Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Impairment of social and moral behavior related to early damage in human prefrontal cortex

Abstract

The long-term consequences of early prefrontal cortex lesions occurring before 16 months were investigated in two adults. As is the case when such damage occurs in adulthood, the two early-onset patients had severely impaired social behavior despite normal basic cognitive abilities, and showed insensitivity to future consequences of decisions, defective autonomic responses to punishment contingencies and failure to respond to behavioral interventions. Unlike adult-onset patients, however, the two patients had defective social and moral reasoning, suggesting that the acquisition of complex social conventions and moral rules had been impaired. Thus early-onset prefrontal damage resulted in a syndrome resembling psychopathy.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

Figure 1: Social and moral reasoning.
Figure 2: Experimental decision-making and psychophysiology.
Figure 3: Neuroanatomical analysis.
Figure 4: Control subjects with adult-onset prefrontal damage.

Similar content being viewed by others

References

  1. Damasio, A. R., Tranel, D. & Damasio, H. in Frontal Lobe Function and Dysfunction (eds. Levin, H. S., Eisenberg, H. M. & Benton, A. L.) 217– 229 (Oxford Univ. Press, New York, 1991).

    Google Scholar 

  2. Damasio, A. R. Descartes' Error. (Grosset/Putnam, New York, 1994).

    Google Scholar 

  3. Damasio, A. R. The somatic marker hypothesis and the possible functions of the prefrontal cortex. Philos. Trans. R. Soc. Lond. B Biol. Sci. 351 , 1413–1420 (1996).

    Article  CAS  Google Scholar 

  4. Grafman, J. in Structure and Functions of the Human Prefrontal Cortex (eds. Grafman, J., Holyoak, K. J. & Boller, F.) 337–368 (1995).

    Google Scholar 

  5. Shallice T. & Burgess, P. W. Deficits in strategy application following frontal lobe damage in man. Brain 114, 727–741 (1991).

    Article  Google Scholar 

  6. Stuss, D. T. & Benson, D. F. The Frontal Lobes (Raven, New York, 1986).

    Google Scholar 

  7. Colby, A. & Kohlberg, L. The Measurement of Moral Judgment (Cambridge Univ. Press, New York, 1987).

    Google Scholar 

  8. Saver, J. & Damasio, A. R. Preserved access and processing of social knowledge in a patient with acquired sociopathy due to ventromedial frontal damage. Neuropsychologia 29, 1241 –1249 (1991).

    Article  CAS  Google Scholar 

  9. Bechara, A., Damasio, A. R., Damasio, H. & Anderson, S. W. Insensitivity to future consequences following damage to human prefrontal cortex. Cognition 50, 7– 15 (1994).

    Article  CAS  Google Scholar 

  10. Bechara, A., Damasio, H., Tranel, D. & Damasio, A. R. Deciding advantageously before knowing the advantageous strategy. Science 275 , 1293–1295 (1997).

    Article  CAS  Google Scholar 

  11. Bechara, A., Tranel, D., Damasio, H. & Damasio, A. R. Failure to respond autonomically to anticipated future outcomes following damage to prefrontal cortex. Cereb. Cortex 6, 215– 225 (1996).

    Article  CAS  Google Scholar 

  12. Damasio, A. R. & Anderson, S. W. in Clinical Neuropsychology, 3rd edn. (eds. Heilman, K. M. & Valenstein, E.) 409–460 (Oxford Univ. Press, New York, 1993).

    Google Scholar 

  13. Ackerly, S. S. & Benton, A. L. Report of a case of bilateral frontal lobe defect. Assoc. Res. Nerv. Ment. Dis. 27, 479–504 ( 1947).

    Google Scholar 

  14. Price, B. H., Daffner, K. R., Stowe, R. M. & Mesulam, M. M. The comportmental learning disabilities of early frontal lobe damage. Brain, 113, 1383–1393 ( 1990).

    Google Scholar 

  15. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders 4th edn. (APA, Washington, District of Columbia, 1994).

  16. Deckel, A. W., Hesselbrock, V. & Bauer, L. Antisocial personality disorder, childhood delinquency, and frontal brain functioning: EEG and neuropsychological findings. J. Clin. Psychol. 52, 639–650 (1996).

    Article  CAS  Google Scholar 

  17. Kuruoglu, A. C. et al. Single photon emission computerised tomography in chronic alcoholism. Br. J. Psychiatry 169, 348– 354 (1996).

    Article  CAS  Google Scholar 

  18. Raine, A., Stoddard, J., Bihrle, S. & Buchsbaum, M. Prefrontal glucose deficits in murderers lacking psychosocial deprivation. Neuropsychiatry Neuropsychol. Behav. Neurol. 11, 1– 7 (1998).

    CAS  PubMed  Google Scholar 

  19. Campagna, A. F. & Harter, S. Moral judgment in sociopathic and normal children. J. Pers. Soc. Psychol. 31, 199–205 (1975).

    Article  CAS  Google Scholar 

  20. Blair, R. J. R. Moral reasoning and the child with psychopathic tendencies. Pers. Individ. Diff. 22, 731–739 (1997).

    Article  Google Scholar 

  21. Scarpa, A. & Raine, A. Psychophysiology of anger and violent behavior. Psychiatr. Clin. North Am. 20, 375–394 (1997).

    Article  CAS  Google Scholar 

  22. Newman, J. D. & Bachevalier, J. Neonatal ablations of the amygdala and inferior temporal cortex alter the vocal response to social separation in rhesus macaques. Brain Res. 758, 180– 186 (1997).

    Article  CAS  Google Scholar 

  23. Damasio, H. & Frank, R. J. Three-dimensional in vivo mapping of brain lesions in humans. Arch. Neurol. 49, 137–143 (1992).

    Article  CAS  Google Scholar 

  24. Frank, R. J., Damasio, H. & Grabowski, T. J. Brainvox: An interactive, multimodal visualization and analysis system for neuroanatomical imaging. Neuroimage 5, 13–30 (1997).

    Article  CAS  Google Scholar 

  25. Platt, J. J. & Spivack, G. Measures of Interpersonal Problem-Solving for Adults and Adolescents (Department of Mental Health Sciences, Hahnemann Medical College, Philadelphia, 1977).

    Google Scholar 

  26. Platt, J. J. & Spivack, G. Manual for the Means-Ends Problem Solving Procedure (Widener University Institute for Graduate Psychology, Chester, Pennsylvania, 1975).

    Google Scholar 

  27. Lezak, M. Neuropsychological Assessment 3rd edn. (Oxford Univ. Press, New York, 1995).

    Google Scholar 

  28. Davis, H. P., Bajsjar, G. M. & Squire, L. R. Tower of Hanoi Test—Colorado Neuropsychology Tests Version 2.0. (Western Psychological Services, Los Angeles, 1995).

    Google Scholar 

  29. Heaton, R. K. et al. Wisconsin Card Sorting Test Manual (Psychological Assessment Resources, Odessa, Florida, 1993).

    Google Scholar 

Download references

Acknowledgements

Supported by the National Institute of Neurological Diseases and Stroke Grant PO1 NS19632 and the Mathers Foundation.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Antonio R. Damasio.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Anderson, S., Bechara, A., Damasio, H. et al. Impairment of social and moral behavior related to early damage in human prefrontal cortex. Nat Neurosci 2, 1032–1037 (1999). https://doi.org/10.1038/14833

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1038/14833

This article is cited by

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing