Measuring Moral Development in Young Adults with Mild
Intellectual Disabilities Using a Computerized Measure: A Pilot Study
Masterthesis Forensic Orthopedagogy Graduate School of Child Development and Education University of Amsterdam Student: W. E. Reijenga Student number: 11579889 First supervisor: dhr. prof. dr. X. M. H. (Xavier) Moonen Second supervisor: dhr. prof. dr. G. J. J. M. (Geert-Jan) Stams Amsterdam, juli 2018
Abstract
Aim The first aim of this study was to examine whether differences in the level of moral development between young adults with average intelligence and young adults with mild intellectual disabilities (MID) existed. The second aim of this study was to make
recommendations on assessing moral reasoning in young adults with MID. Method 48 Dutch young adults (M = 20.9 years, 33,3% boys) participated in this study spread over young adults with and without MID by using the abbreviated version of the Weschler Adult Intelligence Scale (WAIS-IV-NL). Moral dilemmas were presented using the Socio-Moral Reasoning Aptitude Level assessing decision-making, moral maturity, comprehension, as well as the corresponding moral maturity stage. Results indicate that young adults with MID
comprehended fewer dilemmas compared to young adults with average intelligence. In addition, when corrected for comprehension of the dilemmas, young adults with MID showed lower moral maturity compared to young adults with average intelligence. Conclusion
Consistent with existing research it was found that young adults with MID show lower levels of moral maturity. Regarding the Socio-Moral Reasoning Aptitude Level instrument,
suggestions for adaptions are presented to increase participant comprehension of the dilemmas.
Keywords: mild intellectual disabilities (MID), moral reasoning, moral decision-making, moral maturity, moral development
Measuring Moral Development in Young Adults with Mild Intellectual Disabilities Using a Computerized Measure: A Pilot Study
Functioning on the level of mild intellectual disabilities (MID) contributes to a greater likelihood of experiencing social problems, having trouble paying attention to tasks and showing aggressive behaviour in comparison to typically developing peers (Dekker, Koot, van der Ende, & Verhulst, 2002). In addition to these problems, youth and young adults with MID are more likely to engage in criminal behaviour (Drost, van Haaren, & Jongebreur, 2016). Thus, people with MID are particularly vulnerable. In general, people who are involved in criminal behaviour are more likely to have deficits in moral development (Le Sage, 2004; Stams et al., 2006). Therefore, the question arises as to whether people with MID generally do show those shortages in moral development. This could explain the
overrepresentation of individuals with MID in the juridical domain and may be helpful in designing interventions aimed at stimulating moral development. Given the lack of reliable assessment methods, a pilot study is designed to explore whether a recently constructed moral development instrument is suitable for applying for persons with MID..
Moral development is a broad concept which can be divided into cognition and emotion-based sub-concepts. The abilities that are associated with cognitive capacities are moral judgment—the explanation people use to justify the moral decisions they make (Gibbs, 2010)—and cognitive empathy—the ability to understand and recognize the emotions of others (Cohen & Strayer, 1996). The abilities associated with emotion are affective empathy, guilt and shame. Affective empathy can be defined as the ability to share and feel the
emotions of others (Cohen & Strayer, 1996). Guilt and shame respectively refer to a violation of one’s own moral values and a violation of society’s or other persons’ values (Tangney, Miller, Flicker, & Hill-Barlow, 1996).
Using a stage model of moral development, Kohlberg (1984) distinguishes six different stages, whereby each two subsequent stages belong to the three successive
developmental stages: pre-conventional, conventional and post-conventional. Stage one of the six-stage model is characterized by an orientation to avoid punishment and to be obedient, whilst children in stage two use a more instrumental style aiming at seeking mutual benefit. When children subsequently enter stage three, they develop an interpersonal orientation as they are then focused on what others think is right. In stage four, children are focused on complying with the rules and laws. Stage five is all about children developing their own value framework and stage six is characterized by handling universal ethical principles.
There is no consensus on how this last developmental stage should be considered. According to Gibbs, Basinger, and Fuller (1992), given the small amount of people—mainly academically educated persons—which achieve this stage, this could be an unnecessary extension of the stage model. Questions in this post-conventional stage are, according to Gibbs and colleagues, more likely to measure verbal intelligence instead of moral
development and require a form of metatheoretical reasoning. Gibbs (2003) therefore adjusted Kohlberg’s theory by distinguishing only the pre-conventional and the conventional stages. This four-stage model gained cross-cultural validity using the Sociomoral Reflection Measure – Sort Form (Gibbs, Basinger, Grime, & Snarey, 2007).
Kohlberg (1984) assumed that moral judgment is the same across different contexts. He thought that once a new stage was achieved, there was no drawback to previous stages. Krebs and Denton (2005) however proposed a dimensional approach in which people have access to multiple stages of moral judgment at the same time and use them according to the context they perceive they are in. There is also evidence for judging personal versus
impersonal moral dilemmas, both activating different brain regions (Greene, Sommerville, Nystrom, Darley, & Cohen, 2001). Furthermore, prisoners showed higher levels of moral
judgment regarding non-prison dilemmas in comparison to daily prison dilemmas (Kohlberg, Scharf, & Hickey, 1972), indicating a difference between people being confronted with dilemmas beyond their daily experience, or dilemmas more applicable to their own daily situation.
Although every individual moves through the states of moral development in the same order according to Kohlberg (1984), not everyone completes them at the same pace. This may particularly apply to persons belonging to special populations, like people with MID, who were found to lag behind peers with average intelligence (Langdon, Clare, & Murphy, 2010). People with MID are defined by the American Association on Intellectual and Developmental Disorders (AAIDD) as having a total intelligence quotient (IQ) ranging from 50 to 70/75, as well as showing shortages in adaptive behaviour (Schalock et al., 2010). The concept of adaptive behaviour can be divided into conceptual, social and practical skills.
Different views exist regarding people with MID reaching the more advanced stages of moral development. Langdon and colleagues (2010) concluded that people with MID evince a slower pace going from one stage to another compared to people with average intelligence, but that they keep showing progress in achieving the advanced stages with increasing age. The role of intelligence in the concept of moral development even expires when people with MID are matched with typically developing peers based on their mental age instead of on their chronological age. However, according to Sigman, Ungerer, and Russel (1983), out of twenty young adults with an intelligence that, on average, was on the level of MID, the majority scored on the pre-conventional level of moral development—that is, stage one and stage two. Thus, either people with MID move at a slower pace through the stages of moral development, and thereby make moral decisions at one stage for a longer time, or there is a ceiling effect situated in the pre-conventional stage. In both theories, considering the relation with the level of moral development, people with MID are at a higher risk for
antisocial and delinquent behaviour compared to peers with average intelligence (Langdon, Clare, & Murphy, 2011). This risk is caused by people’s orientation toward self-interest and mutual benefit when they enter stage two. People with MID either make moral decisions according to these principles for a longer period than usual or will not achieve higher levels of moral reasoning at all. People in stage one are actually protected against criminal intentions given their focus on obedience and on avoiding punishment.
An explanation for the fact that people with MID lag behind in moral development is that their impairments in higher-order cognitive skills leads to poorer test performance
(Dooley, Beauchamp, & Anderson, 2010; Moore, 2001; Puljol, Reixach, Harrison, Timoneda-Gallart, Vilanova, & Pérez-Alvarez, 2008). Due to a lack of sufficient reliable and valid assessment tools for people with MID, the effect of growing cognitive demands on their level of moral judgment remains unseen (Moore, 2001). Also, methods that depend on higher-order cognitive skills (Heinz dilemma, Moral Judgment Interview, Sociomoral Reflection Measure) provide only limited insight into moral behaviour in daily life (Dooley et al., 2010; Puljol et al., 2008).
Moral reasoning can be measured both using unstandardized measures or assessment measures (Stams et al., 2006). Assessment measures can be categorized as production or recognition measures. Production measures require people to come up with their own answers regarding moral dilemmas, whereas recognition measures require people to choose between statements that are closest to their own beliefs. The latter category enables people to modify their answers to conform to socially acceptable standards (Blasi, 1980). In general, using production measures appears to be most useful for detecting a person’s actual level of moral development (Van Vugt et al., 2011). However, recognition measures may be more useful for people with MID considering their difficulties in using verbal language (Stams et al., 2006).
Phillips and Nettelbeck (1984) found that people with MID respond slower in
recognition tasks than people with average intellectual abilities. This may be caused by their inefficient encoding and response strategies, both for verbal and visual memory. These encoding and response strategies are part of social information processing (Crick & Dodge, 1994). According to the theory of social information processing, people process information in six subsequent steps, in fixed order (see Figure 1). Step one-to-six are, respectively: encoding cues, interpretation and mental representation of those cues, clarification/selection of a goal, generating solutions, making a decision about how to respond and the enactment of the decision. This model of social information processing is compatible with the moral development given that they both focus on the link between social cognition and behaviour (Arsenio & Lemerise, 2004). It is argued that the moral development theory is relevant for those processes in which people reflect on the boundaries of morality, whereas the social information processing theory is relevant for the application of ‘moral boundaries’ during interactions.
Figure 1. Schematic social information processing theory.
In contrast with the theory of social information processing, the social intuitionism theory states that impulsive and intuitive reactions play a primary role in moral reasoning and
that the construction of rational thoughts comes in afterwards (Haidt, 2001). This theory is supported by ‘moral dumbfounding’ which is characterized by a situation in which people who are faced with moral dilemmas make quick decisions, but struggle when asked to give an explanation for the choice they made (Haidt & Hersh, 2001). Thus, according to this, in moral judgment the steps of the social information processing theory are performed in a different manner, as considered by Crick and Dodge (1994).
Such impulsive and intuitive reactions are not detected using self-report measurement procedures as mentioned above, but do appear using implicit cognition tasks (Fazio & Olson, 2003). The cognition part is ‘switched off’ by letting people make choices at high speed, while there is no opportunity for them to address their feelings or thoughts. It appears that the implicit cognition measures have a far higher predictive validity concerning socially sensitive topics, compared to self-report measurement (Greenwald, Poehlman, Uhlmann, & Banaji, 2009). A well-known example of such a task is the Implicit Association Task (IAT) (Greenwald, McGhee, & Schartz, 1998). The goal of this task is to measure the strength of associations between concepts and evaluations. Suppose the concepts given are disabled and abled persons and the type of evaluations are distinguished as good and bad. In the first exercise people are supposed to press ‘A’ for pictures of abled people and evaluations distinguished as good, and press ‘B’ for disabled people and the evaluations distinguished as bad. In the second exercise the response key for the evaluations changes so that new
combinations arise. Finally, the reaction time for all of the combinations is calculated and an implicit preference ought to exist when the time varies. The underlying assumption is that responding is easier when closely related items share the same response key.
Dooley and colleagues (2010) recently developed a computerized task for measuring moral development in adolescents with average intelligence, that is the Socio-Moral
presented using pictures from a first person point-of-view (it is as if somebody takes part in a particular situation). The respondent sees five different screens all of which are part of a photo scenario. Participants are asked whether they would or would not behave as suggested in the dilemma. Afterwards, they are asked to explain their response, aiming at the justification of the choices made. Both tasks gained preliminary support considering validity and reliability. Construction was based on five characteristics that, according to the authors, are related to the successful assessment of moral development, namely emotional reactivity, familiarity,
enjoyment, involvement and comprehension.
Familiarity with the social situations presented in test-items seems to be extra important for people with MID (van den Heuvel, Bos, & Schipper, 1999). Situations which are familiar to people with MID and situations they are able to imagine lead to less activity in the working memory and therefore induce more reliable answers. It is helpful when people are asked to deal with questions in line with their world of experience (Kersten, 1999). In this respect, it is important to keep in mind that the dilemmas are devised by researchers, so it is only hypothesized that the social situations presented in the dilemmas are familiar to
participants (Stams et al., 2006). Testing these hypothesized situations in a representative group before using them in an assessment procedure is therefore highly recommended. In the Socio-Moral Reasoning Aptitude Level, the dilemmas were reviewed by professionals who work with young people with average intelligence (Dooley et al., 2010).
Regarding the importance of target group involvement in the construction of
appropriate test-items, different ideas exist. In any case it is a relevant topic given the results of research indicating that different brain regions light up in fMRI for responding to one’s own moral dilemmas, compared to judging how appropriate somebody else’s action was (Garrigan, 2017). To make sure people feel more involved in the moral dilemmas presented, efforts have been made to use pictures of real people, presenting pictures using a first person
point-of-view and using cartoon caricatures (Harenski & Hamann, 2006; Pujol et al., 2008). Due to limited pilot testing, participants were not able to make distinctions between moral and non-moral dilemmas in the first two categories (Harenski & Hamann, 2006). The cartoon caricatures resulted in low task-involvement due to limited emotional reactivity (Pujol et al., 2008).
Regarding research on task-involvement of children with average intelligence, the chosen stimulus presentation turned out to be a direct predictor for the actual level of involvement (Orobio de Castro, Veerman, Koops, Bosch, & Monshouwer, 2002). Video presentation was hypothesized to have the largest effect on children’s task-involvement. However, research revealed that audio presentation yielded the largest effects, subsequently followed by pictures presentation and video presentation respectively. Seeing the interaction of other persons on the screen made it much more difficult for the children to imagine themselves being part of the interaction and thus yielded the smallest effect. With regards to both picture and video presentation, the degree of distraction due to irrelevant information can also be an explanation for reduced involvement. As described earlier, the Socio-Moral
Reasoning Aptitude Level is designed in such a way that participants see pictures from a first person point-of-view in order to enhance involvement (Dooley et al., 2010).
It is possible that this stimulus-task involvement distribution differs for people with MID as opposed to people with average intelligence, due to possible dysfunctions. For example, their (phonological) working memory and attention span could be limited
(Schuchardt, Gebhardt, & Mäehler, 2010). They also supposed to have a limited vocabulary, less language comprehension and problems applying learned information in new situations (De Wit, Moonen, & Douma, 2012). In addition, they are more susceptible to suggestibility (Henry & Gudjonsson, 2003) and show a tendency to be acquiescent (Finlay & Lyons, 2002).
This latter process is likely to occurs particularly when questions are too complex, both regarding grammar and type of judgment required.
The first aim of this research was to explore differences in the level of moral development between young adults with MID compared to young adults with average
intelligence. In this respect, it was assessed whether young adults with MID and young adults with average intelligence differed in (1) moral decision-making, (2) the degree of moral maturity, (3) achieved moral developmental stage, and (4) comprehension of the presented dilemmas. It was hypothesized that young adults with MID would (1) make fewer moral decisions when faced with dilemmas, (2) expressed a lower degree of moral maturity, (3) achieved lower stages of moral development and (4) experienced greater difficulty with comprehending the dilemmas presented. These hypotheses were based on research that suggests that people with MID evince a slower pace going from one stage to another, compared to people with average intelligence (Langdon et al., 2010), as well as on research suggesting that people with MID get stuck in the pre-conventional stage of moral
development (Sigman et al., 1983). Regarding the use of the Socio-Moral Reasoning Aptitude Level, it was expected that this measure was better suited for the participants with MID since this instrument includes multiple elements which are known to be important for reliable and valid assessment in people with MID. Furthermore, according to Dooley and colleagues (2010) these elements are important for the successful assessment of moral development. First of all, it was attempted to make the presented dilemmas akin to those people with MID are likely to meet in real life. Especially for people with MID, it is helpful when they deal with questions in line with their own world of experience (Kersten, 1999). This reduces the pressure on their working memory and therefore results in more reliable answers (Van den Heuvel et al., 1999). Secondly, difficulties with limited vocabulary and reduced language comprehension (De Wit et al., 2012) will be of less impact using the Socio-Moral Reasoning
Aptitude Level, given the fact that the measure consists primarily of pictures and only a few short sentences. Inefficient encoding strategies of young adults with MID (Phillips &
Nettlebeck, 1984) as part of the Social Information Processing theory (Crick & Dodge, 1994) however, were expected to influence results. In summary, all of the expected group
differences were supposed to be to a degree comparable to findings in earlier research, but disruptive influences were not expected to be completely disappeared. It was thought to be plausible that the instrument needed some adaptions to improve accuracy. Therefore it was decided to complete a pilot study first.
Therefore the second aim of this research was to explore which adaptions had to be made on the Socio-Moral Reasoning Aptitude Level measure in order to make it more suitable for young adults with MID. These possible adaptions aimed at diminishing the need for higher order cognitive skills so enabling a more reliable and valid assessment method (Dooley et al., 2010; Moore, 2001; Puljol et al., 2008; Vilanova & Pérez-Alvarez, 2008).
Methods Participants
48 young adults participated in this study, of which 33,3% were male, spread over two groups (a) young adults with MID and (b) young adults with average intelligence. Their age ranged between 17 and 25 years old (M = 20.9 year, SD = 2.48). Participants were included in the group young adults with average intelligence if their total IQ was between 85 and 115 and they were included in the group young adults with MID if their total IQ was between 50 and 75. All participants were able to express themselves adequately in the Dutch language. There was not checked for comorbid diagnoses like autism and behavioural disorders. Instruments
Abbreviated version of the Weschler Adult Intelligence Scale (WAIS-IV-NL). A 4 item version of the WAIS was used to estimate the total intelligence quotient (IQ) of all
participants. This task consisted of four subtests: Matrix Reasoning, Vocabulary, Arithmetic and Symbol Search. Each subtest covers one of the four indexes, respectively: verbal
comprehension, perceptual reasoning, working memory and processing speed. Research shows this version to give a reliable estimation of the total IQ whereby this was calculated according to the method presented by Van Ool and colleagues (2017).
Socio-Moral Reasoning Aptitude Level. The Socio-Moral Reasoning Aptitude Level (Dooley et al., 2010) is designed to measure moral reasoning skills in adolescents. Since this instrument only existed in English, it was translated and newly programmed in Dutch by the author. Several pictures were photo-shopped to make them contextually appropriate for use in the Netherlands, for example when Canadian money bills or prices were shown and when Canadian grades were presented in pictures. This Dutch version was shared with the initial author of the measure to ensure that it was next to the original version.
The task consists of assessing 10 socio-moral dilemmas that are presented using pictures of adolescent actors from a first person point-of-view (it is as if somebody takes part in a particular situation). Different task versions were designed for boys and girls, each using mainly same sex pictures of adolescents. To make sure participants understood the principle of the first person point-of-view, prior to starting the task, they were talked through various exercise images as well as one exercise photo scenario containing no moral dilemma.
The lay-out of this photo scenario is illustrated in Figure 2. It presents an example item used in the task, showing the five different screens participants see when a dilemma is
presented, respectively: orientation, introduction, core, dilemma and reasoning. Assessment consists of two different, constantly alternating, parts that are meant to measure Decision-making and Moral Maturity. This will be explained below.
Decision-making. The Decision-making part requires participants to choose whether
responses determines the participants’ total score. Participants gain one point for each moral response they give, leading to a total range that spans from 0 to 10 points. A higher total score indicates a higher degree of moral decision-making. The Cronbach’s α for the composite variable, thus the total score on decision-making, is presented in Table 1.
Figure 2. Example dilemma on the Socio-Moral Reasoning Aptitude Level measure (Dooley et al., 2010).
Moral Maturity. The Moral Maturity part of the task requires participants to explain
their responses to the earlier dilemmas, offering them the possibility for a justification. Answers are given in a pre-programmed multiple-choice format. Participants have to choose one of the six pre-programmed multiple-choice answers. Those answers are constructed in a way that five of the six answers represent the five different stages of moral development as defined by the authors of the task. The five levels are defined as follows: (1) Authoritarian-based consequences, (2) Egocentric exchanges, (3) Interpersonal Focus, (4) Societal
Regulation and (5) Societal evaluation. Each level implies a score equal to that number. Thus, by choosing a level one answer the participant gains 1 scoring point, by choosing a level two answer the participant gains 2 scoring points et cetera. The remaining answers are based on completely inappropriate or tangential reasoning and were considered as nonscorable, thus gaining 0 scoring points. .
In the case of the billiards example as described above, choosing to move the ball generates the following possible answers (corresponding score in brackets): It’s my turn (0), I wouldn’t get into trouble (1), I like to win (2), It will teach them to pay more attention (3),
The point of playing is to win (4) and It’s important for games to be fun (5). If people choose to not move the ball, they have the following possible answers: I wouldn’t do it (0), I would get into trouble (1), My friend wouldn’t do it to me (2), It’s not nice to do that to my friends (3), It’s against the rules (4) and It is important to be truthful (5). Thus a higher total score implies a higher degree of moral maturity. The Cronbach’s α for the composite variable, thus the total score on moral maturity, is presented in Table 1.
Moral Maturity Stage. Participants’ Moral Maturity Score corresponds to a Moral
Maturity Stage. Scores can range from 0 to 50 points. A score between 0-10 points
corresponds to stage 1 of moral development, 11-20 points to stage 2, 21-30 points to stage 3, 31-40 points to stage 4 and 41-50 points to stage 5.
Comprehension. Participants were asked, “What is happening in this scenario?”
before they answered the question according the dilemma. It was also scored how many stories the participants understood on the first try. If a dilemma was not understood, the scenario was explained to them so they were able to proceed. Furthermore, it was noted how they initially interpreted the scenario. Participants gained one point for each photo scenario they initially comprehended, leading to a total range between 0 to 10 points. A higher total score thus leads to a higher degree of comprehension. The Cronbach’s α for the composite variable, the total initially comprehended dilemmas, is presented in Table 1.
Corrected Moral Maturity Score. The above mentioned comprehension score was
used to correct for the not initially comprehended dilemmas on the Moral Maturity task. This score was calculated by only adding the Moral Maturity scores of the dilemmas on which participants gained one scoring point and thus comprehended.
Corrected Moral Maturity Stage. The Corrected Moral Maturity Score resulted in a
corresponding Corrected Moral Maturity Stage. When participants comprehend 9 dilemmas, scores can range from 0 to 45 points. A score between 0-9 points corresponds to stage 1,
10-18 points corresponds to stage 2 and so forth. When participants comprehend 8 dilemmas, scores can range from 0 to 40 points. A score between 0-8 points corresponds to stage 1, 9-16 points corresponds to stage 2 and so forth. When participants comprehend 7 dilemma’s, scores can range from 0 to 35 points and so forth.
Table 1
Cronbach’s alfas for the Scores on the Socio-Moral Reasoning Aptitude Level for Young Adults with and without MID
Cronbach’s alfa MID (n = 23) Qualification Average IQ (n = 25)
Qualification
Decision-making .54 Poor .49 Unacceptable
Moral Maturity .53 Poor .56 Poor
Comprehension .52 Poor .42 Unacceptable
Note 1. Beauchamp, Dooley, and Anderson (2013) decided not to calculate validity and reliability statistics for the results found given the small sample size used in their study, which was equal compared to this research.
Note 2. Cronbach’s alfa was not calculated for Corrected Moral Maturity Score and Corrected Moral Maturity Stage since these scores were extracted from a combination of scores and were calculated by hand.
Procedure
After the University of Amsterdam Ethics Committee approved the study, participants were recruited in two different ways. Young adults with MID were recruited through
purposive sampling by contacting various institutions. When consent was obtained from the institution, employees who knew the young adults well asked them whether they were
interested in participating in the study. Eventually, young adults living at the organizations Koraalgroep, Amerpoort, Reinaerde, Ipse de Bruggen and Dichterbij participated in the study. Young adults with average intelligence were recruited through self-selection by using the researcher’s own network. All participants were legally capable to consent and were
individually asked to provide written consent. For the young adults with MID, this form was written in ‘Language for All’ (Moonen, 2016) and suited with pictograms. Participating in the study took, on average, 35 minutes. Participants were included in the group with average intelligence if they had an estimated total IQ between 85 and 115 and were included in the group with MID if they had an estimated total IQ between 50 and 75. Sometimes 95% probability intervals were used to classify a person in one of two groups. All data obtained was treated confidentially and participants’ details were made anonymous.
Data analysis
To answer the question whether young adults with MID and young adults with average intelligence differed in their level of moral development, several analyses were performed using SPSS version 25. First of all, mean scores of age, total IQ, decision-making, moral maturity score, moral maturity stage, comprehension, corrected moral maturity score and corrected moral maturity stage were calculated. Furthermore, the strength of the
relationship between all of those variables was calculated using Pearson correlations. Due to the fact that assumptions for Analysis of Variance (ANOVA), as well as Analysis of
Covariance (ANCOVA), were not met for all variables, Mann-Whitney U tests were
performed to detect differences between groups. For those variables that met the assumptions of ANOVA, this analysis was performed additionally.
Results Descriptive statistics
The means, standard deviations and results of the t-tests for all studied variables are presented in Table 2. The means of the young adults with MID and young adults with average intelligence are compared using an independent t-test. Significant differences were found regarding Intelligence Quotient, Comprehension and Corrected Moral Maturity Score.
Table 2
Means, Standard Deviations and T-tests for the Scores on the Socio-Moral Reasoning Aptitude Level for Young Adults with and without MID
MID (n = 23) Average IQ (n = 25) T-test M SD M SD t Intelligence Quotient 62.01 9.71 100.00 12.22 -11.86* Decision-making 8.91 1.38 8.84 1.31 0.19
Moral Maturity Score 30.87 7.12 33.04 6.85 -1.08
Moral Maturity Stage 3.72 0.69 3.72 0.68 -0.55
Comprehension 7.74 1.66 9.28 0.98 -3.88*
Corrected Moral Maturity Score X 23.96 8.78 31.12 7.04 -3.13*
Corrected Moral Maturity Stage X 3.52 0.85 3.72 0.74 -0.87 Note. X = Corrected for dilemmas not initially comprehended.
* p < .01 (one tailed).
Correlations
Pearson correlations (one-tailed) for all studied variables are presented in Table 3. For both young adults with MID and young adults with average intelligence, significant
Table 3
Correlations for Intelligence Quotient and the Scores on the Socio-Moral Reasoning Level for Young Adults with and without MID
1 2 3 4 5 6 7
1. Intelligence Quotient - -.20 .31 .26 .52** .47** .28
2. Decision-making .22 - .29 .37* -.13 .11 .17
3. Moral Maturity Score .46* .34 - .94** <-.01 .92** .91**
4. Moral Maturity Stage .46* .33 .94** - -.07 .81** .92**
5. Comprehension .42* -.01 .32 .33 - .33 -.12
6. Corrected Moral Maturity Score X .51** .23 .79** .80** .80** - .83**
7. Corrected Moral Maturity Stage X .44* .20 .84** .95** .43* .82** - Note. Correlations under the diagonal for young adults with MID (n = 23), correlations above the diagonal for young adults with average intelligence (n = 25).
X = Corrected for dilemmas not initially comprehended.
* p < .05 (one tailed). ** p < .01 (one tailed).
Assumptions
First of all, it was checked whether the data was normally distributed for both groups of young adults, those with MID and those with average intelligence. This was only the case for three variables, namely the total Intelligence Quotient, the Moral Maturity Score and the Corrected Moral Maturity Score (p > .05). The variable Comprehension was normally distributed for the group of young adults with MID only. All other variables failed the assumption of a normal distribution of the data. An attempt to normalize the data, using
multiple (log) transformations, failed, possibly influenced by a positive skewness statistic for one group and a negative skewness statistic for the other group. Levene’s statistics were calculated, indicating that the assumptions for all of the variables were fulfilled, except for the variable Comprehension. Independent sample t-test are in principle still considered robust when the normality assumptions is somehow violated, however the combination with the violation of the heterogeneity variable in this research makes it necessary to use non-parametric tests. Therefore Mann-Whitney U tests were performed.
Data analysis
Mann-Whitney U tests were performed to assess differences in all dependent variables for young adults with MID and for young adults with average intelligence. All statistical information will be given respectively.
Decision-making. It was assessed whether young adults with MID and young adults with average intelligence differed in the degree to which they make moral choices when faced with dilemmas. A Mann-Whitney U test indicated that the Decision-making of young adults with MID did not significantly differ from that of young adults with average intelligence (Mean Rank = 24.78, n = 23; Mean Rank = 24.24, n = 25), U = 281.00, z = -.14, p = .444 (one tailed). Young adults from both groups provide an equal amount of moral choices when faced with moral dilemmas.
Moral Maturity Score. Secondly, it was assessed whether young adults with MID and young adults with average intelligence differed in terms of moral maturity. A Mann-Whitney U test indicated that Moral Maturity Scores of young adults with MID did not significantly differ from those of young adults with average intelligence (Mean Rank = 22.24, n = 23; Mean Rank = 26.58, n = 25), U = 235.00, z = -.1.08, p = .141 (one tailed). Young adults from both groups provide equal amounts of moral maturity.
Moral Maturity Stage. Thirdly, it was assessed whether young adults with MID and young adults with average intelligence differed in their achieved stage of moral development. The Moral Maturity Stage of young adults with MID did not significantly differ from that of young adults with average intelligence (Mean Rank = 23.65, n = 23; Mean Rank = 25.28, n = 25), U = 268.50, z = -.44, p = .329 (one tailed). Young adults from both groups achieved a similar stage of moral development.
Comprehension. Fourthly, it was assessed whether young adults with MID and young adults with average intelligence differed in their initial understanding of the moral dilemmas presented. Comprehension of young adults with MID was significantly lower than that of young adults with average intelligence (Mean Rank = 17.50, n = 23; Mean Rank = 30.94, n = 25), U = 126.50, z = -3.44, p = <.001 (one tailed). This is a medium effect (r = .50). Young adults with MID hade more difficulties understanding the moral dilemmas in the
computerized task.
Corrected Moral Maturity Score. Fifthly, it was assessed whether young adults with MID and young adults with average intelligence differed in terms of moral maturity after correction for the dilemmas not initially comprehended. The Corrected Moral Maturity Score of young adults with MID was significantly lower than that of young adults with average intelligence (Mean Rank = 19.15, n = 23; Mean Rank = 29.42, n = 25), U = 164.50, z = -2.54 p = .006 (one tailed). This is a medium effect (r = .38). Young adults with MID showed lower moral maturity compared to young adults with average intelligence when only initially
comprehended dilemmas were scored.
Corrected Moral Maturity Stage. Sixthly, it was assessed whether young adults with MID and young adults with average intelligence differed in their achieved stage of moral development after correction of the dilemmas not initially comprehended. The Corrected Moral Maturity Stage of young adults with MID did not significantly differ from that of
young adults with average intelligence (Mean Rank = 23.04, n = 23; Mean Rank = 25.84, n = 25), U = 254.00, z = -.75 p = .226 (one tailed). Young adults with MID achieved a similar stage of moral development even if only initially comprehended dilemmas were scored.
Frequencies Distribution for Developmental Stages. In addition to testing for group differences for the Moral Maturity Stage and the Corrected Moral Maturity Stage scores, the distribution of the number of responses for each stage was checked for both young adults with MID and those with average intelligence. The results are presented in Table 4 and Table 5 respectively. Results indicated the modus for young adults with MID as well as young adults with average intelligence to be in stage four of moral development.
Table 4
Frequencies and Percentages of Achieved Moral Developmental Stages both for Young Adults with and without MID
MID (n = 23) Average IQ (n = 25)
Frequencies Percentage Frequencies Percentage
Stage 1 0 0 0 0 Stage 2 1 4,3 0 0 Stage 3 9 39,1 10 40,0 Stage 4 11 47,8 12 48,0 Stage 5 2 8,7 3 12,0 Table 5
Corrected Frequencies and Percentages of Achieved Moral Developmental Stages both for Young Adults with and without MID
Frequencies Percentage Frequencies Percentage Stage 1 0 0 0 0 Stage 2 3 13,0 1 4,0 Stage 3 7 30,4 8 32,0 Stage 4 11 47,8 13 52,0 Stage 5 2 8,7 3 12,0 Additional Analyses
Due to the variables Moral Maturity Score and Corrected Moral Maturity Score meeting the assumptions of normality, an ANOVA was performed. It was found that Moral Maturity Scores of young adults with MID did not differ significantly from those of young adults with average intelligence F (1, 46) = 1.56, p = .287, 2 = .025. This can be considered
small effect. Young adults with MID and young adults with average intelligence expressed an equal amount of moral maturity. But, it was found that Corrected Moral Maturity Scores of young adults with MID did significantly differ from those of young adults with average intelligence F (1, 46) = 9.80, p = .003, 2 = .176. This can be considered a medium effect.
Young adults with MID expressed a lower degree of moral maturity compared to young adults with average intelligence.
Conclusion and discussion
The first aim of this research was to explore whether there were differences in the level of moral development between young adults with MID and young adults with average intelligence. First of all results found show that they did not differ in their level of decision-making. Secondly, the level of moral maturity only differed when correction for
comprehension was conducted; young adults with MID expressed lower moral maturity. In addition, young adults with MID initially comprehended fewer dilemmas. But achieved moral
developmental stages did not differ between the groups. Rather the frequencies distribution indicated that most young adults from both groups had achieved stage four of moral
development.
Results showed that young adults with MID did not make fewer moral decisions compared to young adults with average intelligence when faced with dilemmas. Although young adults at the age of 15/16 are, according to Kohlberg (1984) able to provide moral reasoning justifications at a stage-five level, these results are in contrast to the fact that young adults with MID are supposed to have a lower mental age compared to their chronological age (Langdon et al., 2010). Two possible explanations can clarify these results found. First the sociomoral dilemmas were, contrary to expectations, not too familiar to the participants. Second, the results might have been influenced by the participants’ socially desirable answering, as decision-making is assessed via self-reporting (Greenwald et al., 2009). Participants may have been aware that their preferred answer could have been perceived as immoral and therefore changed their answer to one more socially acceptable. Research shows that people with MID are more likely to give social desirable answers since they want to be liked and appreciated by others (Rassin & Candel, 2010).
Young adults with MID did not express a lower degree of moral maturity compared to young adults with average intelligence. But, after correction for dilemmas not initially
comprehended, young adults with MID did show significantly lower moral maturity. Again, multiple possible explanations can be given. First people with MID are known to be more prone to suggestibility (Henry & Gudjonsson, 2003) and for acquiescence (Finlay & Lyons, 2002). This latter process predominantly occurs when questions are too complex, both in terms of grammar and in the type of judgement required. This especially may have been the case in the dilemmas young adults with MID did not initially understand, accidently leading to higher expressions of moral maturity. Secondly, the use of recognition measures may have
tempted participants with MID, consciously or subconsciously, to choose multiple-choice answers belonging to the higher stages of moral maturity. This may be especially true for difficult and thus not initially comprehended dilemmas, which may have led to an
overrepresentation of moral maturity in participants with MID, thus leading to higher scores on the not-corrected Moral Maturity Score. In general, using production measures seems most useful for detecting a person’s actual level of moral development (Van Vugt et al., 2011) and recognition measures may be even more useful for people with MID considering their
difficulties using verbal language (Stams et al., 2006). Thirdly, in terms of social desirability, recognition tasks enable people to modify their answers to conform to socially desired
standards (Blasi, 1980). Again, self-reporting measures go hand-in-hand with socially desirable answering (Greenwald et al., 2009). Moral Maturity was assessed using a ‘Why-question’ format. This kind of questioning may tempt people to justify themselves. This could result in people giving answers that calculate for higher levels of moral maturity especially when they don’t know how to answer questions that they do not fully comprehend.
Results showed that young adults with MID did not achieve lower stages of moral development compared to young adults with average intelligence. This is in contrast with the results found in earlier studies (Langdon et al., 2010; Sigman et al., 1983). Two young adults with MID even achieved the fifth stage of moral development! Social desirable answering as well as the influence of the multiple-choice format could apply for this.
It was found that young adults with MID experienced greater difficulty with comprehension compared to young adults with average intelligence. This could be due to inefficient encoding strategies of the young adults with MID (Phillips & Nettlebeck, 1984) as part of the Social Information Processing theory (Crick & Dodge, 1994). However,
particularly given the small power of this research, it’s also possible that the differences found in this study might in fact be non-existent.
The second aim of this study was to assess which adaptions should be made to make the Socio-Moral Reasoning Aptitude Level measure more suitable for young adults with MID. In summation, these adaptions are due to the definition of a dilemma, the effect of moral dumbfounding, the validity of participants’ answers, the question format, setting-dependent choices regarding dilemmas, socially desirable answering, increasing involvement, increasing comprehension, replacing/clarifying certain dilemmas and checking familiarity.
General recommendations
Definition of a dilemma. A dilemma is “a situation with an or/or character in which both choices have negative consequences but a choice must be made; when you do nothing you also make a decision” (Graste, 2003). This implies that there is no preferred solution. If there is a preferred solution, the dilemma can be considered a false-dilemma. The Socio-Moral Reasoning Aptitude Level is constructed in such a way that participants are shown a photo scenario and have to choose whether they would or would not behave as is suggested to them in the context of each sequence. Each moral response yields one scoring point, which implies that there is a preferred solution: the moral response. With the definition of a (false) dilemma in mind, it would be more sensible to only grant scoring points to the argumentation given by participants for the choices they made (in this research: the Moral Maturity
question). Also, it would be better to no longer use the word ‘dilemma’.
Moral dumbfounding. The impulsive and intuitive reactions which play a primary role in the moral responses people give (Haidt, 2011) are not taken into account in the current measure. The concept of moral dumbfounding supports this theory. This term refers to people who make quick decisions when faced with moral dilemmas but struggle when asked to give an explanation for the choice they made (Haidt & Hersh, 2001). In fact, when people are asked to provide argumentation for both possible answers to a dilemma, it will make them feel more trapped in the situation since they will weigh the positive and negative
consequences for both options. Weighting both options will prevent participants from defending the answer that they chose in a split second.
Validity of answers. The mechanism described above is further supported by the findings of an Swedish experiment on statements about moral questions where people were asked to fill in a survey in which an illusion was used to change the direction of a few statements when people flipped the pages (Hall, Johanson, & Strandberg, 2012). As a result, the answers people initially filled in were manipulated and replaced with reversed statements giving respondents the illusion that this opposite answers were represented their original opinions. When they were asked to explain some of this manipulated answers, more than half of the respondents had not noticed that the direction of their answering had changed and they defended the opposite opinion contrary to their initial opinion. They started reasoning as to why they had given a particular answer and would come up with justifications for it. This was shown by people with weaker as well as by those with stronger opinions. Results showed that justifications people offer for their choices are not as authoritative as was initially assumed.
Question format. The Decision-making as well as the Moral Maturity part of the instrument contained multiple-choice questions. Regarding the Decision-making part, people were pushed in a certain direction during the process of answering of the multiple-choice questions. It is possible that people wanted to present a solution to the dilemma that was not offered as one of the possible answers. This could be explained as follows: in the presented scenario in which someone walks behind a person who loses his/her wallet, people can choose to either return the wallet or keep the wallet for themselves. However, there is the possibility that the respondent wants to remove money from the wallet subsequently delivering the wallet to a police station so that the rightful owner can be found and receive for instance his
bankcards back. Regarding the Moral Maturity part of the instrument, people were asked to explain why they made a certain choice. Such a ‘Why-question’ format may lead to people
making up answers instead of giving their actual and truthful opinion. A more subtle formulation of the question would be: “Explain how you came to give this answer.” Furthermore, the Moral Maturity part of the instrument pushes people to make certain choices. It was often the case that the answer participants wanted to give was not among one of the multiple-choice options. A suggestion is to provide the option for people to write their original answer, especially in cases when they really do not agree with the provided
answering options.
Setting-dependent choices. During the answering of the dilemmas, participants often mentioned that the behaviour they would display in the presented photo scenario would depend on the actual setting. For example, they would be more likely to upgrade an examination result if it would have helped them to pass the school year compared to a situation in which they were aiming to achieve excellence in a course. Also, they would be more likely to let someone see their answers during an exam if this someone was a cherished friend compared to just a random classmate. Furthermore, the chances of getting caught play a major role in different dilemmas. This implies that some people will react differently to the same photo scenario depending on the characteristics of the setting. The distinction between people who adhere to moral rules at all times (deontology) and people who balance costs and benefits in every single situation (consequentialism), may influence these findings (Bartels, 2008). The research could have been different if the same photo scenario would have been inserted multiple times whilst changing the underlying setting. This would have provided the researchers with insight into whether or not people were basing their answers on the moral rules they apply or if they changed their answers according their perception of different settings.
Socially desirable answering. Since it is expected that socially desirable answering influences the results of this instrument, it may be valuable to add questions to control for
such patterns. Socially desirable behaviour is defined as the general tendency of individuals to present themselves in a manner that makes them look positive with regards to culturally accepted standards of behaviour (Chung & Monroe, 2003). It appears that people are likely to estimate themselves as more ethical compared to their peers when asked how they intend to act in certain situations, as well as how they think their peers would act (Cohen, Pant, & Sharp, 1998; Cohen, Pant, & Sharp, 2001; Jurgensen, 1978). This knowledge could be added to the instrument expanding it with questions regarding how peers would behave in each dilemma.
Increasing involvement. Dooley and colleagues (2010) stated that involvement is one of the elements that is related to the successful assessment of moral development. It appears that people’s judgements regarding hypothetical situations have no predictive value regarding real-life situations (Bostyn, Sevenhant, & Roets, 2018). Thus, what people think they will do doesn’t necessarily match with their actual behaviour. In this respect, measuring moral development in any hypothetical situation gives little insight into the actual behaviour considering the studied constructs. Therefore, it is strongly recommended to, in some way, measure moral development in real-life situations.
MID-specific recommendations
Increasing comprehension. Compared to young adults without MID, young adults with MID experience more difficulties comprehending (the wording of) the dilemmas. Regarding social information processing, many young adults with MID have to deal with inefficient encoding strategies (Phillips & Nettlebeck, 1984; Van Rest et al., 2018). These inefficient encoding strategies and the resulting lower level of comprehension seem to be interrelated. In the social information processing theory encoding can be seen as the first step whilst decision making can be seen as the fifth step (Crick & Dodge, 1994). Garrigan, Adlam, & Langdon (in press) extended the theory of social information processing in order to clarify
the process in which moral response decisions are influenced by elements concerning social information processing, resulting in the Social Information Processing-Moral Decision-making framework. It is important to include all necessary information in dilemmas to enable a weighted decision. For example, in case you want to study whether people pick up a lost money billet from the street when a police van is nearby, you need to know for sure that participants noticed the van in order to draw conclusions on their chosen behaviour alternative. The photo scenarios of the current Socio-Moral Reasoning Aptitude Level
challenge the encoding skills of young adults with MID. This problem became apparent in the movie dilemma, where participants with MID frequently did not understand that the dilemma meant that they would not have enough money to buy a movie ticket. Ensuring that
participants are no longer need to encode photo stories very precise can increase the overall level of comprehension. In this case, the researcher could assist the participants or the participants could be informed about the photo stories by means of an audio fragment. It would be valuable to offer this help in an Easy to Read English format (in Dutch Language for All; Moonen, 2016). By adapting information to become more comprehensible for people with MID, the amount of reading mistakes could be diminished and a greater level of
understanding of textual information, even comparable to that of people without MID, could be achieved (Karreman, van der Geest, & Buursink, 2007).
Replacing/clarifying certain dilemmas. Frequency statistics indicated that four of the dilemmas were not initially understood by several of the participants. The number of
participants who did not initially comprehend each of the dilemmas will be given
respectively. These four dilemmas were, the wallet dilemma (52,6% MID; 24% average IQ), the billiards dilemma (47,4% MID; 16% average IQ), the movie dilemma (31,6% MID; 24% average IQ) and the social media dilemma (31,6% MID; 0% average IQ). In the wallet dilemma, participants often interpreted the last picture as the receiving of reward money or as
the returning of the wallet to its rightful owner. However, the image actually depicts a scene in which the imaginary participant is showing the money in the wallet to his or her friends. It may be helpful to introduce these friends somewhat earlier in the dilemma, for example by adding them to the first picture. In the billiards dilemma, participants often interpreted the second picture as the boy passing the billiards stick to the girl next to him. However, the point of the dilemma is that the boy becomes distracted talking to the girl and therefore the
respondent gets the possibility to cheat. It may be helpful to place the billiards stick further away from the hands of the girl. In the movie dilemma, participants often interpreted the second picture as a scene in which they would receive money from someone. However, the picture should make clear that the amount of money they brought would not be enough to buy a movie ticket. It may be helpful to point out that the imaginary participant is searching for the price he/she has to pay and is getting the money billet out of his/her own wallet. In the social media dilemma, participants often did not notice that they were sitting behind a friend who was logging in on his/her account. It may be helpful to introduce the friend by giving him/her more space in the picture. In summation, it is recommended to either replace these four dilemmas with new ones or to adjust some of the pictures in order to clarify the intended storyline.
Checking familiarity. Dooley and colleagues (2010) stated that familiarity is one of the elements that is related to the successful assessment of moral development. In this respect, it is important to keep in mind that the dilemmas are devised by researchers, so it is only hypothesized that the social situations presented in the dilemmas are familiar to the actual participants (Stams et al., 2006). In constructing the Socio-Moral Reasoning Aptitude Level (Dooley et al., 2010) checking the dilemmas were done by people who work with youth with average intelligence. It is recommended that this familiarity check is also done with young adults with MID.
Limitations and strengths
There are several limitations to this study. Firstly, the generalizability and the representativity of the results are limited due to the small sample used in this study not accounting for a power of .80, meaning that the differences found in this study might in fact be non-existent. Also, the sample was quite homogenous as most of the participants were white and were native Dutch speakers. This does not represent current Dutch population demographics. The homogeneous sample characteristics may have influenced the results. In earlier studies the sample not all demographics were presented. This could be relevant given the fact that moral reactions are partly determined by using a native or foreign language (Hayakawa & Keysar, 2018). People answering in a foreign language primarily weight the degree in which actions contribute to the public benefit, whilst people answering in a native tongue are more focused on norms and values they personally have, regardless of the situation they are in. An explanation for this finding could be that people answering in a foreign
language are less emotionally involved and experience less vividness of images (Harris, Aycicegi, & Gleason, 2003; Hayakawa & Keysar, 2018). These emotional processes are supposed to trigger people to use the deontological principles in moral dilemmas (Cushman, 2013).
Furthermore, as mentioned before socially desirable answering may have influenced the results. It is also possible that the researcher-participant relationship was not independent. This could have been especially true for the group of young adults with average intelligence because they already knew the researcher.
Lastly, comorbidity was not assessed and therefore may have influenced the results. People with MID frequently have a comorbid autism spectrum disorder as well as lower levels of social-emotional development. People with these conditions are known to show less
empathy, which is related to a lower level of moral reasoning skills (Senland & Higgings-D’Alessandro, 2013). Furthermore, people with MID frequently have comorbid behavioural disorders. These behavioural disorders are again related to lower levels of moral reasoning (Blair, Monson, & Frederickson, 2001). In addition, Langdon and colleagues (2010) concluded that the role of intelligence in the concept of moral development expires when people with MID are matched with typically developing peers based on their mental age instead of their chronological age. In this research only chronological age was used to include participants.
Besides these limitations, this study has several strengths. The fact that a specific age group was researched makes it possible to generalize the results to persons of this age. Furthermore, the control group of young adults with average intelligence made comparisons possible. In previous studies, total IQ scores appeared to be highly correlated with Socio-Moral Reasoning Aptitude Level and age was a direct predictor for moral developmental stages. Additionally, controlling for comprehension was a strength, since this contributed for significant results. This emphasis the usefulness of such corrections and stresses the fact as well as how little information is actually obtained without correction for comprehension. Recommendations for further research and implications
In this research, gender differences were not taken into account. However, in earlier research is was found that the effect of gender on moral reasoning is inconsistent and primarily it is the topic of the dilemmas that influences these relationships (Walker, 2014). The Socio-Moral Reasoning Aptitude Level measure contains the option to select the participants’ gender prior to starting the task and in this way provides gender-specific pictures. It may be interesting to gain insight into the differences between the results yielded by boys and girls. Furthermore, it is recommended to repeat the research which Orobio de Catro and colleagues (2002) conducted with children of average intelligence, for the group of
young adults with MID. They assessed whether stimulus presentation (video, pictures and audio) would be a predictor of the level of involvement. Given the fact people with MID tend to have several dysfunctions including a limited attention span (Schuchardt et al, 2010) and lower levels of language comprehension (De Wit et al., 2012), the results may differ from the results yielded by children of average intelligence. In addition, it may be useful to assess whether stimulus presentation influences the level of comprehension of the dilemmas presented. In this research, it appeared that young adults with MID experienced more difficulty in trying to understand what was going on in the dilemmas. Perhaps it could be useful to implement a combination of picture and audio presentation into the stimulus presentation of the measure. Involvement and comprehension are supposed to have a
significant impact on the process of designing the most appropriate tasks for the assessment of moral development in young adults with MID.
Individuals with lower levels of moral reasoning skills are prone of having a higher risk of developing delinquency (Langdon et al., 2011). Contrary to earlier research, young adults with MID were not found to achieve lower stages of moral development in this research. This research shows that young adults with MID express a lower degree of moral maturity compared to young adults with average intelligence. Since these differences only were found after correction for comprehension, it is of great importance to take into account such significant elements when measuring moral reasoning in young adults with MID. When these findings are taken into account it may be helpful to use short-form computerized tasks as the Socio-Moral Reasoning Aptitude Level as a pre-selection in order to select those individuals who may benefit the most from special interventions addressing moral development.
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