Considerations for using the Wisconsin Card Sorting Test to assess cognitive flexibility

Miles, Stephanie; Howlett, Caitlin A.; Berryman, Carolyn; Nedeljkovic, Maja; Moseley, G. Lorimer; Phillipou, Andrea

doi:10.3758/s13428-021-01551-3

Cited by 77 publications

(80 citation statements)

References 54 publications

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“…Further, it is important to note that a portion of these studies report variables that may not be an appropriate index of “cognitive flexibility” (i.e., TMT—part B; Vall & Wade, 2015 or TMT B-A; Kopp, 2011). It may be prudent to start by validating the most widely acknowledged outcomes of “cognitive flexibility” (i.e., perseverative errors/responses of the WCST; Miles et al, 2021) and aim to confirm the findings through adequately powered replication studies. As stated by the Open Science Collaboration, “direct replication provides the opportunity to assess and improve reproducibility” (Open Science Collaboration, 2015, p. 2).…”

Section: Discussionmentioning

confidence: 99%

Back to the drawing board—The relationship between self-report and neuropsychological tests of cognitive flexibility in clinical cohorts: A systematic review and meta-analysis.

Howlett¹,

Wewege²,

Berryman³

et al. 2022

Neuropsychology

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Objective: Cognitive flexibility has been previously described as the ability to adjust cognitive and behavioral strategies in response to changing contextual demands. Cognitive flexibility is typically assessed via self-report questionnaires and performance on neuropsychological tests in research and clinical practice. A common assumption among researchers and clinicians is that self-report and neuropsychological tests of cognitive flexibility assess the same or similar constructs, but the extent of the relationship between these two assessment approaches in clinical cohorts remains unknown. We undertook a systematic review and meta-analysis to determine the relationship between self-report and neuropsychological tests of cognitive flexibility in clinical samples. Method: We searched 10 databases and relevant gray literature (e.g., other databases and pearling) from inception to October 2020 and used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines. Eleven articles including 405 participants satisfied our eligibility criteria. Results: A multilevel random-effects meta-analysis revealed no relationship between self-report and neuropsychological tests of cognitive flexibility (0.01, 95% CI [−0.16 to 0.18]). Individual random-effects meta-analyses between 12 different tests pairs also found no relationship. Conclusion: Based on our results, it is clear that the two assessment approaches of cognitive flexibility provide independent information—they do not assess the same construct. These findings have important ramifications for future research and clinical practice—there is a need to reconsider what constructs self-report and neuropsychological tests of “cognitive flexibility” actually assess, and avoid the interchangeable use of these assessments in clinical samples.

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Section: Discussionmentioning

confidence: 99%

Back to the drawing board—The relationship between self-report and neuropsychological tests of cognitive flexibility in clinical cohorts: A systematic review and meta-analysis.

Howlett¹,

Wewege²,

Berryman³

et al. 2022

Neuropsychology

Self Cite

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“…The paradigms are focused on flexibility in shifting between thoughts and actions and involve problem-solving and exploration (Ionescu, 2012 ; Marko and Riečanský, 2018 ). In humans, the Wisconsin Card Sorting Test (WCST) is a common test for cognitive flexibility, while in rodents, the Attentional Set Shifting Paradigm is the most common (Brown and Tait, 2016 ; Miles et al, 2021 ). In both procedures, intradimensional (ID) and extradimensional (ED) cues are used, and the subject must learn to shift both within and between dimensions to complete the test (Brown and Tait, 2016 ).…”

Section: Introductionmentioning

confidence: 99%

Sex differences in cognitive flexibility are driven by the estrous cycle and stress-dependent

Gargiulo

Ravaglia

et al. 2022

Front. Behav. Neurosci.

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Stress is associated with psychiatric disorders such as post-traumatic stress disorder, major depressive disorder, anxiety disorders, and panic disorders. Women are more likely to be diagnosed with these stress-related psychiatric disorders than men. A key phenotype in stress-related psychiatric disorders is impairment in cognitive flexibility, which is the ability to develop new strategies to respond to different patterns in the environment. Because gonadal hormones can contribute to sex differences in response to stress, it is important to consider where females are in their cycle when exposed to stress and cognitive flexibility testing. Moreover, identifying neural correlates involved in cognitive flexibility could not only build our understanding of the biological mechanisms behind this crucial skill but also leads to more targeted treatments for psychiatric disorders. Although previous studies have separately examined sex differences in cognitive flexibility, stress effects on cognitive flexibility, and the effect of gonadal hormones on cognitive flexibility, many of the findings were inconsistent, and the role of the estrous cycle in stress-induced impacts on cognitive flexibility is still unknown. This study explored potential sex differences in cognitive flexibility using an operant strategy shifting-paradigm after either control conditions or restraint stress in freely cycling female and male rats (with estrous cycle tracking in the female rats). In addition, we examined potential neural correlates for any sex differences observed. In short, we found that stress impaired certain aspects of cognitive flexibility and that there were sex differences in cognitive flexibility that were driven by the estrous cycle. Specifically, stress increased latency to first press and trials to criterion in particular tasks. The female rats demonstrated more omissions and perseverative errors than the male rats; the sex differences were mostly driven by proestrus female rats. Interestingly, the number of orexinergic neurons was higher in proestrus female rats than in the male rats under control conditions. Moreover, orexin neural count was positively correlated with number of perseverative errors made in cognitive flexibility testing. In sum, there are sex differences in cognitive flexibility that are driven by the estrous cycle and are stress-dependent, and orexin neurons may underlie some of the sex differences observed.

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“…Finally, cognitive flexibility represents a creative and adaptive mindset to rapid circumstance variations. In the experimental setup, the subject is required to shift among different cognitive schemes in response to a dynamic task [31]. Links among EFs and some of the main used tests are shown in Table 1.…”

Section: Executive Function Identificationmentioning

confidence: 99%

A Systematic Review on Feature Extraction in Electroencephalography-Based Diagnostics and Therapy in Attention Deficit Hyperactivity Disorder

Arpaïa

Covino²,

Cristaldi³

et al. 2022

Sensors

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A systematic review on electroencephalographic (EEG)-based feature extraction strategies to diagnosis and therapy of attention deficit hyperactivity disorder (ADHD) in children is presented. The analysis is realized at an executive function level to improve the research of neurocorrelates of heterogeneous disorders such as ADHD. The Quality Assessment Tool for Quantitative Studies (QATQS) and field-weighted citation impact metric (Scopus) were used to assess the methodological rigor of the studies and their impact on the scientific community, respectively. One hundred and one articles, concerning the diagnostics and therapy of ADHD children aged from 8 to 14, were collected. Event-related potential components were mainly exploited for executive functions related to the cluster inhibition,whereas band power spectral density is the most considered EEG feature for executive functions related to the cluster working memory. This review identifies the most used (also by rigorous and relevant articles) EEG signal processing strategies for executive function assessment in ADHD.

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Considerations for using the Wisconsin Card Sorting Test to assess cognitive flexibility

Cited by 77 publications

References 54 publications

Back to the drawing board—The relationship between self-report and neuropsychological tests of cognitive flexibility in clinical cohorts: A systematic review and meta-analysis.

Back to the drawing board—The relationship between self-report and neuropsychological tests of cognitive flexibility in clinical cohorts: A systematic review and meta-analysis.

Sex differences in cognitive flexibility are driven by the estrous cycle and stress-dependent

A Systematic Review on Feature Extraction in Electroencephalography-Based Diagnostics and Therapy in Attention Deficit Hyperactivity Disorder

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