Factor structure of the Wisconsin Card Sorting Test: Dimensions of deficit in schizophrenia.

Abstract

The aim of this study was to explore the factorial structure of the Wisconsin Card Sorting Test (WCST) and to identify the dimensions of deficit in schizophrenia. WCST scores in patients with schizophrenia and schizophrenia-related psychosis (n = 292), 1st degree relatives of schizophrenic patients (n = 91), and normal controls (n = 141) were subjected to a principal factor analysis followed by orthogonal rotation. This led to 3 factors, perseveration, failure to maintain set, and idiosyncratic sorting. The detected factor structure was found to be invariant across the schizophrenic and control subsamples. Moreover, it replicated previous findings from 2 smaller samples. Only perseverations and, to a lesser degree, idiosyncratic sorting appeared to differentiate schizophrenic patients from comparisons. Only perseveration had good sensitivity and specificity, as well as the most robust significant correlations with estimates of IQ, attention, and other measures of executive functioning. Thus, perseveration appears to be the most diagnostically useful and characteristic WCST feature of schizophrenia.

More evidence supports the association of PPP3CC with schizophrenia

“…The Total Correct index was not included as it is complementary to Total Errors. In this study, the indexes of WCST for association analyses were (1) Perseverative Errors (PE): the number of errors that were perseverative, reflecting the tendency towards perseveration; and (2) categories achieved (CAT): the number of times that 10 consecutive correct responses were made, reflecting overall success.These two indicators were found to be impaired in schizophrenic probands 23,24 and in the first-degree relatives of schizophrenic probands. 25 The PE and CAT were used as the endophenotype indicators of WCST in this study.…”

“…When patients with schizophrenia having a z score below À2.5 were assigned to have deficit in sustained attention, the recurrence risk ratio for schizophrenia among parents or siblings in the subgroup of schizophrenia with this CPT endophenotype was higher than that in the whole group of schizophrenia probands. 20,21 Executive functions as measured by the Wisconsin Card Sorting Test (WCST) 22 are known to be impaired in schizophrenic patients 23,24 and their first-degree relatives. 25 The WCST is a classic neuropsychological procedure used to evaluate cognitive-based executive function of the frontal lobe dysfunction.…”

The Wisconsin Card Sorting impairment in schizophrenia is evident in the first four trials

“…WCST performance has been linked to activity in the prefrontal cortex (Haut et al 1996;Konishi et al 1999;Lie et al 2006;Lombardi et al 1999;Mansouri et al 2006;Monchi et al 2001;Nagahama et al 1996), but the source of SZ patients' deficit remains obscure given the complexity of the task. Various accounts focus on the role of abstracting and rule-learning (Keri et al 2001;Perrine 1993), working memory demands (Glahn et al 2000;Gold et al 1997;Hartman et al 2003), attentional deficits and unmodulated perseverative behavior (Amos 2000;Koren et al 1998;Li 2004). We took a different approach, examining behavior over the first four trials of the test in order to determine if a very elementary deficit in the ability to use feedback on a rapid, trial-to-trial basis can provide a biologically motivated account of SZ patients' impairment.…”

The effect of black tea on human cognitive performance in a cognitive test battery

“…Moreover, previous studies used relatively simple tasks [14,[30][31][32] (although see [4] for a more complicated task). Therefore, we used relatively complex test procedures such as trail making tests [33], card sorting test [34,35], calculation tasks etc. We hypothesized that BT at a low dose [caffeine (50 mg) and plus L-theanine (15 mg)] would enhance cognitive performance.…”