Moral cognition in schizophrenia

Disordered moral behaviour and understanding of moral rules were described early in the literature on schizophrenia; however, moral cognition has received scant attention in spite of a large literature focused on social cognitive impairments and violent behaviour in schizophrenia.

We conducted a narrative synthesis of the literature on violence, moral judgement and schizophrenia.

Initial empirical research into moral cognition in schizophrenia did not fully account for the basic- and social-cognitive deficits now known to characterise schizophrenia. Importantly, research into moral cognition in autism and psychopathy, disorders in part characterised by social cognitive impairments indicates subtle patterns of difference to the moral cognition of control participants. Recent neuroeconomic studies of moral cognition in schizophrenia have indicated that individuals with schizophrenia display subtle dysfunction in their fairness-related behaviours, but not in their propensity to engage in altruistic punishment.

Further research has the potential to broaden our understanding of what is intact and what is impaired in moral cognition in schizophrenia and also to inform our theories of the structures subserving moral judgement in the general population. Furthermore, a more thorough understanding of moral cognitive impairments in schizophrenia may have implications for both legal process and psychosocial rehabilitation.