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A Method for Investigating Age-related Differences in the Functional Connectivity of Cognitive Control Networks Associated with Dimensional Change Card Sort Performance

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Intact Wisconsin Card Sorting Test performance: implications for the role of executive function in schizophrenia.

Bonnie-Jean Thurston-Snoha¹, Richard R J Lewine

¹University of Louisville, KY 40292, USA. b0thur01@gwise.louisville.edu

The British Journal of Clinical Psychology

|May 31, 2007

Summary

Schizophrenia patients with intact executive function on the Wisconsin Card Sorting Test (WCST) showed fewer negative symptoms. However, these differences in executive function and symptoms were ultimately linked to full-scale IQ.

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Area of Science:

Neuroscience
Psychiatry
Cognitive Psychology

Background:

Schizophrenia is often associated with executive function deficits.
The Wisconsin Card Sorting Test (WCST) is a common measure of executive function.
Some individuals with schizophrenia demonstrate intact performance on the WCST.

Purpose of the Study:

To investigate the characteristics of schizophrenia patients with intact WCST performance.
To compare clinical and socio-demographic variables between schizophrenia patients with intact and impaired WCST performance.
To identify factors differentiating schizophrenia patients with varying executive function on the WCST.

Main Methods:

Classified WCST performance into 'intact' (<15% perseverative errors) and 'impaired' (≥15%).
Compared clinical and socio-demographic data between 61 patients with intact performance and 107 patients with impaired performance.
Utilized binary logistic regression to analyze group differences.

Main Results:

Patients with intact WCST performance had significantly lower negative symptoms (Scale for the Assessment of Negative Symptoms - SANS) and Hamilton Depression Rating Scale (HDRS) scores.
Global Assessment of Functioning Scale (GAF) and positive symptom scores (Scale for the Assessment of Positive Symptoms - SAPS) approached significance.
Differences in WCST performance and symptom scores were attributable to full-scale IQ.

Conclusions:

Intact WCST performance in schizophrenia is associated with fewer negative symptoms and lower HDRS scores.
Full-scale IQ is the primary factor explaining the differences in WCST performance and associated symptoms.
This highlights the significant role of general cognitive ability in executive function and symptom presentation in schizophrenia.