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Teaching the Wisconsin Card Sorting Test to Schizophrenic Patients

Michael Foster Green, PhD; Steven Ganzell, PhD; Paul Satz, PhD; Joseph F. Vaclav
Arch Gen Psychiatry. 1990;47(1):91-92. doi:10.1001/archpsyc.1990.01810130093016.
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To the Editor.—  We were impressed by the article of Goldberg et al1 that appeared in the November 1987 issue of the Archives, in which the authors tried to teach schizophrenic patients how to perform on the Wisconsin Card Sorting Test. Typically, schizophrenic patients do very poorly on this test of frontal lobe functioning, even when compared with their performance on other cognitive measures. The patients were able to perform adequately when the experimenter gave detailed trial-by-trial instructions. Essentially, the experimenter acted as the patient's frontal lobe by giving these instructions. Interestingly, the patients returned to their baseline level of performance when instructions were withdrawn.The Goldberg et al study seems to suggest that the schizophrenic patients are unable to learn the Wisconsin Card Sorting Test. One problem with the study is that the behavioral contingencies for learning to take place were not optimal: sufficient reinforcement for the maintenance

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