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RESEARCH PRODUCT

Do affective episodes modulate moral judgment in individuals with bipolar disorder?

Pilar SierraManuel PereaAntonio José Cañada-martínezLorenzo LivianosBelén GagoAna García Blanco

subject

AdultMaleBipolar DisorderInclusion (disability rights)EmotionsMoralsbehavioral disciplines and activitiesJudgment03 medical and health sciences0302 clinical medicineUtilitarianismReaction TimemedicineHumansBipolar disorderhealth care economics and organizationsDepression (differential diagnoses)Depressive DisorderSocial adaptationMiddle Agedmedicine.diseaseCyclothymic Disorderhumanities030227 psychiatryDilemmaPsychiatry and Mental healthClinical PsychologyEmotional engagementbehavior and behavior mechanismsFemalemedicine.symptomEthical TheoryPsychologyMania030217 neurology & neurosurgeryClinical psychology

description

Abstract Background Bipolar disorder (BD) patients experience altered emotional states and deficits in social adaptation that may also be involved in deontological moral judgments in which participants have to choose whether to sacrifice one person in order to save the lives of a greater number. Methods In the present study we compared the utilitarian responses of BD patients in their different states (euthymia, mania, depression) and healthy controls to moral dilemmas with low (impersonal dilemma) and high (personal dilemma) emotional saliency. Results Our findings revealed an increased tendency to utilitarian judgments in the three groups of BD patients in impersonal dilemmas relative to healthy individuals. In addition, utilitarian responses were increased during manic and depressive episodes in personal moral dilemmas relative to control group. Furthermore, we found no differences in social adaptation between utilitarian and deontological BD responders, though the depressive BD had a lower adaptation than the euthymic individuals. Limitations The recording of response times, the exhaustive control of medication effect, or the inclusion of a non-moral condition in the battery of moral dilemmas would provide a better characterization of moral judgment in BD. Conclusions For impersonal dilemmas, BD patients exhibited more utilitarian reasoning, which is also affected by emotional engagement for personal dilemmas during acute episodes of mania and depression. Social adaptation is not associated to utilitarian reasoning, but is rather influenced by mood state.

https://doi.org/10.1016/j.jad.2018.11.067