Performance on the Wisconsin Card Sorting Test after traumatic brain injury

The performance of 100 patients with traumatic brain injury (TBI) on the Wisconsin Card Sorting Test (WCST) was examined to determine the underlying latent structure as well as profile subtypes. Exploratory factor analysis with oblique rotation identified three factors: response accuracy, learning, and failure to maintain set. Marker variables from each factor were then included in a two-stage cluster analysis, which identified two reliable subtypes. Level of performance differences between these subtypes were meaningfully related to both demographic background and length of coma. It is concluded that interpretation of the WCST results of patients with TBI should consider the multifactorial nature of the instrument in combination with injury severity characteristics and demographic variables.