Austin Health

Title
Considerations for using the Wisconsin Card Sorting Test to assess cognitive flexibility.
Publication Date
2021-10
Author(s)
Miles, Stephanie
Howlett, Caitlin A
Berryman, Carolyn
Nedeljkovic, Maja
Moseley, G Lorimer
Phillipou, Andrea
Subject
Cognitive flexibility
Executive function
Neurocognitive assessment
Neurocognitive measures
Set-shifting
WCST
Type of document
Journal Article
OrcId
0000-0001-8190-894X
0000-0002-4584-8641
0000-0002-5316-0847
0000-0003-0963-0335
0000-0002-3750-4945
0000-0003-1009-6619
DOI
10.3758/s13428-021-01551-3
Abstract
The Wisconsin Card Sorting Test (WCST) is a popular neurocognitive task used to assess cognitive flexibility, and aspects of executive functioning more broadly, in research and clinical practice. Despite its widespread use and the development of an updated WCST manual in 1993, confusion remains in the literature about how to score the WCST, and importantly, how to interpret the outcome variables as indicators of cognitive flexibility. This critical review provides an overview of the changes in the WCST, how existing scoring methods of the task differ, the key terminology and how these relate to the assessment of cognitive flexibility, and issues with the use of the WCST across the literature. In particular, this review focuses on the confusion between the terms 'perseverative responses' and 'perseverative errors' and the inconsistent scoring of these variables. To our knowledge, this critical review is the first of its kind to focus on the inherent issues surrounding the WCST when used as an assessment of cognitive flexibility. We provide recommendations to overcome these and other issues when using the WCST in future research and clinical practice.
Link
Citation
Behavior Research Methods 2021; 53(5): 2083-2091
Jornal Title
Behavior Research Methods

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