Wisconsin Card Sorting Test: Factor structure and relationship to productivity and supervision needs following severe traumatic brain injury

Abstract

Primary objective: The Wisconsin Card Sorting Test (WCST) has been demonstrated to have a relatively stable factor structure in traumatic brain injury (TBI) samples. What is less clear is whether the scores derived from WCST factors are related to functional outcomes. The purpose of the current study was to replicate the WCST factor structure in a sample with severe TBI, and to evaluate the relationship between the factor scores and outcome.

Research design: Retrospective correlational study.

Methods and procedures: Participants (n = 143) who had suffered severe TBI were administered a battery of neuropsychological tests including the WCST within one month of admission to a brain injury rehabilitation program. In addition, participants were administered supervision (Supervision Rating Scale; SRS) and productivity measures (Community Integration Questionnaire- Productivity subscale; CIQ-P) at admission and following discharge.

Experimental intervention: None.

Main outcomes and results: For individuals who were more than one year post injury, more failure to maintain set errors were associated with better occupational outcomes, while more nonperseverative errors were associated with increased supervision needs.

Conclusions: The WCST factor scales are related to functional outcomes in severe TBI. Specifically, the inability to establish a series of correct responses is associated with poorer outcome.

• Neuropsychological test performance
• Wisconsin Card Sorting Test
• traumatic brain injury