Morality problems cause much more worry for people with OCD (obsessive-compulsive disorder), compared to the general population, researchers from the Hospital de Mar, Barcelona, Spain, and the University of Melbourne reported in Archives of General Psychiatry.

The authors added that their findings prove that patients with OCD are much more morally sensitive than people without the disorder.

Obsessive-compulsive disorder is a chronic (long-term) condition in which the patient has persistent and repetitive thoughts and compulsive behaviors.

Co-lead authors, Carles Soriano, said:

“Faced with a problem of this type, people suffering from this type of anxiety disorder show that they worry considerably more.”

The scientists studied how the participants’ neurofunctional activity rose when faced with moral dilemmas with the use of fMRI (functional magnetic resonance imaging). They recruited 146 volunteers, 73 with OCD and 73 “healthy” individuals. They measured each person’s brain activity when faced with different moral questions – choices had to be made between two alternatives, neither of which led to positive consequences.

For example, they were presented with a classic in philosophy classes – The Crying Baby. The participants had to imagine they were in a war and enemy soldiers were lying in wait to attack. The whole village is hiding in a cellar. A baby starts crying. Unless the crying is stopped immediately, the solders will find the villagers. Smothering the baby’s crying would save the villagers, but would also risk suffocating the baby – would it be right to stop the crying in this way?

Soriano pointed out:

“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.

The authors found that during moments of moral dilemma, those with OCD had significantly more activity in the orbitofrontal cortex, especially in the medial part, which is associated with decision making processes and the development of moral sentiment.

The researchers wrote “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. This allows us to expand further on the characterization of altered cerebral mechanisms in OCD.”

Obsessive-compulsive disorder is characterized by persistent thoughts (obsessions) that trigger worry and fear, as well as repetitive behaviors (compulsion) which are performed in an attempt to reduce associated anxiety. Approximately 2% of people are affected by OCD.

OCD patients are generally categorized into different types. “The majority are characterized 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 behavior makes then repeatedly check whether they have performed such actions.”

Other obsessions and compulsions may include the need to be surrounded by perfectly symmetrical objects – patients may hoard them.

In some cases, patients may suffer from unwanted sexual or religious thoughts in which they are not sure whether they have committed an unacceptable sexual act, and wonder (worry) whether they have blasphemed. “This last group of patients is identified for precisely having a higher level of moral hypersensitivity.”

Written by Christian Nordqvist