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Impaired Wisconsin Card Sort Performance in Schizophrenia May Reflect Motivational Deficits

Ann T. Summerfelt; Larry D. Alphs, MD, PhD; Frank R. Funderburk, PhD; Milton E. Strauss, PhD; Althea M.I. Wagman, PhD
Arch Gen Psychiatry. 1991;48(3):282-283. doi:10.1001/archpsyc.1991.01810270094019.
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To the Editor.—  During the past several years important reports have appeared in the Archives1-3 concerning relationships between regional cerebral blood flow and impaired Wisconsin Card Sort (WCS) performance in schizophrenia. One provocative finding has been that impairment on this task is not corrected by instruction.4 The WCS task requires the respondent to match cards that vary simultaneously in a number of dimensions (color, form, and number of elements) to one of four models. The subject is told whether each placement is correct or incorrect and must discover the correct sorting rule from this feedback. The first rule is to sort by color. When this rule has been learned, the correct dimension is changed, first to form and then to number. The subject is not informed of this change; rather, he or she must discover the new rule.5Although many different scores can be derived from the


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