Abstract
The Wisconsin Card Sorting Test (WCST) represents the gold standard for the neuropsychological assessment of executive function. However, very little is known about its reliability. In the current study, 146 neurological inpatients received the Modified WCST (M-WCST). Four basic measures (number of correct sorts, categories, perseverative errors, set-loss errors) and their composites were evaluated for split-half reliability. The reliability estimates of the number of correct sorts, categories, and perseverative errors fell into the desirable range (rel ≥ .90). The study therefore disclosed sufficiently reliable M-WCST measures, fostering the application of this eminent psychological test to neuropsychological assessment. Our data also revealed that the M-WCST possesses substantially better psychometric properties than would be expected from previous studies of WCST test-retest reliabilities obtained from non-patient samples. Our study of split-half reliabilities from discretionary construed and from randomly built M-WCST splits exemplifies a novel approach to the psychometric foundation of neuropsychology.
Highlights
The Wisconsin Card Sorting Test (WCST) was developed by Berg and Grant (Berg, 1948; Grant & Berg, 1948) to assess abstraction and the ability to shift cognitive strategies in response to changing environmental contingencies
The median and the 95% highest density intervals (HDI; shown as horizontal lines in red color in the histograms) of the emergent distribution were computed as estimates of the central tendency and uncertainty of split-half reliability estimates, respectively. (b) For the purpose of our reliability analysis, we considered random and systematic splits of scores that were derived from test halves
Our study provides an example for nongeneralizability of reliability because Modified WCST (M-WCST) measures obtained from neurological patients showed good reliabilities, which contrasts with the bulk of the published studies on WCST reliability that were predominantly obtained from non-clinical samples
Summary
The Wisconsin Card Sorting Test (WCST) was developed by Berg and Grant (Berg, 1948; Grant & Berg, 1948) to assess abstraction and the ability to shift cognitive strategies in response to changing environmental contingencies. Based on test-retest data from 142 healthy volunteers, these authors computed reliability estimates for MCST scores as low as .56 (number of categories), .64 (number of perseverative errors), and .46 (number of non-perseverative errors, which roughly corresponds to number of set-loss errors) Such low estimates of W/MCST score reliability raise the issue whether or not W/MCST scores could be confidently utilized in clinical practice, thereby putting the legitimacy of the W/MCST as a means to quantitatively assess abilities in executive function into doubt (Bowden et al, 1998). The M-WCST manual (Schretlen, 2010) provides a sole reliability estimate of .50 for its main composite measure of executive function, which combines number of categories and perseverative errors This reliability coefficient was derived from a subsample of the standardization sample for which 5.5-year test-retest measurements were available (n = 103; without further specification of sample characteristics). We supposed that the rather disappointing reliability estimates that have been obtained by Lineweaver et al (1999), Schretlen (2010), and other researchers might have originated from particular characteristics of the previous studies
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