Abstract

IntroductionCognitive impairment is a core feature of schizophrenia and other psychotic disorders and executive deficits are within the most impaired cognitive functions The Wisconsin Card Sorting test (WCST) has been extensively used in literature on schizophrenia and psychosis. The underlying structure of executive impairment may have important implications for our understanding of the complex connections between executive dysfunction and the psychopathology and neurofunctional basis of psychosis.ObjectivesThe objective was to empirically validate the dimensions of the WCST network structure of patients regarding antecedent, concurrent and outcome variables.MethodsSubjects were 298 patients with a DSM 5 diagnosis of psychotic disorder. To assess the empirical validation of network structure of the WCST antecedent, concurrent and outcome variables were selected from the CASH interview and other scales of patients.ResultsPearson coefficient correlations between the 4 network loadings (NL) of WCST, namely perseveration, inefficient sorting, failure to maintain the set and learning, and antecedent, concurrent and outcome validators are shown in the table. PER and IS showed common and strong associations with antecedent, concurrent and outcome validators. LNG dimension was also moderately associated and FMS did not show significant associations.Conclusions‘Perseveration’ and ‘Inefficient sorting’ dimensions achieve and share common antecedent, concurrent and outcome validators. While ‘Learning’ dimension achieves partial validation in terms of antecedent and outcome validators and ‘Failure to maintain the set’ dimension was not associated with external validators. These four underlying dysfunctions might help to disentangle the neurofunctional basis of executive deficits in psychosis.

Highlights

  • European PsychiatryS519 executive deficits remains unclear, as there may be different underlying processes

  • Cognitive impairment is a core feature of schizophrenia and other psychotic disorders and executive deficits are within the most impaired cognitive functions The Wisconsin Card Sorting test (WCST) has been extensively used in literature on schizophrenia and psychosis

  • Pearson coefficient correlations between the 4 network loadings (NL) of WCST, namely perseveration, inefficient sorting, failure to maintain the set and learning, and antecedent, concurrent and outcome validators are shown in the table

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Summary

European Psychiatry

S519 executive deficits remains unclear, as there may be different underlying processes. Objectives: The study’s aims were to explore and compare the network structure of the WCST measures in psychosis and their unaffected siblings. Methods: Subjects were 298 patients with a DSM 5 diagnosis of psychotic disorder and 89 of their healthy siblings. The dimensionality and network structure of the 13 WCST measures were examined by means of the Exploratory Graph Analysis (EGA) and centrality parameters. Results: The WCST network structure comprised 4 dimensions: Perseveration (PER), Inefficient sorting (IS), Failure to maintain set (FMS) and Learning (LNG). Patient and sibling groups showed a similar network structure and in both cases the network structure was reliably estimated. Exploratory and confirmatory studies demonstrating an invariant cognitive factor structure between schizophrenia patients and their unaffected siblings

Empirical validation of the wcst network structure in patients
Introduction
Conclusions
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