The Milwaukee Card Sorting Test

The Milwaukee Card Sorting Test (MCST) is a variation of the Wisconsin Card Sorting Test (WCST). This variation requires the patient to verbalize which principle is being used to make the sort. This simple change in procedure allows several new scores that fractionate executive function into separate, behaviorally distinct processes. Below is an example of three new scores made possible by the increased information afforded from the verbalization:

Preliminary factor analysis has found the Automatic Perseverative Response (APR) to be a more stable score than the traditional Perseverative Response score (PR). The APR loads most heavily on the first factor. The first factor has been interpreted in a geriatric rehabilitation population to represent difficulty "forming a mental set". The second factor is composed of primary loading from the Loss of Set (LS) score and represents a difficulty "maintaining mental set". The third factor is composed primarily of the Verbal Behavior Discord (VBD) score and represents difficulty "switching mental set". More information is avialable in a forthcoming article on the MCST in Archives of Clinical Neuropsychology or by sending an e-mail message to neuropsy@csd.uwm.edu.


A model of the cognitive process in performing the MCST is provided in the above mentioned article. Another article addresses the construct validity of the MCST by using traditional frontal lobe tasks as well as measures of crystallized, non-executive, intellectual ability; premorbid IQ estimate; and measures of postmorbid cognitive functioning to predict the various new scores as well as the traditional scores. We currently have over 300 rehabilitation patients examined and a cluster analysis of common MCST profiles is in the works.


If you are interested in obtaining instructions for administering the MCST then e-mail neuropsy@csd.uwm.edu. The MCST requires no additional testing materials beyond that used with the WCST. All administration and scoring procedures are provided in a brief manual.

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