Deontological Guilt (DG) and Altruistic Guilt (AG) emerge from the appraisal of violating an introjected rule (DG) and of behaving in non-altruistic way (AG), respectively. DG has been suggested to play a pivotal role in the development and maintenance of Obsessive-Compulsive Disorder (OCD) and to be associated to the activation of the insula. Consistently, OCD patients show an hyperactivation of the insula in context associated with DG and disgust. Previous studies have shown that after DG induction, healthy participants respond to hypothetical moral dilemmas (e.g. turn a trolley and kill one person to save many) with an higher rate of omissions (following the deontological principal according to which no man -only God- can decide who should live or die). This behavior is consistent with that of OCD patients in the same kind of dilemmas.
However, how DG might differentially impact real (not hypothetical) moral decisions (i.e., whether to deceive or not another person) in patients with OCD has not been explored yet. We collected preliminary data showing that DG induction made healthy participants, especially those with high sensitivity to disgust, behave more immorally. This suggests that experiencing DG leads people, particularly those high in Disgust Sensitivity, to experience a decrement in their own moral value which translates into higher immorality.
The aim of this project is to carry on two studies in order to test whether: i) DG induction might differently affect moral decision in OCD patients and healthy controls and ii) the inhibition of the insula via cathodal transcranial direct current stimulation (tDCS) over temporal areas, would decrease the effect of DG on moral behaviour in healthy controls.
The results of this project will contribute: i) to a better understanding of the role of DG on OCD patients¿ moral behaviour and; ii) to proving the efficacy of brain modulation in reducing the impact of emotion on subsequent moral behaviour.
This project is particularly innovative since it aims at using a multidisciplinary approach (combining neuroscience, social psychology and clinical psychology) in order to provide experimental evidence regarding the role of deontological guilt and insula hyperactivation on moral behavior.
Sensibility to guilt and in particular to deontological guilt is particularly crucial in several psychopathological conditions and in OCD specifically.
In fact, early life experiences of these patients are very often characterized by memories of being blamed associated with extreme feelings of guilt. The most recent psychotherapeutic interventions, such as the Imagery with Rescripting (IwR), aim at detecting such memories and helping patients change their perception regarding those episodes and diminish their sensibility to guilt.
This project will not only provide evidence regarding the consequences of experiencing deontological guilt on subsequent moral behavior in OCD patients, but will also test whether a neuromodulation technique that has been proven to be able to dampen insula activity can help participants being less sensitive to deontological guilt and thus less affected by it.
On the one hand, the findings of this project might shed light on possible maintenance factors that might worsen the OCD condition. If, as we expected on the bases of our preliminary data, the feeling of deontological guilt makes OCD patients feel more immoral and act accordingly, then the immoral behavior might concur to enhance deontological guilt and feeling of being immoral resulting in a vicious circle.
On the other hand, these findings might further improve psychotherapeutic techniques working on vulnerability to guilt. In fact, if this kind of neuromodulation approach works to decrease the effect of deontological guilt on moral behaviour, then it might be used in combination with IwR technique in order to improve its effects.