The brain of OCD sufferers is more active when faced with a moral dilemma

Along with the help of experts from the Barcelona's Hospital del Mar and the University of Melbourne (Australia), researchers at the Hospital de Bellvitge in Barcelona have proven that patients with obsessive-compulsive disorder, known as OCD, are more morally sensitive.

"Faced with a problem of this type, people suffering from this type of anxiety disorder show that they worry considerably more," as explained to SINC by Carles Soriano, researcher at the Catalan hospital and one of the lead authors of the work published in the journal Archives of General Psychiatry.

Using functional magnetic resonance imaging, the experts studied the neurofunctional basis of this increased moral sensitivity. They measured the brain activity of a group of 73 patients with OCD and 73 healthy patients when faced with different moral problems in which they had to choose between two alternatives both leading to very negative consequences.

For example, they were faced the dilemma of the crying baby, a classic in philosophy classes. They were asked to imagine themselves in a hypothetical war. Enemy soldiers lie in wait to attack and the entire village hides in a cellar. A baby starts to cry. If nobody makes the baby stop, the soldiers will discover everyone. Would it be justifiable to smother the baby's cry running the risk of suffocating it to save the others?

"The brain activations displayed by participants in the face of such a moral question were compared to those displayed for trivial choices, like choosing between going to the countryside or the beach for the weekend," as Soriano points out.

The results verified that during situations of moral dilemma those subjects with OCD displayed a higher degree of activation in the orbitofrontal cortex, especially in the medial part, which is linked to decision making processes and the development of moral sentiment.

"The data allows us for the first time to objectify the existence of cerebral dysfunctions related to alterations in complex cognitions, such as experiencing morality," adds the researcher from Catalonia. "This allows us to expand further on the characterisation of altered cerebral mechanisms in OCD."

Anxiety compulsion

OCD is characterised by persistent thoughts named obsessions that cause fear and worry. It is also characterised by repetitive behaviour called compulsions that aim to reduce associated anxiety. It affects 2% of the population.

Affected patients can be differentiated into different types. "The majority are characterised by being obsessed with dirt and compulsive cleaning or by doubting that they have carried out important actions properly, like turning off the gas. Such behaviour makes then repeatedly check whether they have performed such actions," says Soriano.

There are other types of obsessions and compulsions, like those displayed by patients who need surrounding objects to be perfectly symmetrical and in order or who accumulate different types of objects that they can later not get rid of.

Lastly, there are also those that suffer from involuntary and unwanted thoughts of a sexual or religious kind whereby they are unsure whether they have committed a sexual act that is unacceptable in their opinion or they worry that they have blasphemed. "The last group of patients is identified for precisely having a higher level of moral hypersensitivity," concludes the researcher.

More information: Ben J. Harrison; Jesus Pujol; Carles Soriano-Mas; Rosa Hernández-Ribas; Marina López-Solà; Hector Ortiz; Pino Alonso; Joan Deus; José M. Menchon; Eva Real; Cinto Segalàs; Oren Contreras-Rodríguez; Laura Blanco-Hinojo; Narcís Cardoner. "Neural Correlates of Moral Sensitivity in Obsessive-Compulsive Disorder". Arch Gen Psychiatry 2012; 69(7):741-749.

Journal reference: JAMA Psychiatry

Provided by Spanish Foundation for Science and Technology (FECYT)