Wisconsin card sort
Encyclopedia
The Wisconsin Card Sorting Test (WCST) is a neuropsychological test
of "set-shifting", i.e. the ability to display flexibility in the face of changing schedules of reinforcement. The WCST was written by David A. Grant and Esta A. Berg. The Professional Manual for the WCST was written by Robert K. Heaton, Gordon J. Chelune, Jack L. Talley, Gary G. Kay, and Glenn Curtiss.
The original WCST used paper cards and was carried out with the experimenter on one side of the desk facing the participant on the other. Since the early 1990s, however, computerized versions of the task have been available, the most recent version being the Microsoft Windows
-compatible version 4.0. The latter has the advantage of automatically scoring the test, which was quite complex in the manual version. The test takes approximately 12–20 minutes to carry out and generates a number of psychometric scores, including numbers, percentages, and percentiles of: categories achieved, trials, errors, and perseverative
errors.
, clinical psychologists, neurologists
and psychiatrists
in patients with acquired brain injury
, neurodegenerative disease, or mental illness
such as schizophrenia
. It has been considered a measure of executive function because of its reported sensitivity to frontal lobe dysfunction. As such, the WCST allows the clinician to assess the following "frontal" lobe functions: strategic planning, organized searching, utilizing environmental feedback to shift cognitive sets, directing behavior toward achieving a goal, and modulating impulsive responding. The test can be administered to those 6.5 years to 89 years of age.
Although successful completion of the test relies upon a number of intact cognitive functions including attention
, working memory
, and visual processing, it is loosely termed a "frontal lobe
" test on the basis that patients with any sort of frontal lobe lesion generally do poorly at the test. In particular, patients with lesions of the dorsolateral frontal lobe make a higher number of perseverative errors than control participants. A recent factor analysis
of the WCST has shown these perseverative errors to be the most useful outcome measure in assessing cases. A more sophisticated description of deficits of this type is "executive dysfunction
".
paradigms such as PET
and fMRI. As predicted by the acquired brain injury
literature, early PET studies have shown the task involves significant activation of the dorsolateral prefrontal cortex
. However, more recent fMRI studies have shown that the ventrolateral prefrontal cortex (Konishi et al., 1998, Nature Neuroscience) together with the caudate nucleus (Monchi et al., 2001, J. Neuroscience) may be the regions most important for the set-shifting process required in the WCST. These regions are also associated with working memory functions (Frank et al., 2001). The test's use in neurodegenerative diseases such as motor neurone disease
has identified at least a subgroup of these patients for whom there is some subtle degree of cognitive dysfunction, in contrast to the traditional view that these were pure disorders of the motor system
.
The test is also widely used in research into schizophrenia
.
(Reg. #2320931, Ser # 75-588988) by Wells Printing and Digital Services of Madison, Wisconsin
. Although filed in 1998, the trademark application states the mark has been in use in commerce since at least 1970. The trademark covers "psychological testing materials, namely printed tests, printed cards, and printed instruction manuals in the field of psychological evaluation
." This trademark does not cover the computer implementation of the test, distributed by Psychological Assessment Resources, Inc., sometimes referred to as simply WCST.
Neuropsychological test
Neuropsychological tests are specifically designed tasks used to measure a psychological function known to be linked to a particular brain structure or pathway. Tests are used for research into brain function and in a clinical setting for the diagnosis of deficits. They usually involve the...
of "set-shifting", i.e. the ability to display flexibility in the face of changing schedules of reinforcement. The WCST was written by David A. Grant and Esta A. Berg. The Professional Manual for the WCST was written by Robert K. Heaton, Gordon J. Chelune, Jack L. Talley, Gary G. Kay, and Glenn Curtiss.
Method
Initially, a number of stimulus cards are presented to the participant. The shapes on the cards are different in color, quantity, and design. The person administering the test decides whether the cards are to be matched by color, design or quantity. The participant is then given a stack of additional cards and asked to match each one to one of the stimulus cards, thereby forming separate piles of cards for each. The participant is not told how to match the cards; however, he or she is told whether a particular match is right or wrong. During the course of the test the matching rules are changed and the time taken for the participant to learn the new rules, and the mistakes made during this learning process are analysed to arrive at a score.The original WCST used paper cards and was carried out with the experimenter on one side of the desk facing the participant on the other. Since the early 1990s, however, computerized versions of the task have been available, the most recent version being the Microsoft Windows
Microsoft Windows
Microsoft Windows is a series of operating systems produced by Microsoft.Microsoft introduced an operating environment named Windows on November 20, 1985 as an add-on to MS-DOS in response to the growing interest in graphical user interfaces . Microsoft Windows came to dominate the world's personal...
-compatible version 4.0. The latter has the advantage of automatically scoring the test, which was quite complex in the manual version. The test takes approximately 12–20 minutes to carry out and generates a number of psychometric scores, including numbers, percentages, and percentiles of: categories achieved, trials, errors, and perseverative
Perseveration
Perseveration is the repetition of a particular response, such as a word, phrase, or gesture, despite the absence or cessation of a stimulus, usually caused by brain injury or other organic disorder. If an issue has been fully explored and discussed to a point of resolution, it is not uncommon for...
errors.
Clinical use
Clinically, the test is widely used by neuropsychologistsNeuropsychology
Neuropsychology studies the structure and function of the brain related to specific psychological processes and behaviors. The term neuropsychology has been applied to lesion studies in humans and animals. It has also been applied to efforts to record electrical activity from individual cells in...
, clinical psychologists, neurologists
Neurology
Neurology is a medical specialty dealing with disorders of the nervous system. Specifically, it deals with the diagnosis and treatment of all categories of disease involving the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all effector tissue,...
and psychiatrists
Psychiatry
Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...
in patients with acquired brain injury
Acquired brain injury
An acquired brain injury is brain damage caused by events after birth, rather than as part of a genetic or congenital disorder such as fetal alcohol syndrome, perinatal illness or perinatal hypoxia. ABI can result in cognitive, physical, emotional, or behavioural impairments that lead to permanent...
, neurodegenerative disease, or mental illness
Mental illness
A mental disorder or mental illness is a psychological or behavioral pattern generally associated with subjective distress or disability that occurs in an individual, and which is not a part of normal development or culture. Such a disorder may consist of a combination of affective, behavioural,...
such as schizophrenia
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
. It has been considered a measure of executive function because of its reported sensitivity to frontal lobe dysfunction. As such, the WCST allows the clinician to assess the following "frontal" lobe functions: strategic planning, organized searching, utilizing environmental feedback to shift cognitive sets, directing behavior toward achieving a goal, and modulating impulsive responding. The test can be administered to those 6.5 years to 89 years of age.
Although successful completion of the test relies upon a number of intact cognitive functions including attention
Attention
Attention is the cognitive process of paying attention to one aspect of the environment while ignoring others. Attention is one of the most intensely studied topics within psychology and cognitive neuroscience....
, working memory
Working memory
Working memory has been defined as the system which actively holds information in the mind to do verbal and nonverbal tasks such as reasoning and comprehension, and to make it available for further information processing...
, and visual processing, it is loosely termed a "frontal lobe
Frontal lobe
The frontal lobe is an area in the brain of humans and other mammals, located at the front of each cerebral hemisphere and positioned anterior to the parietal lobe and superior and anterior to the temporal lobes...
" test on the basis that patients with any sort of frontal lobe lesion generally do poorly at the test. In particular, patients with lesions of the dorsolateral frontal lobe make a higher number of perseverative errors than control participants. A recent factor analysis
Factor analysis
Factor analysis is a statistical method used to describe variability among observed, correlated variables in terms of a potentially lower number of unobserved, uncorrelated variables called factors. In other words, it is possible, for example, that variations in three or four observed variables...
of the WCST has shown these perseverative errors to be the most useful outcome measure in assessing cases. A more sophisticated description of deficits of this type is "executive dysfunction
Executive dysfunction
Executive dysfunction , in psychology , is a disruption to the efficacy of the executive system. It can refer to both neurocognitive deficits and behavioural symptoms...
".
Use in research
The WCST has been used in neuroimagingNeuroimaging
Neuroimaging includes the use of various techniques to either directly or indirectly image the structure, function/pharmacology of the brain...
paradigms such as PET
Positron emission tomography
Positron emission tomography is nuclear medicine imaging technique that produces a three-dimensional image or picture of functional processes in the body. The system detects pairs of gamma rays emitted indirectly by a positron-emitting radionuclide , which is introduced into the body on a...
and fMRI. As predicted by the acquired brain injury
Acquired brain injury
An acquired brain injury is brain damage caused by events after birth, rather than as part of a genetic or congenital disorder such as fetal alcohol syndrome, perinatal illness or perinatal hypoxia. ABI can result in cognitive, physical, emotional, or behavioural impairments that lead to permanent...
literature, early PET studies have shown the task involves significant activation of the dorsolateral prefrontal cortex
Dorsolateral prefrontal cortex
The dorsolateral prefrontal cortex , according to a more restricted definition, is roughly equivalent to Brodmann areas 9 and 46. According to a broader definition DL-PFC consists of the lateral portions of Brodmann areas 9 – 12, of areas 45, 46, and the superior part of area 47. These regions...
. However, more recent fMRI studies have shown that the ventrolateral prefrontal cortex (Konishi et al., 1998, Nature Neuroscience) together with the caudate nucleus (Monchi et al., 2001, J. Neuroscience) may be the regions most important for the set-shifting process required in the WCST. These regions are also associated with working memory functions (Frank et al., 2001). The test's use in neurodegenerative diseases such as motor neurone disease
Motor neurone disease
The motor neurone diseases are a group of neurological disorders that selectively affect motor neurones, the cells that control voluntary muscle activity including speaking, walking, breathing, swallowing and general movement of the body. They are generally progressive in nature, and can cause...
has identified at least a subgroup of these patients for whom there is some subtle degree of cognitive dysfunction, in contrast to the traditional view that these were pure disorders of the motor system
Motor system
The motor system is the part of the central nervous system that is involved with movement. It consists of the pyramidal and extrapyramidal system....
.
The test is also widely used in research into schizophrenia
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
.
Legal ownership of trademark
The trademark "Wisconsin Card Sorting Test" was registered in 2000 with the United States Patent and Trademark OfficeUnited States Patent and Trademark Office
The United States Patent and Trademark Office is an agency in the United States Department of Commerce that issues patents to inventors and businesses for their inventions, and trademark registration for product and intellectual property identification.The USPTO is based in Alexandria, Virginia,...
(Reg. #2320931, Ser # 75-588988) by Wells Printing and Digital Services of Madison, Wisconsin
Madison, Wisconsin
Madison is the capital of the U.S. state of Wisconsin and the county seat of Dane County. It is also home to the University of Wisconsin–Madison....
. Although filed in 1998, the trademark application states the mark has been in use in commerce since at least 1970. The trademark covers "psychological testing materials, namely printed tests, printed cards, and printed instruction manuals in the field of psychological evaluation
Psychological evaluation
A psychological evaluation or mental examination is an examination into a person's mental health by a mental health professional such as a psychologist. A psychological evaluation may result in a diagnosis of a mental illness...
." This trademark does not cover the computer implementation of the test, distributed by Psychological Assessment Resources, Inc., sometimes referred to as simply WCST.
External links
- PEBL Psychological Test Battery - free computerized psychological tests