patients do not have observable difficulties in integrating the protagonist's belief in the rating of the moral permissibility of the action-outcome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Austria
  • Bayes Theorem
  • Case-Control Studies
  • Cognition
  • Humans
  • Intention*
  • Judgment*
  • Male
  • Models, Psychological
  • Morals*
  • Schizophrenic Psychology*
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Task Performance and Analysis
  • Theory of Mind
  • Young Adult

Grants and funding

This work was supported by grants provided to Martin Kronbichler by the Austrian Science Fund (FWF grant number: P 30390-B27) and the Scientific Funds of the Paracelsus Medical University (grant number: E-13/18/097-KRO).