Kate Carter. Case Western Reserve University Department of Cognitive Science Social Cognition and the Brain, 12/9/2024

Abstract

Pathological altruism is a phenomenon that has long puzzled researchers, from biologists observing alarm calling in rodents to neuroscientists studying heroic rescuers. It describes actions taken by an individual that benefit the well-being of another at the expense of the altruistic individual. While many behaviors fall under this common definition, understanding the root causes and motivations for these actions requires consideration on multiple time scales. The form of pathological altruism discussed in this paper is that of acute, definitive acts that benefit another at a great risk or expense to the altruist. As the contexts for these acts vary, so do the neurological correlates and immediate motivations. However, the overarching commonality between all populations investigated is increased amygdala activation in response to others’ distress. The networks activated around this central thread vary based on the circumstances of the act, but the amygdala is always an important player.

Introduction

A man jumps in front of a bus to save a child who’s run into the road. A match for a stranger’s kidney donates despite knowing the health risks. These acts of altruism come with great risk and potential cost to the altruist with seemingly little payout. Defining altruistic behavior as an action or actions that benefit the welfare of others, pathological altruism can be defined by adding the condition that the altruistic act comes at the expense of the altruist.

Some behaviors that seem to fall under this definition are observed in the animal kingdom. Worker bees do not reproduce and spend their entire lives tending to their queen and the hive. Female prairie dogs will alarm call when an aerial predator is detected, decreasing their chance of survival but increasing the survival of other colony members. On closer inspection, none of these acts are truly “altruistic”. They all benefit the altruist in line with the selfish gene hypothesis (Ågren, 2016) All workers in a hive were born to the queen, and serving her allows the genes of the hive to be passed down. The prairie dog alarm callers are primarily adult, reproductive females: calling to protect the colony protects the subset of the colony that is the progeny or relatives of the caller. These are not acts of altruism, just social behavior that directly benefits the passage of genetic material, not the personal well-being of the altruist.

Humans have been observed to perform acts of costly kindness for people who are not their kin, however, making pathological altruism a uniquely human social behavior. An act of altruism does not fall under kin selection or the selfish gene hypothesis unless it directly benefits the passage of the altruist’s genes, including through relatives like siblings and cousins who possess a percentage of the original individual’s genetic code. This distinction puts human altruism in a different category: “true” altruism, or altruism that does not directly benefit the individual or their genes.

There are two categories of pathological altruism observed in humans: chronic and acute. Chronic altruism occurs in situations of long, repetitive behaviors that hurt the altruist. Examples of this are parents who forgo vaccines for their children because the child is distressed by needles, and partners who enable substance abuse rather than administer tough love and force the one they love to get help (Sapolsky, pg. 346). Acute altruism occurs when someone performs a single costly, risky, or otherwise self-destructive action to help another, usually a stranger or someone genetically unrelated to them. This second type is what this paper focuses on.

The studies that form the basis of this paper focus on several populations that have exhibited pathologically altruistic behaviors. Each describes their subjects a little differently. The first is Carnegie Hero Award Winners. A study by Dr. David Rand investigated 51 extreme altruists who had received the CHA. All of these individuals were civilians who had voluntarily risked death or extreme injury to save the life of another person. One of the requirements for this award is that the civilian needed to have no connection or responsibility for the safety of the victim prior to the rescue, ruling out kin selection (“Carnegie Hero Fund Commission”, 2024). A second study by Rhoads in 2023 studied 6 populations of extraordinary altruists, including non-directed kidney donors, marrow donors, and humanitarian aid workers who had committed acts of extraordinary altruism. These “acts” were very similar to those of the CHA recipients, except that the person was not a civilian—usually an EMT or firefighter (Rhodes, 2023). Non-directed kidney donors were also considered in Marsh, 2014 in an fMRI study comparing the brains of pathological altruists, who show extreme levels of empathy, and psychopaths, who are incapable of such empathy (Marsh 2014, Dolan 2009). The final population studied is people who have not been documented to perform pathological altruism previously. Behavioral and fMRI studies on adults centering around altruistic and pathologically altruistic tasks have been performed parallel to those on subjects who have previously demonstrated pathological altruism (Vekaria 2017, de Waal 2008, Marsh 2016). This was used to investigate whether altruistic behaviors were more characteristic to individuals or would be performed by anyone under the right circumstances.

There were unique qualities to each of the populations and analysis criteria for each study based both on the people involved and the tasks they were assessed by. Because of this, they can be used to paint a picture of the common threads involved in multiple types of pathological altruism, but do not all report on the same things. Their findings have been broken down into three sections to put together a cohesive understanding of the motivations, cognitive processes, and neurological correlates that are involved in acute acts of pathological altruism.

The Seconds section explores the neurological correlates that are activated during acts of pathological altruism as well as the intuitive decision making common to empathetic-concern based actions. Minutes to Hours delves into the social dynamics and cognitive processes thought to motivate empathetic-concern and relieving-personal-discomfort hypothesis actions. These factors play out in the immediate situation the altruist finds themselves in before acting. Finally, the Months to Years section looks at the differences in pathological altruist and control brains and the personality traits commonly found in individuals who exhibit these behaviors.

Seconds

There were found to be two types of decision making processes that motivated pathological altruism, and one of them occurs in seconds. In interviews conducted with Carnegie Hero Medal winners, many described their decision to step in as intuitive and split-second. They saw someone in trouble. They were close enough to help. They helped. The decision and their explanation of it held consistent even when they had time to reflect before acting (Rand, 2014). This gut-instinct, intuitive decision making is indicative of subcortical involvement. It is consistent with an earlier study on care-based altruism that found that it was strongly connected to empathetic concern (Marsh, 2015).

Care based altruism, or altruism based in other-oriented concern, falls under the “eliminating other’s distress” hypothesis. It’s aimed at improving the wellbeing of distressed and vulnerable individuals, and is usually motivated by strong empathetic concern. The brain regions activated when this type of altruism is performed includes structures dense with receptors to oxytocin and vasopressin, including the amygdala, stria terminalis, and striatum (Marsh, 2015). Another study on similar subjects found that the VTA, caudate, and sgACC activated during other-oriented prosocial costly altruistic behaviors (FeldmanHall, 2015).

Minutes to Hours

Pathological altruism is often situational, with the decision to help at cost to oneself occurring within the context the altruist finds themselves in. However, not all altruistic decisions are made intuitively in a split second. Several populations were investigated through interviews and performance on research tasks to evaluate under what conditions people would choose altruism.

Pathological altruists consistently demonstrated increased other-oriented concern (FeldmanHall, 2015), (Rand, 2014), (Rhoads, 2023). This manifested in state distress (FeldmanHall, 2015), automatic, intuitive decision-making (Rand, 2014), and increased sensitivity to others’ fearful faces (Marsh et al, 2016). Behavioral studies investigated two different cognitive mechanisms for understanding the motivation and enabling of costly altruism. Individuals were thought to be motivated by either an egoist drive to eliminate one’s distress when watching another in distress or other-oriented concern (FeldmanHall, 2015).

The relieving personal discomfort hypothesis is supported by de Waal 2008, which studied empathetic altruistic motivation as derived from the “emotional stake it offers the self in the other’s welfare” (de Waal, 2008) and FeldmanHall’s finding that pathological altruism is motivated by state distress rather than trait distress (2015). State distress is a situational feeling of discomfort, rather than trait distress, which is an engrained pattern of emotional responses. Extreme altruists who acted out of their own self-interest were motivated by the discomfort they felt in the moment, rather than having a history of helping others to make themselves feel better.

The other-oriented concern hypothesis has been investigated in much more detail, and was one of the main motivations for Carnegie Award Recipents. Also motivated by state distress, their actions were governed by split-second, intuitive decision making. However, altruistic decision making can occur over minutes to hours, rather than seconds. The decision to donate an organ takes a little longer. A study focusing on kidney, marrow, and liver donors found that they had an unusually high valuation of of other’s outcomes and reduced personal distress (Rhoads, 2023). They also performed reduced social discounting (Vekaria, 2017), which likely supports the higher value placed on other’s outcomes. While a reduced concern for one’s own wellbeing combined with an increased value placed on the wellbeing of others does not directly motivate altruistic behavior, this affective framework explains the reasoning behind the decision to go forward with pathologically altruistic actions. Importantly, these motivations were connected with other-oriented concern consistent with the “relieving other’s discomfort” hypothesis, and not the “relieving personal discomfort” hypothesis.

Months to Years

There are some features that contribute to pathological altruism that act on a larger time scale: neural plasticity and the development of personality traits. Neural circuits that are activated more often tend to be more developed, and this is reflected in the size of the activated brain region. One study focused on individuals who had donated a kidney to a stranger, a costly altruism that cannot be explained by kin selection mechanisms. It revealed that these individuals shared “enhanced volume in the right amygdala and enhanced responsiveness of this structure to fearful facial expressions.” using fMRI imaging of individuals while completing behavioral tasks like the face-emotion paradigm (Marsh, 2016). This enlargement is not something that occurs overnight, but rather is an increase in region size due to repeated, increased activation of the brain area, in responding to fearful facial expressions among other things. This implies that an individual who has committed pathological altruism in this manner would be more likely to make other prosocial, empathetic-concern based decisions. Altruists relieving their own discomfort may be motivated by state distress, but there’s neurological evidence that some empathy-driven altruists have a pattern of similar amygdala activation.

While Marsh, 2015, was the only study to report on brain region size and not just activation, amygdala activation during pathologically altruistic acts is the commonality held through all of the neural imaging studies that cover this topic, indicating that it has a special significance among the brain regions implicated. The amygdala is the brain’s headquarters for quick, emotional responses, and lights up especially strongly in response to percieved pain, fear, and anxiety. It has also been found to be enlarged in young mothers soon after giving birth. The increased amygdala volume has been linked to higher attention being paid to the infant’s emotional needs, especially relieving distress (Holz, 2021).

Assessed using the HEXACO personality test, pathological altruists also scored higher for some personality traits than their control counterparts. Altruistic individuals differed from controls in “traits and decision-making patterns indicating unusually high valuation of others’ outcomes: high Honesty-Humility, reduced Social Discounting, and reduced Personal Distress.” (Rhoads, 2023). These two traits were part of the “Interpersonal Reactivity” index, and are thought to contribute to the motivation to commit acts of costly altruism. The HEXACO test was administered to six populations of altruists: liver, kidney, and marrow donors, civilian heroic rescuers, and humanitarian aid workers who had performed a heroic rescue.

Discussion

Studying acute acts of pathological altruism and the individuals that commit them requires consideration for the situational context, personality, and history of behavior that they stem from. Studies have been conducted to analyze the neurological correlates and immediate motivations for pathological altruism in a variety of contexts, and some commonalities have been identified. Amygdala activation is at the core of all neural correlates that have been identified, across motivations and contexts. Pathological altruists who act out of empathetic concern, or the “relieving others’ discomfort” hypothesis have similar patterns of neurological activation as parental care, and extreme altruists show an enlargement of the right amygdala and increased activation in response to fearful expressions. Altruists acting with the “relieving personal discomfort” hypothesis are motivated by situational, state distress rather than ingrained, trait distress.

These findings support the notion that altruistic decision making is incredibly context dependent. Many aspects of the motivations and decision making are social and situational, dependent on what’s going on around the altruist and the recipient. Some are habitual, stemming from the lived experiences of the altruist that have shaped their personality and brain chemistry. Others are situational, with social and intuitive motivations occurring in context.

While the causality of pathological altruism has been explored through a cognitive science approach in recent years, gaps in the literature still exist. To create a more cohesive understanding of the neuroscience behind pathological altruism, conducting an fMRI study on Carnegie Hero Award Recipients and organ donors would help fill in the gaps. Comparing these two populations would shed light on the neurological correlates involved in split-second, intuitive decision making of the heroes and the empathetic, pro-social decision making governed by reduced social discounting and personal distress found in non-directed organ donors. Evaluating both populations, as well as a control with a task designed to stimulate either a snap-decision or an empathetic act similar in weight to an organ donation while performing fMRI could identify whether there’s a difference in the neural activation patterns found in each population or each type of decision. This could begin to unify our understanding of the neurological correlates involved in pathologically altruistic acts, or to separate out the different structures that are involved with each process based on the context the act occurs within.

References

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‌Rhoads, S. A., Vekaria, K. M., O’Connell, K., Elizabeth, H. S., Rand, D. G., Kozak Williams, M. N., & Marsh, A. A. (2023). Unselfish traits and social decision-making patterns characterize six populations of real-world extraordinary altruists. Nature Communications, 14(1), 1807. https:/ /doi.org/10.1038/s41467-023-37283-5

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‌Vekaria, K. M., Brethel-Haurwitz, K. M., Cardinale, E. M., Stoycos, S. A., & Marsh, A. A. (2017). Social discounting and distance perceptions in costly altruism. Nature Human Behaviour, 1(5). https:/ /doi.org/10.1038/s41562-017-0100

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