Wisconsin Card Sorting Test

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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.[1][2] 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.


Screenshot from the PEBL computerized version of the Wisconsin Card sort

A number of stimulus cards are presented to the participant. The participant is told to match the cards, but not how to match; however, he or she is told whether a particular match is right or wrong. 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. 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.

This image shows the four lobes of the human brain: the frontal lobe (red), the parietal lobe (orange), the temporal lobe (green), and the occipital lobe (yellow). Also shown are the insular cortex (purple), the brain stem (black), and the cerebellum (blue).
This image shows a midsagittal cross-section of a human brain. The portion in color is the left frontal lobe, destroyed in Phineas Gage's accident.

Clinical use[edit]

Since 1948, the test has been used by neuropsychologists, neurologists and psychiatrists in patients with acquired brain injury, neurodegenerative disease, or mental illness such as schizophrenia. It is one of several psychological tests which can be administered to patients to measure frontal lobe dysfunction. When administered, the WCST allows the clinician speculate to 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 from 6.5 years to 89 years of age. The WSCT, relies upon a number of cognitive functions including attention, working memory, and visual processing.

The WCST test may be used to help measure an individual's competence in abstract reasoning, and the ability to change problem-solving strategies when needed.[3] In this test, a number of cards are presented to the participants. The figures on the cards differ with respect to color, quantity, and shape.[4] However, according to recent studies,[which?] clinical research and recent brain imaging have brought into question the validity and specificity of this test as a marker of frontal dysfunction.[citation needed] Clinical studies with neurological patients have confirmed that, in its traditional form, the WCST fails to discriminate between frontal and non-frontal lesions.[5] In addition, functional brain imaging studies show rapid and widespread activation across frontal and non-frontal brain regions during WCST performance. These studies suggest that the concept of an anatomically pure test of prefrontal function is not only empirically unattainable, but also theoretically inaccurate.[citation needed] The aim of the present review[which?] is to examine the causes of these criticisms and to resolve them by incorporating new methodological and conceptual advances in order to improve the construct validity of WCST scores and their relationship to prefrontal executive functions. These objectives can be achieved by drawing on theory-guided experimental design, and on precise spatial and temporal sampling of brain activity, and then exemplify this using an integrative model of prefrontal function [i.e., Miller, E. K. (2000)][5][6][7][8]

Psychological tests such as the WCST, administered alone, cannot be used to measure the effects of a frontal lobe injury, or the aspects of cognitive function it may affect, such as working memory; a variety of tests must be used.[citation needed] A subject may be good at one task but show dysfunction in executive function overall. Similarly, test results can be made misleading after testing the same individual over a long period of time. The subject may get better at a task, but not because of an improvement in executive cognitive function. He/she may have simply learned some strategies for doing this particular task that made it no longer a good measurement tool.[9]

Legal ownership of trademark[edit]

The trademark "Wisconsin Card Sorting Test" was registered in 2000 with the United States Patent and Trademark Office (Reg. #2320931, Ser # 75-588988) by Wells Print 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.


  1. ^ Monchi, O., Petrides, M. Petre, V., Worsley, K., & Dagher, A. (2001). Wisconsin card sorting revisited: Distinct neural circuits participating in different stages of the task identified by event-related functional magnetic resonance imaging. The Journal of Neuroscience, 21(19), 7733-7741.
  2. ^ E. A. Berg. (1948). A simple objective technique for measuring flexibility in thinking J. Gen. Psychol. 39: 15-22.
  3. ^ Biederam J, Faraone S, Monutaeux M, et al. (2000). "Neuropsychological functioning in nonreferred siblings of children with attention deficit/hyperactivity disorder". Journal of Abnormal Psychology 109 (2): 252–65. doi:10.1037/0021-843X.109.2.252. 
  4. ^ US National Library of Medicine National Institutes of Health, 2009
  5. ^ a b Brain Cogn. 2009 Dec;71(3):437-51. doi: 10.1016/j.bandc.2009.03.005. Epub 2009 Apr 17.Department of Psychology, University of Colorado at Boulder, CO, USA.
  6. ^ The prefrontal cortex and cognitive control Nature Reviews Neuroscience, 1, 59-65.]
  7. ^ combined with the formal information theoretical approach to cognitive control [Koechlin, E., & Summerfield, C. (2007).
  8. ^ An information theoretical approach to prefrontal executive function. Trends in Cognitive Sciences, 11, 229-235.].
  9. ^ Kane, M.J. & Engle, R.W. (2002). "The role of prefontal cortex in working-memory capacity,executive attention, and general fluid intelligence: An individual-differences perspective." Psychonomic Bulletin & Review 9(4), 637-671. Retrieved from http://psychology.gatech.edu/renglelab/Publications/2002/The%20role%20of%20prefrontal%20cortex%20in%20working-memory%20capacity.pdf

Further reading[edit]