Korsakoff’s syndrome (KS) is a neuropsychiatric disorder, caused by a vitamin B1 deficiency. Although it is known that patients with KS display diminished theory of mind functioning and frequently exhibit marked antisocial interactions little attention has so far focused on the integrity of moral decision-making abilities, moral reasoning, and empathy. In an experimental cross-sectional design, 20 patients diagnosed with KS, and twenty age-, education-, and gender-equivalent healthy participants performed tests assessing moral decision-making, moral reasoning maturity, empathy, and executive functioning. Participants were administered the Moral Behaviour Inventory (MBI) for everyday moral dilemmas, and ten cartoons of abstract moral dilemmas. Responses were scored according to the Kohlberg stages of moral reasoning. Empathy and executive functioning were assessed with the Interpersonal Reactivity Index (IRI) and the Frontal Assessment Battery (FAB). In contrast to frontal traumatic brain injury patients, KS patients did not display a utilitarian bias, suggesting preserved moral decision-making abilities. Of interest, KS patients had significantly lower levels of moral reasoning maturity on everyday moral dilemmas, and abstract moral dilemmas. In patients, empathy was moderately related to the level of moral maturity on both tasks, while executive functioning was not. In conclusion, KS patients have preserved moral decision-making abilities, but their moral reasoning abilities are poorer in everyday and abstract situations. Lower moral reasoning abilities and lower levels of empathy together may be responsible for adverse social functioning in KS.

中文翻译：

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Korsakoff 综合征中的道德推理、道德决策和同理心

柯萨科夫综合征 (KS) 是一种由维生素 B1 缺乏引起的神经精神疾病。尽管众所周知，KS 患者的心理功能理论减弱并且经常表现出明显的反社会互动，但迄今为止很少有人关注道德决策能力、道德推理和同理心的完整性。在一项实验性横断面设计中，20 名被诊断患有 KS 的患者和 20 名年龄、教育程度和性别相当的健康参与者进行了评估道德决策、道德推理成熟度、同理心和执行功能的测试。参与者接受了针对日常道德困境的道德行为量表（MBI）和十幅抽象道德困境的漫画。根据道德推理的科尔伯格阶段对反应进行评分。用人际反应指数 (IRI) 和正面评估电池 (FAB) 评估同理心和执行功能。与额叶创伤性脑损伤患者相比，KS 患者没有表现出功利主义偏见，这表明保留了道德决策能力。有趣的是，KS 患者对日常道德困境和抽象道德困境的道德推理成熟度显着降低。在患者中，同理心与两项任务的道德成熟度有中度相关，而执行功能则没有。总之，KS患者保留了道德决策能力，但他们的道德推理能力在日常和抽象情况下较差。较低的道德推理能力和较低的同理心可能是KS中不良社会功能的原因。