Emotion and Morality in Psychopathy and Paraphilias

Abstract

Understanding the role of emotion in moral judgment has been an active area of investigation and debate. Here we comment on this topic by examining the interaction between emotion and moral judgment in certain psychopathological groups that are characterized by abnormalities in emotion processing, such as psychopaths and sexual offenders with paraphilic disorders.

The role of emotion in moral judgment has been demonstrated across several research domains. Studies have shown that people make harsher moral judgments when they are in a heightened emotional state (Schnall, Haidt, Clore, & Jordan, 2008; Wheatley & Haidt, 2005). Patients with damage to the medial prefrontal cortex, who perform poorly on emotion-based tasks, show unusual moral judgment (Ciaramelli, Muccioli, Làdavas, & di Pellegrino, 2007; Koenigs et al., 2007). Functional neuroimaging has shown that moral judgments are accompanied by activity in brain regions implicated in emotional processing (Young & Koenigs, 2007). These studies suggest that individuals with impaired emotion processing will have impaired moral judgment. The purpose of this review is to consider the association between emotion and moral judgment in psychological disorders that are characterized by abnormal emotion processing.

It is important to define “abnormal emotion processing” and how this manifests in certain disorders. Koenigs et al. (2007) found that medial prefrontal-damaged patients, relative to control subjects, generate reduced electrodermal responses to emotional pictures. They also show impairments in empathy, embarrassment, and guilt, and poorly regulated anger and frustration tolerance (Koenigs & Tranel, 2007). These traits are similar to those associated with psychopathy. Psychopathy is a complex personality disorder characterized by the frequent commission of moral transgressions without remorse. An intriguing aspect of psychopathy is that psychopaths commit immoral acts despite appearing to understand their “wrongness.” Although there seems to be a consensus among psychopathy researchers that psychopaths understand moral wrongness on a superficial level, research aimed at uncovering failures in deeper moral reasoning has proved challenging, since psychopaths are skilled at giving the “right” answers to interviewers. To date, the only moral-reasoning task to elicit behavioral differences in psychopaths and nonpsychopaths is one used by Blair (1995), who found that psychopaths were less able to distinguish between moral transgressions (e.g., hitting another person) and conventional transgressions (e.g., poor table manners) than nonpsychopaths. Psychopaths were also less likely to mention harm caused to others when discussing transgressions, which was attributed to their emotional impairments (lack of empathy).

Moral insensitivity in psychopathy is usually attributed to callousness and lack of empathy. However, psychopaths have wide-ranging abnormalities in emotion processing, thus it is worth considering other psychopathic traits related to emotional processing and their role. For example, pathological reward seeking may increase the likelihood of engaging in behaviors that are dangerous to themselves and others (Buckholtz et al., 2010). Poor anger regulation may promote distorted beliefs that justify moral transgressions (person X “deserves what they get”). In future research it will be informative to evaluate contributions of specific emotion abnormalities in psychopathy to moral insensitivity.

Although many studies of impaired emotion processing and moral judgment have focused on psychopathy, psychopaths are not the only individuals who commit immoral actions and show abnormal emotion processing. Sex offenders, in particular, might be considered even more “immoral” than psychopaths. They show emotion abnormalities that are similar to psychopaths. Child molesters and rapists of adults have difficulty interpreting emotional facial and vocal expressions (Hudson et al., 1993). The similarity to psychopathy might not sound surprising, as psychopathy is associated with rape (Vess, Murphy, & Arkowitz, 2004). However, child molesters have low psychopathy rates, thus the findings cannot simply be explained by psychopathic characteristics.

Psychopaths and sex offenders might also be distinguished by their understanding of moral wrongness. While psychopaths typically acknowledge that moral transgressions are wrong, many sex offenders exhibit cognitive distortions which justify moral transgressions (Polaschek & Gannon, 2004; Ward & Keenan, 1999). Some rapists believe victims invited or enjoyed the rape. Some child molesters believe children are sexually motivated, and sexual abuse is not harmful. These beliefs may suppress the aversive emotional response normally engaged at the prospect of harming another. However, it is important to distinguish individuals with true distortions from those who use them to justify offenses. These indicate different types of moral insensitivity that represent different emotional abnormalities (callousness versus inability to recognize harmful behavior).

Many sex offenders suffer from a paraphilia. Paraphilias are disorders characterized by recurrent and intrusive deviant sexual impulses. One paraphilia that shares some characteristics with psychopathy is sexual sadism. Sadism, like psychopathy, is characterized by callousness, anger, and low empathy. Sadists derive sexual gratification from inflicting physical or emotional pain and suffering on others, and may thus represent the extreme end of the “moral sensitivity spectrum” ranging from compassion to callousness. They show increased arousal (measured by penile plethsymograph responses) when perceiving people in pain, in sexual or non-sexual situations (Seto, Lalumiere, Harris, & Chivers, 2009). While this clearly represents profound moral insensitivity, the capacity for “normal” moral judgment has not been directly investigated in this disorder. Sadists may be less likely than other sex offenders to show cognitive distortions that justify moral transgressions, since an understanding of the immorality of their actions (causing harm) is precisely what facilitates sexual gratification. Thus, like psychopaths they appear to understand the wrongness of their actions. Unlike psychopaths, however, they are not merely indifferent to the suffering of others, they enjoy it (for a recent study suggesting that psychopaths may show some reward-based responses to causing harm, see Decety, Michalska, Akitsuki, & Lahey, 2009).

A paraphilia that is less related to psychopathy, but is the most common and often considered the most morally repugnant, is pedophilia. Pedophilia is defined by sexual fantasies or behavior involving prepubescent children. Thus, while the immoral aspect of sadism concerns the type of activity from which sexual gratification is derived, in pedophilia it concerns the preferred sexual partner. This may highlight different emotional abnormalities in these disorders. While sadism is associated with traits such as callousness and anger, pedophilia may be related to disgust, or the absence of disgust typically evoked by the prospect of sex with prepubescent children. The relation of disgust to specific domains of immoral behavior has recently been discussed; for example, common and distinct disgust mechanisms may underlie attitudes towards moral transgressions such as harming another versus deviant sexual activities (Schaich Borg, Lieberman, & Kiehl, 2008). Relative to sadists and psychopaths, pedophiles are most likely to show clear cognitive distortions that underlie impaired moral judgment (e.g., adult–child sexual relationships are acceptable).

In summary, different types of emotion deficits in psychopathy and the paraphilias may promote the commission of moral transgressions. However, the relation between emotion and moral judgment in sadism, pedophilia, and other paraphilias has been unexplored to date and represents an important avenue for future research.