Am J Psychiatry 1992; 149:1718-1722
Copyright © 1992 by American Psychiatric Association
Effect of instructional cues on schizophrenic patients' performance on the Wisconsin Card Sorting Test
RS Goldman, BN Axelrod and LM Tompkins
VA Medical Center, Ann Arbor, Mich. 48105.
OBJECTIVE: Schizophrenic patients are particularly deficient on measures of
executive functioning, notably the Wisconsin Card Sorting Test. This study
was conducted to determine the efficacy of a cuing strategy in facilitating
performance on this cognitive measure of the integrity of prefrontal brain
structures and functioning. METHOD: Twenty-four schizophrenic inpatients
and 24 demographically matched inpatients with mood disorders were
administered the Wisconsin Card Sorting Test either with instructional cues
at the beginning of the task or with the standard administration procedure.
RESULTS: There was a significant benefit of cues for the patients with
affective disorders as well as for the schizophrenic patients. The
schizophrenic subjects in the uncued condition maintained poor but stable
performance throughout the course of the task. CONCLUSIONS: The study
suggests that the deficit in executive functioning of schizophrenic
patients may lie in the formation of concepts, not in their application.
