Your doctor and psychologist should be informing you of this problem since it likely also occurs in stroke survivors and caregivers.
http://www.alphagalileo.org/ViewItem.aspx?ItemId=163588&CultureCode=en
To cope with Multiple Sclerosis, patients become morally stricter.
Multiple sclerosis (MS) can have a strong impact on the life of
patients. Not only must they address the unpleasant symptoms, they are
also subject to unpredictable relapses after more or less long periods
of remission (which are irregular in duration), a condition that can
cause anxiety and stress. As noted in a new study carried out by SISSA
of Trieste in collaboration with the Medical University of South
Carolina (and other international institutions), this condition has
consequences for the "moral cognition" of patients, who become
particularly intransigent in moral judgments of third parties. This
”moral inflexibility” results from cognitive styles adopted to overcome
the inconveniences of the disease. Understanding their causes, explain
the authors of the recently published study in Social Neuroscience, has
important ramifications for the social wellbeing of patients.
Multiple Sclerosis affects nearly 2 and a half million people
worldwide. It is a highly debilitating autoimmune disease: the condition
severely reduces patients’ quality of life through symptoms which
disrupt motor, cognitive, and sensory systems. The disease, which in its
most typical form is characterized by irregular remissions and acute
attacks can create a state of increased anxiety in patients, and,
according to scientists, can have negative cognitive/emotional effects
as well, even influencing moral cognition in patients, as was observed
in the recent study.
Indrajeet Patil, a researcher at the International School for
Advanced Studies (SISSA) of Trieste, and first author of the study, and
his colleagues, subjected a group of patients to third-person "moral
dilemmas." The moral dilemma is a common test for measuring moral
cognition, but it is usually used in the first person. In this case,
subjects had to judge others’ actions, as if they were jury members in a
trial. For this specific study, manslaughter (accidental killings,
i.e.) and attempted murder were considered. Subjects evaluated the
appropriateness of and punishment for a variety of third-party moral
behaviors that varied on two key dimensions: intent to harm and harmful
consequence. That is, the agents in these scenarios either acted with an
intent to harm or not and consequently either produced or did not
produce a harmful outcome.
"These conditions are important because we know that two main
criteria come into play in judgments of this kind," says Patil. "We take
into account both the intention, and the seriousness of the
consequences. We tend to be more forgiving in cases of manslaughter,
where intentions are innocent but consequences are serious, and to
punish an attempted murder, whose intention is bad but the consequences
are not serious. "
It is well known that certain pathological conditions alter this kind
of judgment: if there are alterations in the Theory of mind (the
ability to attribute mental states to others), as happens in autism, for
example, it is difficult to evaluate intentions, so manslaughter is
judged severely, because of the serious consequences. Psychopaths tend
instead to forgive culpable homicide more easily, not so much because
they do not have a correct assessment of intentions, but rather because
of reduced empathy towards the victims.
Surprising results
In MS patients, Patil and colleagues were expecting a greater
tendency for forgiveness, because of difficulty with Theory of mind that
has been described in some of these patients, as well as a decrease in
empathic response. "The results, however, were surprising: subjects’
answers were more severe than average in all conditions. They also
proved overly confident about the validity of their own judgment, much
more so than in healthy subjects, declaring they were sure that anyone
would respond as they did."
Further tests have allowed the authors to develop a hypothesis for
this unexpected attitude. "We believe that these severe responses are
connected to a type of emotional/general cognitive strategy used by MS
patients, possibly emerging as a mechanism to cope with their medical
condition and the many challenges that are associated with it," says
Ezequiel Gleichgerrcht, a neurologist and researcher at the Medical
University of South Carolina. "The constant stress they face can elicit
persistently negative emotions. In the long run, this state can induce
cognitive strategies that help them minimize the damage. Neuroscientists
have coined the term ‘externally oriented thinking’ to refer to this
phenomenon which is characterized by the tendency to orient thoughts on
the external events rather than introspecting on our inner experiences
and feelings."
"It is a common strategy, resulting in an inability to properly
reflect and identify emotions," says Patil. "In situations of moral
judgment like those in the study, there is an inability to identify the
real cause of their negative emotional state, attributing it to external
causes, and not to the medical condition."
Put simply, during the experiments, the MS patients tended to
attribute their negative emotions to what they read in the dilemma.
Whether the consequences were the result of an accident as in the
manslaughter situation, or bad intentions as in the attempted murder,
mattered little. "The patient believed that these situations led to the
negative affect they felt and therefore judged the third-party actors
more severely. This explains why we observed more harsh judgments even
in neutral conditions where there was neither bad intent nor outcome,"
says Patil.
"Knowing that MS patients tend to adopt this cognitive strategy,
along with their nearly constant state of emotional stress, is
important," he concludes. “On one hand, it helps healthcare providers
working with them to objectively read their behavior, and improve
interpersonal relationships, which are vital in this type of care. On
the other hand, knowing this 'dark' side can also help us develop
cognitive/behavioral treatment for helping patients improve their
emotional response."
https://www.sissa.it/news/harsh-out-necessity
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