Moral reasoning in obsessive-compulsive disorder.

An inflated sense of responsibility often characterizes patients with obsessive-compulsive disorder (OCD). In this study, we asked OCD patients (n=20) and control participants (n=18) to resolve a series of moral dilemmas embedded in hypothetical scenarios. Each scenario required participants to choose one of two undesirable courses of action, both involving loss of life. The utilitarian option required them to act, thereby causing the death of one person, but indirectly saving the lives of others whose death would otherwise have occurred. The other option involved no action on their part, but their failure to act resulted in the deaths of people. The groups did not differ significantly in the options chosen, or in their latencies to resolve moral dilemmas. However, within the OCD group, the higher patients' scores on the Responsibility Attitude Scale, the less likely they were to act to kill one person to save the lives of others. In summary, these data imply a stronger association between moral reasoning patterns and responsibility attitudes than to OCD per se.