Insight, Neurocognition, and Schizophrenia: Predictive Value of the Wisconsin Card Sorting Test

Lack of insight in schizophrenia is a key feature of the illness and is associated with both positive and negative clinical outcomes. Previous research supports that neurocognitive dysfunction is related to lack of insight, but studies have not examined how neurocognition relates to change in insight over time. Therefore, the current study sought to understand how performance on the Wisconsin Card Sorting Test (WCST) differed between participants with varying degrees of change in insight over a 6-month period. Fifty-two patients with schizophrenia or schizoaffective disorder were administered the WCST and Positive and Negative Syndrome Scale (PANSS) at baseline, and the PANSS was again administered at a 6-month follow-up assessment. Results indicated that while neurocognition was related to insight at baseline, it was not related to subsequent change in insight. The implications of findings for conceptualization and assessment of insight are discussed.

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Do schizotypy dimensions reflect the symptoms of schizophrenia?

Australian & New Zealand Journal of Psychiatry ◽

10.1177/0004867418769746 ◽

2018 ◽

Vol 53 (3) ◽

pp. 236-247 ◽

Cited By ~ 5

Author(s):

Elizabeth HX Thomas ◽

Susan L Rossell ◽

Eric J Tan ◽

Erica Neill ◽

Tamsyn E Van Rheenen ◽

...

Keyword(s):

Empirical Evidence ◽

Clinical Manifestations ◽

Continuum Theory ◽

Wisconsin Card Sorting Test ◽

Cognitive Testing ◽

Card Sorting ◽

Symptom Dimensions ◽

Syndrome Scale ◽

Sorting Test ◽

Negative Syndrome

Objective: The personality characteristics and symptoms observed in schizophrenia are postulated to lie on a continuum, with non-clinical manifestations referred to as schizotypy. High schizotypy behaviours are argued to correspond with the three main clusters of symptoms in schizophrenia: positive, negative and cognitive/disorganised symptoms, yet there is limited empirical evidence to support this. This study aimed to investigate whether schizotypy dimensions significantly correlate with their respective schizophrenia symptomatology in the largest sample to date. Methods: A total of 361 adults (103 patients with schizophrenia/schizoaffective disorder and 258 healthy controls) were assessed for schizotypy using the Oxford-Liverpool Inventory of Feelings and Experiences. The MATRICS Consensus Cognitive Battery supplemented by the Stroop task and Wisconsin Card Sorting Test was administered to all participants to obtain objective measurements of cognition. Schizophrenia symptomatology was assessed using the Positive and Negative Syndrome Scale in patients only. Results: The results demonstrated significant correlations between the Oxford-Liverpool Inventory of Feelings and Experiences positive and negative subscales and their respective Positive and Negative Syndrome Scale subscales only, indicating that positive and negative schizotypy dimensions across patients and controls accurately reflect the respective schizophrenia symptomatology observed in patients. Cognitive performance did not correlate with cognitive/disorganised symptom dimensions of the Oxford-Liverpool Inventory of Feelings and Experiences or the Positive and Negative Syndrome Scale, indicating that cognitive impairment is an independent symptom dimension that requires objective cognitive testing. Conclusion: Collectively, the findings provide empirical evidence for the continuum theory and support the use of schizotypy as a model for investigating schizophrenia.

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Wisconsin card sorting test performance over time in schizophrenia

Schizophrenia Research ◽

10.1016/0920-9964(91)90081-2 ◽

1991 ◽

Vol 5 (3) ◽

pp. 233-242 ◽

Cited By ~ 16

Author(s):

Larry J. Seidman ◽

John R. Pepple ◽

Stephen V. Faraone ◽

William S. Kremen ◽

Geraldine Cassens ◽

...

Keyword(s):

Test Performance ◽

Wisconsin Card Sorting Test ◽

Card Sorting ◽

Wisconsin Card Sorting ◽

Sorting Test ◽

Over Time

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Misattribution bias of threat-related facial expressions is related to a longer duration of illness and poor executive function in schizophrenia and schizoaffective disorder

European Psychiatry ◽

10.1016/j.eurpsy.2007.10.004 ◽

2008 ◽

Vol 23 (1) ◽

pp. 14-19 ◽

Cited By ~ 49

Author(s):

Preethi Premkumar ◽

Michael A. Cooke ◽

Dominic Fannon ◽

Emmanuelle Peters ◽

Tanja M. Michel ◽

...

Keyword(s):

Schizoaffective Disorder ◽

Wisconsin Card Sorting Test ◽

Card Sorting ◽

Facial Emotions ◽

Duration Of Illness ◽

Syndrome Scale ◽

Emotion Attribution ◽

Perseverative Errors ◽

Sorting Test ◽

Negative Syndrome

AbstractBackgroundWhile it is known that patients with schizophrenia recognize facial emotions, specifically negative emotions, less accurately, little is known about how they misattribute these emotions to other emotions and whether such misattribution biases are associated with symptoms, course of the disorder, or certain cognitive functions.MethodOutpatients with schizophrenia or schizoaffective disorder (n = 73) and healthy controls (n = 30) performed a computerised Facial Emotion Attribution Test and Wisconsin Card Sorting Test (WCST). Patients were also rated on the Positive and Negative Syndrome Scale (PANSS).ResultsPatients were poor at recognizing fearful and angry emotions and attributed fear to angry and angry to neutral expressions. Fear-as-anger misattributions were predicted independently by a longer duration of illness and WCST perseverative errors.ConclusionThe findings show a bias towards misattributing fearful and angry facial emotions. The propensity for fear-as-anger misattribution biases increases as the length of time that the disorder is experienced increases and a more rigid style of information processing is used. This, at least in part, may be perpetuated by subtle fearfulness expressed by others while interacting with people with schizophrenia.

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The relationship between cognitive function and clinical and functional outcomes in major depressive disorder

Psychological Medicine ◽

10.1017/s0033291708003620 ◽

2008 ◽

Vol 39 (3) ◽

pp. 393-402 ◽

Cited By ~ 54

Author(s):

A. Withall ◽

L. M. Harris ◽

S. R. Cumming

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Rating Scale ◽

Wisconsin Card Sorting Test ◽

Card Sorting ◽

Major Depressive ◽

Perseverative Errors ◽

Wisconsin Card Sorting ◽

Sorting Test

BackgroundAlthough cognitive variables have been shown to be useful in predicting outcomes in late-life depression, there has not yet been a comprehensive study in younger persons with depression.MethodThe clinical symptoms and cognitive performance of participants were evaluated at admission to one of two university teaching hospitals and again at 3 months after remission and discharge. A total of 52 participants with a DSM-IV diagnosis of major depressive disorder, aged between 20 and 60 years and with a Hamilton Depression Rating Scale score ⩾17 entered the study. The sample for this paper comprises the 48 subjects (mean age 37.9 years, s.d.=10.7) who received admission and follow-up assessments; an attrition rate of 7.7%.ResultsMore perseverative errors on the shortened Wisconsin Card Sorting Test at admission predicted a worse clinical outcome at follow-up. Poor event-based prospective memory and more perseverative errors on the shortened Wisconsin Card Sorting Test at admission predicted worse social and occupational outcome at follow-up.ConclusionsThese results suggest that a brief cognitive screen at hospital admission, focusing on executive function, would have a useful prognostic value in depression. Determining early predictors of individuals at risk of poorer outcomes is important for identifying those who may need altered or additional treatment approaches.

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The Role of Shifting, Inhibition and Working Memory in Older Adults' Performance in the Wisconsin Card Sorting Test

PsycEXTRA Dataset ◽

10.1037/e512682013-588 ◽

2007 ◽

Author(s):

Nadia Gamboz ◽

Erika Borella ◽

Maria Antonella Brandimonte

Keyword(s):

Older Adults ◽

Working Memory ◽

Wisconsin Card Sorting Test ◽

Card Sorting ◽

Wisconsin Card Sorting ◽

Sorting Test

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Dopaminergic Genes Polymorphisms and Prefrontal Cortex Efficiency Among Obese People - Whether Gender is a Differentiating Factor?

Current Molecular Medicine ◽

10.2174/1566524019666190424143653 ◽

2019 ◽

Vol 19 (6) ◽

pp. 405-418

Author(s):

Maciej Bieliński ◽

Natalia Lesiewska ◽

Roman Junik ◽

Anna Kamińska ◽

Andrzej Tretyn ◽

...

Keyword(s):

Prefrontal Cortex ◽

Executive Functions ◽

Tandem Repeats ◽

Wisconsin Card Sorting Test ◽

Variable Number ◽

Card Sorting ◽

Obese People ◽

Perseverative Errors ◽

Wisconsin Card Sorting ◽

Sorting Test

Background:Obesity is a chronic condition associated with poorer cognitive functioning. Wisconsin Card Sorting Test (WCST) is a useful tool for evaluating executive functions. In this study, we assessed the association between dopaminergic gene polymorphisms: DAT1 (SLC6A3), COMTVal158Met, DRD4 (48-bp variable number of tandem repeats - VNTR) and WCST parameters to investigate the functions of the frontal lobes in obese individuals.Objective:To find the significant correlations between polymorphisms of DAT1, COMTVal158Met, DRD4 and executive functions in obese subjects.Methods:The analysis of the frequency of individual alleles was performed in 248 obese patients (179 women, 69 men). Evaluation of the prefrontal cortex function (operating memory and executive functions) was measured with the Wisconsin Card Sorting Test (WCST). Separate analyzes were performed in age subgroups to determine different activities and regulation of genes in younger and older participants.Results:Scores of WCST parameters were different in the subgroups of women and men and in the age subgroups. Regarding the COMT gene, patients with A/A and G/A polymorphisms showed significantly better WCST results in WCST_P, WCST_CC and WCST_1st. Regarding DAT1 men with L/L and L/S made less non-perseverative errors, which was statistically significant. In DRD4, significantly better WCST_1st results were found only in older women with S allele.Conclusion:Obtained results indicate the involvement of dopaminergic transmission in the regulation of prefrontal cortex function. Data analysis indicates that prefrontal cortex function may ensue, from different elements such as genetic factors, metabolic aspects of obesity, and hormonal activity (estrogen).

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