Wisconsin Card Sorting Test Scores Research Articles

Test-Retest Stability of the Wisconsin Card Sorting Test

Eighty-seven normal older persons were administered the Wisconsin Card Sorting Test (WCST) on two occasions an average of 1.1 years apart. Means for age and education were 68.79 years ( SD = 6.21) and 14.80 years ( SD = 2.42), respectively. Stability coefficients ranged from .12 on the Learning to Learn scale to .66 for the Total Number of Errors scale. The majority of individuals improved on retest with five WCST scores demonstrating significant average retest gains of 5 to 7 standard score points. The standard error of prediction, standard error of difference, and abnormal test-retest discrepancy scores were calculated to assist clinicians in detecting possible meaningful changes in WCST scores on retest.

Familial/sporadic schizophrenia: Differences in neuropsychological function

There is now substantial evidence that both genetic and environmental factors play a role in the etiology of schizophrenia; however, little is known about the relationships between these factors and known markers for schizophrenia. In this paper we apply the familial/sporadic subtyping method as a first step towards examining the contribution of familial (approximated to genetic in this study) and environmental factors to relevant neurobiological markers in schizophrenia. Specifically, we compare cerebral ventricular size and neuropsycho[ogical function in schizophrenic patients with and without a first-degree relative with schizophrenia. Family history was ascertained by interview with the patient and a family member and a review of the medical record in 48 schizophrenic inpatients diagnosed by SADS/RDC and DSM-III-R criteria. Seven patients had a first-degree relative with schizophrenia. Neuropsychological functions were measured on the Wechsler Adult Intelligence Scale-Revised (full scale IQ, verbal IQ, and performance IQ); Trail Making Test Part B; Reaction Time (choice); Wisconsin Card Sorting Test (WCST); and the Controlled Oral Word Association Test. IQ, Trails B, and WCST scores were standardized to acoount for differences in age, sex, and education levels. Ventricle-brain ratios (VBRs) were calculated from CT scans. Patients with positive (FHpos) and negative (FHneg) family histories did not differ on the severity of either positive or negative symptomatology. Our results showed that a negative family history was associated with increased VBR (means -FHpos: 0.06; FHneg: 0.09; p = 0.06); these findings are consistent with several other reports. Of the neuropsychological indicators, only scores on Trails B differed significantly in the FHpos and FHneg groups; positive family history was associated with worse functioning (FHpos: 62.7; FHneg: 84.1; Mann-Whitney U: p = 0.01). These data suggest that nonfamilial factors contribute to ventricular enlargement while familial factors contribute to frontal lobe deficits in schizophrenia. This might reflect the presence of ventricular enlargement and frontal lobe neuropsychological dysfunction on separate pathogenetic pathways in schizophrenia. The results support the utility of the familial/sporadic approach in studying the pathogenetic heterogeneity of schizophrenia.

Schizophrenia, training paradigms, and the Wisconsin Card Sorting Test redux

The question of whether and to what extent poor performance on the Wisconsin Card Sorting Test (WCST) in patients with schizophrenia can be improved with coaching has been controversial. We review relevant studies with particular reference to the following issues: (1) can improvement occur? (2) if improvement does occur, what is its significance? and (3) what is the association between performance and neurophysiology? The studies indicate that in patients with schizophrenia performance can frequently be improved, but usually remains in the abnormal range. Similar results for memory measures have been reported in patients with amnesias or dementias of known neurological origin. This suggests that simple dichotomies between neurologic and psychological explanations of cognitive impairment and potential amelioration of such impairment may be inadequate. Comparisons of the results of studies using the WCST as a clinical tool with binary cut-off scores to define normal and abnormal, as a measure of neuropsychological function along a continuum, and as an activation stimulus to probe neurophysiology suggest that absolute WCST scores may not always accurately gauge the functional integrity of neural systems dedicated to the task. This situation may arise because of individual differences in endowment and in the capacity for neuronal compensation, as well as measurement error. Given these issues, caution is advised in the interpretation of WCST scores, which are best understood as representing a final common cognitive pathway that can be the product of diverse psychological, physiological, and neuroanatomic mechanisms.

Wisconsin Card Sorting Test performance in healthy, older adults: relationship to age, sex, education, and IQ.

We obtained Wisconsin Card Sorting Test (WCST) scores on 91 (35 male and 56 female) healthy, well-educated individuals aged 45 to 83. Women scored better than men on six WCST scores (categories, errors, perseverative responses, % perseverative errors, % conceptual level responses, and trials to first category), while subjects with more than 16 years of education outscored those limited to high school education on four measures (perseverative responses, errors, % perseverative errors, % conceptual level responses). Individuals older than 70 years of age scored less well than younger subjects on only two indices (errors, % conceptual level responses). Full Scale IQ was not related to WCST scores. Our findings suggest that WCST scores should be interpreted within the context of patient gender, education, and age.

Major depressives' and dysthymics' performance on the wisconsin card sorting test

Despite awareness that depression may affect performance on commonly used neuropsychological tests, little research has been conducted on the relative impact of severity and type of depression on higher problem-solving ability. Major depressives (n = 13), dysthymics (n = 17), and non-psychiatric comparison subjects (n = 18) were administered the Wisconsin Card Sorting Test (WCST). Although diagnostic category was related only marginally to some WCST measures after controlling for intellectual function, depressive symptom severity emerged as an independent predictor of Total Errors, Perseverative Responses, and Failure to Maintain Set. These findings lend support to the suggestion that neuropsychological test batteries should include assessment for depression and suggest that even relatively mild depression may affect WCST scores.

Comparison of two short forms of the Wisconsin Card Sorting Test

Two short forms of the Wisconsin Card Sorting Test (WCST) were evaluated. The WCST-64 consists of one deck of 64 cards; derived measures are number of categories obtained and number of perseverative responses. The WCST-3 includes measures of the number of cards required to complete three categories and the number of perseverative responses. WCST protocols from 37 schizophrenics, 20 temporal lobe epileptics, 11 patients with probable SDAT, and 54 normal controls, were scored using the three methods. Pearson correlations between WCST and WCST-64 scores ranged from.70 to.91. while correlations between WCST and WCST-3 were somewhat lower (.36 to.82). The WCST-64 was superior to the WCST-3 in agreement with the full WCST. The WCST-3 tended to underestimate the number of perseverative responses on the full WCST. Although the use of a short form reduces reliability, the WCST-64 appears to be an acceptable alternative when administration of the full WCST is not possible.

Comparison of two short forms of the Wisconsin Card Sorting Test

Two short forms of the Wisconsin Card Sorting Test (WCST) were evaluated. The WCST-64 consists of one deck of 64 cards; derived measures are number of categories obtained and number of perseverative responses. The WCST-3 includes measures of the number of cards required to complete three categories and the number of perseverative responses. WCST protocols from 37 schizophrenics, 20 temporal lobe epileptics, 11 patients with probable SDAT, and 54 normal controls, were scored using the three methods. Pearson correlations between WCST and WCST-64 scores ranged from.70 to.91. while correlations between WCST and WCST-3 were somewhat lower (.36 to.82). The WCST-64 was superior to the WCST-3 in agreement with the full WCST. The WCST-3 tended to underestimate the number of perseverative responses on the full WCST. Although the use of a short form reduces reliability, the WCST-64 appears to be an acceptable alternative when administration of the full WCST is not possible.