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Responsibility and Brain Function

The idea that behavior is determined by physical causes is hard to reconcile with the intuitive notions of free will and moral agency on which our legal systems are based. Although many people believe that, in principle, human behavior is the physical result of a causally determined chain of biophysical events, most of us also put that aside when making moral judgments. We don’t say “but he had no choice—the laws of physics made him do it!”

However, as the neuroscience of decision-making and impulse control begins to offer a more detailed and specific account of the physical processes leading to irresponsible or criminal behavior, the amoral deterministic viewpoint will probably gain a stronger hold on our thinking. Whereas the laws of physics are a little too vague and general to displace the concept of personal responsibility in our minds, our judgment might well be influenced if an offender was shown to have sustained damage to certain brain systems necessary for responsible decision-making and self-control.

What has cognitive neuroscience learned about the causes of "good" versus "bad" behavior? Research has identified brain systems involved in many of the psychological abilities required for prosocial behavior.

The ability to weigh uncertain risks and rewards and make prudent decisions has been intensively studied in simple game-like tasks. Evidence from patients with damage to certain regions of prefrontal cortex and from normal subjects in functional neuroimaging experiments highlights the importance of prefrontal cortex in this ability. Acting without regard to potential negative consequences would be expected to increase the likelihood of criminal behavior.

Other abilities that are essential for prosocial behavior include the ability to take another's viewpoint and to empathize. Brain imaging has shown that when subjects understand stories or cartoon pictures whose plot or punch line depends on the thoughts or viewpoint of a character, some prefrontal cortical and limbic brain regions are more active than during similar tasks in which mental states are not relevant. A network encompassing many of the same areas is active in experiments that evoke empathy or a sense of moral violation.

Furthermore, these brain areas can be damaged in subtle and gradual ways, making it harder to draw a line between someone who should be excused due to an obvious brain injury and someone who should not because their brain is normal. Most illicit drugs affect prefrontal cortex and prolonged use has been linked to impaired prefrontal function. Even childhood abuse or severe neglect, which involve neither a direct mechanical insult to the brain nor a foreign substance crossing the blood-brain barrier, damage these systems. There are also genetic factors that influence the function of these systems.

Society is gradually responding to the emerging neuroscientific view of human behavior. This is evident in our treatment of criminals within the legal system, and also in our social mores and attitudes toward "bad" but noncriminal behavior such as compulsive drinking, gambling or sex. Within the legal system, evidence of neurological dysfunction is frequently introduced in the penalty phases of criminal trials. We perceive this as relevant to the defendant's responsibility for his or her behavior, and it seems reasonable to punish a person less harshly if they are less responsible. This may put us on a slippery slope, however, once we recognize that all behavior is 100% determined by brain function, which is in turn determined by the interplay of genes and experience.

The growing awareness of neuroscience explanations of criminal behavior has prompted ethicists and legal theorists to seek other interpretations of responsibility that do not depend on free will and to propose so-called "forward thinking" penal codes, designed not to mete out just deserts for previous behavior, but to encourage good behavior and protect the public. The "disease model" of substance addiction, and the extension of the medicalized notion of addiction to other compulsive behaviors such as compulsive gambling and compulsive sex, is another way in which brain-based explanations of behavior have impacted society. The disease model emphasizes the deterministic and physiological nature of the behaviors and thereby reduces their moral stigma.

Martha J. Farah

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I'm curious about your opinion on something. Mind if I toss it in? Maybe you can make heads or tails of it.

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I haven't done any research, because well, I have an opinion already based on observation. But it is important to have as best an educated assessment as possible. I've been putting it off.

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The "disease model" of substance addiction, and the extension of the medicalized notion of addiction to other compulsive behaviors such as compulsive gambling and compulsive sex, is another way in which brain-based explanations of behavior have impacted society. The disease model emphasizes the deterministic and physiological nature of the behaviors and thereby reduces their moral stigma.

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Barbara Stitt's book, Food and Behavior, is dedicated to the children and adults who have been mis-led and mis-fed. In other words, it is dedicated to America. In fact, even though Barbara became intimately involved with the relationship between food and behavior mainly through her work as a probation officer, most Americans could read this book and relate it to problems of their own or those of some friend or family member -- even though these problems didn't necessarily lead to run-ins with the law.

Despite the fact that most AMA doctors mention diet as an afterthought when dealing with an illness, most people would still be able to make the connection between diet and certain illnesses. We see public service announcements on television for cancer or high blood pressure that remind us that these illnesses are diet related. If you eat cereal for breakfast, chances are your box says that it may help prevent heart disease or lower your cholesterol.

But how many people would relate an emotional or mental problem to diet? In this area, people are given advice ranging from "buck up" or "get it together," to advice to seek professional counseling, to prescriptions for mood-altering drugs. It is now common practice for doctors, in the absence of an obvious physical problem, to evaluate a patient's emotional situation and prescribe antidepressants accordingly.

But could there be another factor overlooked by the majority of Americans? Author Barbara Stitt says yes, and that factor is food.

According to Barbara, the Standard American Diet (SAD diet), loaded with empty calories, overly processed foods -- sweetened, refined, stripped of nutrients, over-cooked, chemically treated, and devoid of any real nutrition -- is affecting people's mental health.

Barbara touches on several dietary related issues that affect the brain, the most important organ of the body.

The first issue covered in depth is reactive hypoglycemia, in which the body's blood sugar levels are too low to meet the brain's needs. Although there are other causes of hypoglycemia, the average 129 pounds of sugar per person eaten each year by Americans is the main cause of the reactive hypoglycemia that sends blood sugar on a wild roller coaster ride from high to low -- accompanied with a craving for sweets that starts the cycle all over again if sugary laden foods are eaten. Amazingly, due to the high amount of processed sugar we now eat, as much as 50 percent of all Americans may be hypoglycemic. The physical and mental results of the hypoglycemic state include: apprehension, trembling, irritability, confusion, amnesia, and hallucinations -- all symptoms the average psychiatrist would diagnose as neurosis, psychosis or schizoprenia. There is also a documented link between hypoglycemia and aggressive or violent behavior.

The next startling topic in the book is sub-clinical pellagra -- a once wide-spread niacin-deficiency disease in the southern United States with symptoms that include dermatitis, disorientation, confusion, memory lapses, depression, anxiety, fatigue, and ultimately, dementia and death.

While pellagra is thought to have been eliminated, Barbara raises the issue of developing some symptoms of the disease without developing full blown pellagra.

The startling part of sub-clinical pellagra, like hypoglycemia, is that the symptoms also mirror those of schizophrenia, a problem so widespread that those who suffer from it occupy one out of every four hospital beds in the United States.

A third topic the author details is vitamin B deficiencies, giving symptoms that could easily be confused with mental disorders. These B vitamins include B1, B2, B6, and B12. B12 deficiencies, for example, are well known for causing mental disturbances, such as paranoia, mental confusion, and dementia. In fact, the included table that compares vitamin B deficiencies to neuropsychiatric disorders is uncanny.

Interestingly enough, Barbara points out that a B-vitamin deficiency can be related to a high sugar intake because, even though sugar contains no nutrients, the body must use stored nutrients to metabolize the sugar into energy. Therefore, meals high in processed foods not only provide little if any nutrition, they compound deficiency-related problems by robbing the body of nutrients in order to convert these non-foods into forms useable by the body.

Other food-related problems covered in some depth in the book as they relate to behavior are: allergic reactions to food; alcohol consumption; the effects of toxic substances such as aluminum, lead, mercury, etc.; man-made chemical additives such as MSG and Nutrasweet; and milk, which is surprisingly high in sugar and causes allergic reactions in a large percentage of the population.

These problems are also related to crime and violence, often with real-life examples pulled from the author's probation files or related studies, with names changed, of course.

Overall, Food & Behavior is well worth taking the time to read. If there was any complaint at all with the book, it would be that the diet information is a little sparse. This is nothing too out of the ordinary, however, since the book was not designed to be a cookbook. And any minor complaints, such as Barbara advocating whole-wheat products, when many of these products are only slightly better than white-flour products health-wise, really are minor when you factor in the success she has had with keeping people out of trouble.

Barbara claims more than 80 percent of probationers who came to her after she started using a food-based treatment were able to go on to live full, productive lives; and analyzing a twelve year study, found that not a single individual who stayed with the program had been back in trouble. While there very well may be other issues involved with crime and violence, it is hard to ignore the results Barbara has had with her program.

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Without delving any further into this as it gets very mired down in explanation, I'll conclude in saying that there's a terrible shortage of self-awareness in human nature. And I believe, through chosen deliberate awareness, most can choose to do better. Even through a diseased brain. Perhaps not wet-brain or severe damage to the prefrontal cortex, but those are extreme exceptions. My experience with drugs that directly affect perception suggests to me that people have far, far more capacity to direct our actions and reactions than we actually engage.

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most can choose to do better.I believe, through chosen deliberate awareness,

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There isn't much more I can do for him nutritionally, as he passes out drunk almost nightly now. He skips many meals due to this. I pack him healthy lunches and make sure he gets a supplement. He needs to do his part!

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