A clinical comparison of two forms of the card sorting test

Switching between spatial stimulus-response mappings: a developmental study of cognitive flexibility

“…Although the steep decrease between ages 8-9 and 11-12 was observed for both the cued and the non-cued task, switch cues attenuated perseverative behaviour for the youngest age group. This latter result was unexpected, given that previous studies including prefrontal patients and elderly subjects showed that switch cues failed to attenuate perseverative behaviour (Nelson, 1976;Ridderinkhof et al, 2002;Van Gorp et al, 1997). The typical interpretation of these studies is that prefrontal patients and older subjects fail to switch responses while noticing the rule change.…”

“…Even though the explicit cues helped the patients to recognize that the previous categorization rule was no longer correct and that a new rule was to be introduced and applied (as inferred from exit interviews), the frontal patients perseverated longer than the other patient groups in no‐longer correct categorization rules. Thus, the perseverative behaviour in frontal‐lobe patients in the cued WCST appeared to be due to deficient set‐switching abilities as opposed to deficits in noticing a rule change (see also deZubicaray & Ashton, 1996; Nagahama, Sadato, Yamauchi, Katsumi, Hayashi, Fukuyama, Kimura, Shibasaki & Yonekura, 1998; Ridderinkhof, Span & Van der Molen, 2002; Van Gorp, Kalechstein, Moore, Hinkin, Mahler, Foti & Mendez, 1997). Other authors have used WCST versions to address errors specifically linked to deficits in the ability to apply rules, rather than the ability to identify a rule change (Greve, Williams, Haas, Littell & Reinoso, 1996).…”

Perseverative Behavior and Adaptive Control in Older Adults: Performance Monitoring, Rule Induction, and Set Shifting

“…Even though the explicit cues helped the patients to recognize that the previous categorization rule was no longer correct and that a new rule was to be induced and applied (as inferred from exit interviews), the frontal patients perseverated much longer than the other patient groups in no-longer-correct categorization rules. Nelson mentioned also (without further detail) that a pilot study had pointed out that the tendency to perseverate in frontal patients was not affected by the explicit rule-change instructions (this suggestion received support from a recent comparison between the cued and regular WCST; van Gorp et al, 1997). She compared her findings with the occasional observation of dissociations in frontal-lobe patients who can verbally demonstrate their full understanding of what they ought to be doing in the sorting test, but who nevertheless continue to perseverate with an incorrect categorization response, often much to their own frustration.…”

A meta-analytic review of the sensitivity of the Wisconsin Card Sorting Test to frontal and lateralized frontal brain damage.

“…This last feature of the test may be particularly helpful for patients with perseverative tendencies. Despite these differences, van Gorp et al (1997) determined that performance on these administrations is roughly equivalent in participants with either dementia or HIV-1 infection. Nonetheless, no study has directly compared these administration methods in patients with frontal impairment, and, in an extensive review of Nelson's revision, de Zubicaray and Ashton (1996) noted that the comparability of these measures had yet to be established.…”