Executive dysfunction in traumatic brain injury: The effects of injury severity and effort on the Wisconsin Card Sorting Test

This study examined the persistent effects of traumatic brain injury (TBI) on Wisconsin Card Sorting Test (WCST) performance. Since poor effort can contaminate results in populations with incentive to perform poorly, performance validity was explicitly assessed and controlled for using multiple well...

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Bibliographic Details
Published in:Journal of clinical and experimental neuropsychology 2010-02, Vol.32 (2), p.132-140
Main Authors: Ord, Jonathan S., Greve, Kevin W., Bianchini, Kevin J., Aguerrevere, Luis E.
Format: Article
Language:English
Subjects:
Adult
Adult and adolescent clinical studies
Aged
Biological and medical sciences
Brain Injuries - complications
Brain Injuries - physiopathology
Brain Injuries - psychology
Cognition Disorders - complications
Cognition Disorders - diagnosis
Cognition Disorders - physiopathology
Effort
Executive function
Executive Function - physiology
Female
Humans
Injuries of the nervous system and the skull. Diseases due to physical agents
Male
Malingering
Malingering - prevention & control
Medical sciences
Middle Aged
Neuropsychological Tests
Organic mental disorders. Neuropsychology
Outcome
Performance validity
Problem Solving - physiology
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Severity of Illness Index
Task Performance and Analysis
Traumas. Diseases due to physical agents
Traumatic brain injury
Wisconsin Card Sorting Test
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Description
Summary:This study examined the persistent effects of traumatic brain injury (TBI) on Wisconsin Card Sorting Test (WCST) performance. Since poor effort can contaminate results in populations with incentive to perform poorly, performance validity was explicitly assessed and controlled for using multiple well-validated cognitive malingering indicators. Participants were 109 patients with mild TBI and 67 patients with moderate-to-severe TBI seen for neuropsychological evaluation at least one year post injury. Patients with diffuse neurological impairment and healthy controls were included for comparison. Results suggested a dose-response effect of TBI severity on WCST performance in patients providing good effort; the mild TBI group did not differ from controls while increased levels of impairment were observed in the moderate-to-severe TBI group. Effort during testing had a larger impact on WCST performance than mild or moderate-to-severe TBI. Clinical implications of these findings are discussed.
ISSN:1380-3395
1744-411X
DOI:10.1080/13803390902858874