The Cleveland Sorting Test: a preliminary study of an alternate form of the Wisconsin Card-Sorting Test

During the past two decades, studies have repeatedly shown that the Wisconsin Card-Sorting Test (WCST) is not as sensitive to prefrontal-lobe functioning as was originally suspected. Specifically, both clinical and brain-imaging studies have shown that several distinct neural circuits contribute to one's ability to successfully complete different aspects of the test. Another limitation of the WCST is its length, which makes it difficult and frustrating for certain clinical populations. To address the above limitations, researchers have proposed the development of new indexes and the integration of an adaptive testing approach that will allow for the premature termination of the test. Unfortunately, given the proprietary nature of the WCST, none of the above recommendations have been adopted. The present preliminary study examined an alternate form of the 64-Item WCST (WCST-64), the Cleveland Sorting Test (CST-64). The normative data of the two measures as well as the total number of errors, perseverative responses, perseverative errors, and categories completed were compared using a repeated-measures design. Overall, the study supports psychometric approximation of the CST-64 and the WCST-64. Suggestions for future studies and modifications of the CST-64, including the use of recently proposed indexes and adaptive administration approaches, are provided.