Neural Correlates of Moral Judgment in Criminal Offenders with Sadistic Traits.

Sexual sadism is a paraphilia that focuses on domination, humiliation, and infliction of pain on a victim to stimulate sexual arousal. Although extensively described in psychology and forensic sciences, less is known about whether the harmful acts committed by sexual sadists are accompanied by deficits in moral judgment. A limited amount of behavioral research suggests moral insensitivity in sexual sadists; however, the neural networks underlying moral judgment in sadists have not been studied. In this pilot study, 21 incarcerated male sexual offenders with (n = 11) and without (n = 10) sexual sadism were scanned with functional magnetic resonance imaging (fMRI) while they viewed pictures that did or did not depict situations considered by most individuals to represent moral transgressions, and rated their degree of moral transgression severity. Results indicated primarily overlapping neural systems underlying moral judgment in sadists and non-sadists. However, non-sadists but not sadists showed a positive correlation between moral transgression severity ratings and activity in the anterior temporal cortex (ATC). This lack of ATC engagement in sadists might be a biomarker of altered moral judgment.