Use of the WCST and the WCST-64 in the Assessment of Traumatic Brain Injury

Authors: Sherer M.; Nick T.G.; Millis S.R.; Novack T.A.

Source: Journal of Clinical and Experimental Neuropsychology (Neuropsychology, Developm, Volume 25, Number 4, June 2003 , pp. 512-520(9)

Publisher: Psychology Press, part of the Taylor & Francis Group

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Abstract:

The Wisconsin Card Sorting Test (WCST) has been found to be valid in characterizing cognitive dysfunction in a variety of neurological disorders including traumatic brain injury (TBI). However, the test has been criticized as being too lengthy and frustrating for severely impaired patients. As a result, shortened versions of the WCST have been proposed. The utility of one of these shortened versions, the Wisconsin Card Sorting Test-64 (WCST-64), was examined in 106 persons with TBI. Findings showed strong associations between scores derived from the two tests. WCST scores were predicted from WCST-64 scores with sufficient accuracy for research purposes with adjusted R -squared values ranging from .74 to .87. Using the standard cutpoint of < 40T to indicate impairment or normal performance for perseverative responses from each of the two tests, 91 (86%) of 106 subjects received the same classification showing substantial agreement (Kappa statistic 0.71; 95% CI 0.58–0.84). The WCST and the WCST-64 also performed comparably in predicting functional status at discharge from inpatient rehabilitation using the first score from a principal components analysis as a summary measure (both significant with p =.0002). These findings support the use of the WCST-64 in early evaluations of persons with moderate and severe TBI.

Document Type: Research article

DOI: http://dx.doi.org/10.1076/jcen.25.4.512.13877

Publication date: 2003-06-01