Moral Reasoning in Children with Focal Brain Insults to Frontotemporal Regions

Abstract

Neuroscientific evidence indicates that human social functioning is supported by a distributed network of frontal and temporal brain regions that undergoes significant development during childhood and adolescence. Clinical studies of individuals with early brain insults (EBI) to frontotemporal regions suggest that such lesions may interfere with the maturation of sociocognitive skills and lead to increased sociobehavioural problems. However, little attention has focussed on the direct assessment of sociocognitive skills, such as moral reasoning, following focal EBI. In the present study, the performance of 15 patients with focal EBI (8–16 years) was compared to that of 15 demographically matched controls on basic neuropsychological measures (IQ and executive functions), sociocognitive tasks (moral reasoning, moral decision-making and empathy) and parent reports of sociobehavioural problems and social adaptive skills. Patients with focal EBI had significantly lower levels of moral reasoning maturity, moral decision-making, and empathy than their matched controls, but did not differ on more general measures of cognition. Their parents also reported increased sociobehavioural problems. These findings suggest that focal EBI to frontotemporal regions can result in reduced sociocognitive capacities, more specifically moral reasoning, and increased vulnerability to sociobehavioural problems.

Unravelling moral cognition in acquired brain injury: a scoping review

“…Impairments on this task could be a consequence from impairments in other cognitive functions, such as attention or working memory, needed to perform the task. It is possible that a task presented in a different modality (i.e., via pictures, story boards or cartoons), which have mostly been used to assess moral cognition in adolescence (Beauchamp et al, 2013(Beauchamp et al, , 2019Chiasson et al, 2017;Dooley et al, 2010), may lead to a different outcome in early-onset ABI too. Thus, not only the age of onset differs between these two groups of studies but also the assessment approach used to index moral maturity.…”

What's New in the Clinical Management of Disorders of Social Cognition?

“…Long-term social outcomes following paediatric TBI are predicted by poor executive function, social information processing and pragmatic language skills (Yeates et al, 2004). Further, while poor social outcomes have been frequently attributed to severe, diffuse injuries such as TBI, in this volume, Chiasson et al (2017) found that 15 children with focal brain lesions had impaired social cognitive skills, specifically moral reasoning, decision making and empathy. They also found these children experienced socio-behavioural problems suggesting a possible link between the two.…”

“…Attributional bias, which refers to the personal filter through which the behaviour of others is interpreted (such as seeing ambiguous social behaviour as hostile) has been associated with schizophrenia (Savla, Vella, Armstrong, Penn, & Twamley, 2013) but is also relevant to other conditions such as brain injury (Cassels, McDonald, Kelly, & Togher, 2016). Other facets of social cognition such as the development of social knowledge and morality are particularly relevant to children in whom maturational processes are complicated by the presence of brain injury, as discussed in this volume (Chiasson, Elkaim, Well, Crevier, & Beauchamp, 2017). Social cognition also impinges on behaviour such as the capacity to make effective decisions to enhance prosocial engagement (Adlam, Adams, Turnbull, Yeates, & Gracey, 2017) while inhibiting antisocial urges (Honan, Allen, Fisher, Osborne-Crowley, & McDonald, 2017).…”

“…Of course, it is also important to consider that factors other than the clinical disorder itself may impact upon social cognition. This is especially true when considering children, who are developing their social cognitive skills in the context of an injury or other disorder (Chiasson et al, 2017; Ryan et al, 2017). Ryan et al(2017) present data on children with mild to severe TBI in which they found that severity of injury did not predict poor social cognition but family emotional responsivity was strongly associated.…”

“…For other aspects of social cognition there are, in fact, very few clinical instruments. As a significant advance, in this volume, Chiasson and colleagues (2017) describe a social moral assessment instrument that has proven sensitive to brain injury in children and is useful for determining whether children have reached appropriate developmental stages in their moral reasoning. As with the instrument devised by Canty et al (2015), the The Socio-Moral Reasoning Aptitude Level Task (So-Moral: Beauchamp, Dooley, & Anderson, 2013) uses visual vignettes from a first person perspective to increase participant engagement.…”