Hostname: page-component-76fb5796d-2lccl Total loading time: 0 Render date: 2024-04-30T00:54:39.240Z Has data issue: false hasContentIssue false

Validity of the Dynamic Wisconsin Card Sorting Test for Assessing Learning Potential in Brain Injury Rehabilitation

Published online by Cambridge University Press:  10 November 2014

Hileen Boosman
Affiliation:
Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
Johanna M.A. Visser-Meily
Affiliation:
Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
Tamara Ownsworth
Affiliation:
School of Applied Psychology and Griffith Health Institute, Griffith University, Australia
Ieke Winkens
Affiliation:
Maastricht University, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht, the Netherlands
Caroline M. Van Heugten*
Affiliation:
Maastricht University, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht, the Netherlands Maastricht University, Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht, the Netherlands
*
Correspondence and reprint requests to: C. M. van Heugten, Maastricht University, School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, P.O. Box 616, 6200 MD Maastricht, The Netherlands. E-mail: c.vanheugten@maastrichtuniversity.nl

Abstract

The dynamic Wisconsin Card Sorting Test (dWCST) examines the effects of brief training on test performance where pre- to post-test change reflects learning potential. The objective was to examine the validity of the dWCST as a measure of learning potential in patients with acquired brain injury (ABI). A total of 104 patients with ABI completed the dWCST at rehabilitation admission. Performance of a subgroup (n=63) was compared to patients (n=28) who completed a repeated administration of the conventional WCST (rWCST). Furthermore, dWCST performance was compared between patients with ABI (n=63) and healthy controls (n=30) matched on gender, age, and education. Three learning potential indices were used: post-test score, gain score, and a group classification (decliners, poor learners, strong learners, high achievers). The median dWCST administration time was 30 min. The dWCST showed no floor or ceiling effects and the post-test and gain score were significantly intercorrelated. The pre-test score showed no significant associations with other neuropsychological tests. The learning potential indices were significantly associated with language and/or memory. In contrast to the dWCST group, the rWCST group showed no significant pre- to post-test improvement. There were significantly more poor learners in the rWCST group. Compared to controls, patients obtained similar gains, but significantly lower pre- and post-test scores for the dWCST. The ratio of poor learners between-groups was not significantly different. The results support the validity of the dWCST for assessing learning potential in patients with ABI. Further research is needed to investigate the predictive validity of the dWCST. (JINS, 2014, 20, 1–11)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bisoglio, J., Mervis, J., & Choi, J. (2014). Meta-analysis of “learning potential” on the dynamic Wisconsin Card Sorting Test (D-WCST): Distinct cognitive subgroups with divergent functional outcomes. Abstracts of the 4th Biennial Schizophrenia International Research Conference. Schizophrenia Research, 153, S156.Google Scholar
Boosman, H., Visser-Meily, J. M. A., Winkens, I., & van Heugten, C. M. (2013). Clinicians’ views on learning in brain injury rehabilitation. Brain Injury, 27, 685688. doi: 10.3109/02699052.2013.775504 Google Scholar
Caffrey, E., Fuchs, D., & Fuchs, L. S. (2008). The predictive validity of dynamic assessment. A review. The Journal of Special Education, 41, 254270. doi: 10.1177/0022466907310366 Google Scholar
Calero, M. D., & Navarro, E. (2004). Relationship between plasticity, mild cognitive impairment and cognitive decline. Archives of Clinical Neuropsychology, 19, 653660. doi: 10.1016/j.acn.2003.08.008 Google Scholar
Cohen, J. W. (1983). Statistical power analysis for the behavioral sciences, second edition. Hillsdale, NJ: Lawrence Erlbaum Associates.Google Scholar
Deelman, B. G., Koning-Haanstra, M., Liebrand, W. G. B., & van de Burg, W. (1987). Handleiding van de SAN test. Lisse: Swets en Zeitlinger.Google Scholar
Devilly, G. J. (2005). ClinTools Software for Windows (Version 3.5) [Computer program]. Melbourne, Australia: Psytek Ltd.Google Scholar
Fernández-Ballesteros, R., Botella, J., Zamarrón, M. D., Molina, M. A., Cabras, E., Schettini, R., & Tárraga, L. (2012). Cognitive plasticity in normal and pathological aging. Clinical Interventions in Aging, 7, 1525. doi: 10.2147/CIA.S27008 CrossRefGoogle ScholarPubMed
Fiszdon, J. M., & Johannesen, J. K. (2010). Comparison of computational methods for the evaluation of learning potential in schizophrenia. Journal of the International Neuropsychological Society, 16, 613620. doi: 10.1017/S1355617710000317 Google Scholar
Grigorenko, E. L., & Sternberg, R. J. (1998). Dynamic testing. Psychological Bulletin, 124, 75111.CrossRefGoogle Scholar
Grigorenko, E. L. (2009). Dynamic assessment and response to intervention: two sides of one coin. Journal of Learning Disabilities, 42, 111132. doi: 10.1177/0022219408326207 CrossRefGoogle ScholarPubMed
Heaton, R. K. (1981). Wisconsin Card Sorting Test (WCST). Odessa, FL: Psychological Assessment Resources.Google Scholar
Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 1219. doi: 10.1037/0022-006X.59.1.12 Google Scholar
Jurado, M. B., & Rosselli, M. (2007). The elusive nature of executive functions: A review of our current understanding. Neuropsychology Review, 17, 213233. doi: 10.1007/s11065-007-9040-z Google Scholar
Kaplan, E., Goodglass, H., & Weintraub, S. (1983). Boston naming test. Philadelphia: Lea & Febiger.Google Scholar
Kongs, S. K., Thompson, L. L., Iverson, G. L., & Heaton, R. K. (2000). Wisconsin Card Sorting Test – 64 card version professional manual. Lutz, FL: Psychological Assessment Resources.Google Scholar
Kurtz, M. M., & Wexler, B. E. (2006). Differences in performance and learning proficiency on the Wisconsin Card Sorting Test in schizophrenia: Do they reflect distinct neurocognitive subtypes with distinct functional profiles? Schizophrenia Research, 81, 167171. doi: 10.1016/j.schres.2005.09.003 Google Scholar
Kurtz, M. M., Jeffrey, S. B., & Rose, J. (2010). Elementary neurocognitive function, learning potential and everyday life skills in schizophrenia: What is their relationship? Schizophrenia Research, 116, 280288. doi: 10.1016/j.schres.2009.08.011 Google Scholar
Lezak, M., Howieson, D., & Loring, D. (2004). Neuropsychological assessment. 4th ed. New York: Oxford University Press.Google Scholar
Merrick, E. E., Donders, J., & Wiersum, M. (2003). Validity of the WCST-64 after traumatic brain injury. The Clinical Neuropsychologist, 17, 153158. doi: 10.1076/clin.17.2.153.16521 CrossRefGoogle ScholarPubMed
Nasreddine, Z. S., Phillips, N. A., Bedirian, V., Charbonneau, S., Whitehead, V., Collin, I., … Chertkow, H. (2005). The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53, 695699. doi:10.1111/j.1532 Google Scholar
Nelson, H. E. (1982). The National Adult Reading Test (NART): Test manual. Windsor: NFER-Nelson.Google Scholar
Nederlands Instituut van Psychologen sectie Revalidatie en sectie Neuropsychologie (2010). Richtlijn voor kort NPO bij patiënten met een beroerte. Augustus 2010.Google Scholar
Ohrmann, P., Kugel, H., Bauer, J., Siegmund, A., Kölkebeck, K., Suslow, T., … Pedersen, A. (2008). Learning potential on the WCST in schizophrenia is related to the neuronal integrity of the anterior cingulated cortex as measured by proton magnetic resonance spectroscopy. Schizophrenia Research, 106, 156163. doi: 10.1016/j.schres.2008.08.005 Google Scholar
Reitan, R. (1956). Trail Making Test: Manual for administration, scoring and interpretation. Bloomington, IN: Indiana University.Google Scholar
Rempfer, M., Hamera, E., Brown, C., & Bothwell, R. J. (2006). Learning proficiency on the Wisconsin Card Sorting Test in people with serious mental illness: What are the cognitive characteristics of good learners? Schizophrenia Research, 87, 316322. doi: 10.1016/j.schres.2006.05.012 Google Scholar
Rempfer, M., Brown, C., & Hamera, E. (2011). Learning potential as a predictor of skill acquisition in people with serious mental illness. Psychiatry Research, 185, 293295. doi: 10.1016/j.psychres.2009.12.009 Google Scholar
Rey, A. (1958). L’Examen Clinique en Psychologie. Paris, France: Press Universitaire de France.Google Scholar
Schmand, B., Groenink, S. C., & Van den Dungen, M. (2008). Letter fluency: psychometrische eigenschappen en Nederlandse normen. Tijdschrift voor Gerontology en Geriatrie, 39, 6476.Google Scholar
Schmand, B., Lindeboom, J., & Van Harskamp, F. (1992). Nederlandse Leestest voor volwassenen. Lisse: Swets & Zeitlinger.Google Scholar
Sergi, M. J., Kern, R. S., Mintz, J., & Green, M. F. (2005). Learning potential and the prediction of work skill acquisition in schizophrenia. Schizophrenia Bulletin, 31, 6772. doi: 10.1093/schbul/sbi007 Google Scholar
Sherer, M., Nick, T. G., Millis, S. R., & Novack, T. A. (2003). Use of the WCST and the WCST-64 in the assessment of traumatic brain injury. Journal of Clinical and Experimental Neuropsychology, 25, 512520. doi: 10.1076/jcen.25.4.512.13877 Google Scholar
Terwee, C. B., Bot, S. D. M., De Boer, M. R., Van der Windt, D. A. W. M., Knol, D. L., Dekker, , … De Vet, H. C. W. (2007). Quality criteria were proposed for measurement properties of health status questionnaires. Journal of Clinical Epidemiology, 60, 3442.Google Scholar
Uprichard, S., Kupshik, G., Pine, K., & Fletcher, B. C. (2009). Dynamic assessment of learning ability improves outcome prediction following acquired brain injury. Brain Injury, 23, 278290.Google Scholar
Van der Elst, W., Van Boxtel, M. P., Van Breukelen, G. J., & Jolles, J. (2006). Normative data for the animal, profession and letter M naming verbal fluency tests for Dutch speaking participants and the effects of age, education, and sex. Journal of the International Neuropsychological Society, 12, 8089. doi: 10.1017/S1355617706060115 Google Scholar
Vaskinn, A., Sundet, K., Friis, S., Ueland, R., Simonsen, C., Birkenaes, A. B., … Andreassen, O. A. (2009). Using the Wisconsin Card Sorting Test to assess learning potential in normal IQ schizophrenia: Does it have potential? Nordic Journal of Psychiatry, 63, 405411. doi: 10.1080/08039480902879941 Google Scholar
Wade, D. T. (2005). Describing rehabilitation interventions. Clinical Rehabilitation, 19, 811818. doi: 10.1191/0269215505cr923ed Google Scholar
Waldorf, M., Wiedl, K. H., & Schöttke, H. (2009). The concordance of three reliable change indexes: An analysis applying the dynamic Wisconsin Card Sorting Test. Journal of Cognitive Education and Psychology, 8, 6380. doi: 10.1891/1945-8959.8.1.63 CrossRefGoogle Scholar
Watzke, S., Brieger, P., Kuss, O., Schöttke, H., & Wiedl, K. H. (2008). A longitudinal study of learning potential and rehabilitation outcome in schizophrenia. Psychiatric Services, 59, 248255. doi: 10.1176/appi.ps.59.3.248 Google Scholar
Watzke, S., Brieger, P., & Wiedl, K. H. (2009). Prediction of vocational rehabilitation outcome in schizophrenia: Incremental prognostic validity of learning potential beyond basic cognitive performance. Journal of Cognitive Education and Psychology, 8, 5262. doi: 10.1891/1945-8959.8.1.52 Google Scholar
Weingartz, S., Wiedl, K. H., & Watzke, S. (2008). Dynamic assessment of executive functioning: (How) can we measure change? Journal of Cognitive Education and Psychology, 7, 368387. doi: 10.1891/194589508787724088 Google Scholar
Wiedl, K. H., & Wienöbst, J. (1999). Interindividual differences in cognitive remediation research with schizophrenic patients – indicators of rehabilitation potential? International Journal of Rehabilitation Research, 22, 5559. doi: 10.1097/00004356-199903000-00007 Google Scholar
Wiedl, K. H., Wienöbst, J., Schöttke, H. H., Green, M. F., & Nuechterlein, K. H. (2001). Attentional characteristics of schizophrenia patients differing in learning proficiency on the Wisconsin Card Sorting Test. Schizophrenia Bulletin, 27, 687696.Google Scholar
Wiedl, K. H., Schöttke, H., Green, M. F., & Nuechterlein, K. H. (2004). Dynamic testing in schizophrenia. Does training change the construct validity of a test? Schizophrenia Bulletin, 30, 703711.CrossRefGoogle ScholarPubMed
Wilson, B., Cockburn, J., & Halligan, P. (1987). Development of a behavioural test of visuo-spatial neglect. Archives of Physical Medicine and Rehabilitation, 68, 98102.Google Scholar