Wisconsin Card Sorting Test
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, in 1948. The Professional Manual for the WCST was written by Robert K. Heaton, Gordon J. Chelune, Jack L. Talley, Gary G. Kay, and Glenn Curtis.
Initially, 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. 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 and could lead to possible clinician error in scoring and interpreting the results. 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.
Clinically, the test is widely used by neuropsychologists, clinical psychologists, neurologists and psychiatrists in patients with acquired brain injury, stroke, or neurodegenerative disease. It has been considered a measure of executive function because of its reported sensitivity to frontal lobe dysfunction. The WCST allows the clinician to 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.
A Critical Update of the Wisconsin Card Sorting Test: For over four decades the Wisconsin Card Sorting Test (WCST) has been used to test prefrontal function. Clinical research and recent brain imaging have brought into question the validity and specificity of this test as a marker of frontal dysfunction. Clinical studies with neurological patients have confirmed that, in its traditional form, the WCST fails to discriminate between frontal and non-frontal lesions. 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. The aim of the present review 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). The prefrontal cortex and cognitive control. Nature Reviews Neuroscience, 1, 59-65.] combined with the formal information theoretical approach to cognitive control [Koechlin, E., & Summerfield, C. (2007). An information theoretical approach to prefrontal executive function. Trends in Cognitive Sciences, 11, 229-235.].
Legal ownership of trademark
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.
- Monchi, O., Petrides, M. Petre, V., Worsley, K., & Dagher, A. (2001). Recent clinical studies suggest that the concept of an anatomically pure test of prefrontal function is not only empirically unattainable, but also theoretically inaccurate. 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.
- E. A. Berg. (1948). A simple objective technique for measuring flexibility in thinking J. Gen. Psychol. 39: 15-22.
- Psychological Assessment Resources. Computerised Wisconsin Card Sort Task Version 4 (WCST). Psychological Assessment Resources; 2003.
- US National Library of Medicine National Institutes of Health, 2009
- 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.
- Strauss, Esther; Sherman, Elizabeth M.; Spreen, Otfried (2006). A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary. Oxford: Oxford University Press. ISBN 978-0-19-515957-8. Retrieved 14 July 2013.