On the historical and conceptual background of the Wisconsin Card Sorting Test

Eling, P.A.T.M.; Derckx, K.; Maes, J.H.R.

2008, Article / Letter to editor (Brain and Cognition, 67, 3, (2008), pp. 247-253)
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Brain and Cognition 67 (2008) 247–253

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On the historical and conceptual background of the Wisconsin

Card Sorting Test
Paul Eling *, Kristianne Derckx, Roald Maes
Radboud University Nijmegen, Nici, Biological Psychology, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands

Accepted 24 January 2008

Available online 6 March 2008

Abstract

In this paper, we describe the development of the Wisconsin Card Sorting Test (WCST). We trace the history of sorting tasks from the
studies of Narziss Ach on the psychology of thinking, via the work of Kurt Goldstein and Adhémar Gelb on brain lesioned patients
around 1920 and subsequent developments, up to the actual design of the WCST by Harry Harlow, David Grant, and their student
Esther Berg. The WCST thus seems to originate from the psychology of thinking (‘Denkpsychologie’), but the test, as it is used in clinical
neuropsychological practice, was designed by experimenters working within the behaviorist tradition. We also note recent developments
suggesting that, contrary to the general impression, implicit learning may play a role in WCST-like discrimination learning tasks.
Ó 2008 Elsevier Inc. All rights reserved.

Keywords: Wisconsin Card Sorting Test; Narziss Ach; Thinking; Concept formation; Goldstein; Abstract attitude; Discrimination learning; Executive
functions; Frontal lobes

1. Introduction to measure the capacity to deduce concepts and to apply

a strategy to adapt behavior to changing conditions. Over
The concept of executive functions has become very the years several variants of the WCST have been devel-
popular over the last two decades in clinical (neurological oped. In the original version of Berg (1948), switching of
and psychiatric patients) and fundamental (neuroimaging) the relevant concept (generally referred to as shifting)
studies on the (pre-)frontal cortex (e.g., Stuss & Knight, occurred without a warning by the examiner, whereas this
2002). These executive functions are assumed to serve as shifting was explicitly announced in the version of Nelson
cognitive control processes, in particular for planning and (1976). Heaton, Curtiss, and Tuttle (1993) have introduced
organizing behavior. Luria (1966) argued that planning a computerized version of the test. A test frequently used in
and organization of behavior occur in the prefrontal cor- research is the set-shifting subtest of the CANTAB (Fray,
tex. Clinical neuropsychological evidence seems to support Robbins, & Sahakian, 1996).
this conclusion. For example, patients with frontal lesions In this paper, we trace the history of the Wisconsin Card
due to traumatic brain injury show symptoms that are Sorting Test (WCST) and similar sorting tasks, beginning
referred to as the Dysexecutive Syndrome (Baddeley & with the studies of Narziss Ach on the psychology of think-
Wilson, 1988). Impairments in these executive functions ing, via the work of Kurt Goldstein and Adhémar Gelb
are often assessed with the Wisconsin Card Sorting Test around 1920 and subsequent developments, up to the
(WCST), along with a range of other instruments. actual design of the WCST by Harry Harlow, David
According to Lezak (2004), the WCST is generally used Grant, and their student Esther Berg at the Wisconsin Uni-
versity. What we find interesting is the apparent disconti-
nuity, where the cognitive underpinnings of the task are
*
Corresponding author. Fax: +31 24 3616066. quickly turned intro a Behaviorist framework, and how
E-mail address: p.eling@nici.ru.nl (P. Eling). long it has taken to rediscover its conceptual origins.

0278-2626/$ - see front matter Ó 2008 Elsevier Inc. All rights reserved.
doi:10.1016/j.bandc.2008.01.006
248 P. Eling et al. / Brain and Cognition 67 (2008) 247–253

2. Ach and the ‘Denkpsychologie’ Narziss Ach (1871–1946) was a student of Külpe (Hoff-
mann et al., 1996). From 1898 until 1899 he studied psy-
Wilhelm Wundt (1832–1920) was the founder of psy- chology in Strassbourg and then returned to Würzburg
chology as an institution (Bringmann & Tweney, 1980). to study under Külpe and to write a dissertation on the
He first defined scientific psychology in his Grundzüge der psychology of the Will. He began his experiments on the
Physiologischen Psychologie (Principles of Physiological Will in the summer of 1900, working with Külpe, and con-
Psychology; Wundt, 1873). Although in the 1870s the word tinued these in Göttingen, while working with Müller. An
‘physiological’ was acquiring its current meaning, it was overview of these studies can be found in Ach (1921).
often used in a broader meaning, more or less indicating Ach designed a paradigm for observing the process of con-
an experimental approach to the study of natural phenom- cept formation by the experimenter (rather than through
ena (Leahey, 2001). Wundt distinguished the experimental introspection by ‘the observer’). Individuals were presented
approach, using instruments to measure sensations and with cardboard (or wooden) geometrical figures, large or
experiences (‘experimentelle Selbstbeobachtung’), from small in size, light or heavy in weight. To each object a
the more traditional way of examining mental processes small card was attached on which was written a meaning-
purely introspectively (‘reine Selbstbeobachtung’). He less word, for example, Garun, Ras, Tal, Tar, Garun, for
argued that experimental psychology should focus on per- instance, represented heavy objects. These words were read
ception. In his view, thinking could not be analyzed with out loud by the experimenter and the cards were removed
experimental procedures (Humphrey, 1951). from the objects. Subsequently, the subject had to discover
One of Wundt’s most outstanding students was Oswald how the words were related to particular features of the
Külpe (1862–1915). He wrote his dissertation under Wundt: objects. The meaningless words thus came to refer to a
‘On the theory of sensual feeling’ in 1887 (Ogden, 1951). He group of objects characterized by a common feature. This
became an assistant at Wundt’s Institute of Psychology in paradigm can be considered the model task from which
Leipzig, and subsequently was named Professor of Philoso- other sorting tasks, including the WCST is derived. A basic
phy and Aesthetics in Würzburg (1894). Külpe strove to feature of these tasks is that multidimensional stimuli are
make psychology a more complete natural science and less presented and the subject has to discover the sorting
a branch of philosophy: ‘...it would seem well to dispense principle.
with the idea of a general philosophy of mind, or of the
mental sciences, altogether’ (Külpe, 1895, p. 64). Arriving 3. From Ach to Goldstein
in Würzburg, he immediately started a research program
on thinking and in 1896 he founded, together with Karl A second phase in the historical background of the
Marbe (1869–1953) the Institute for Psychology. The devel- WCST is formed by the studies on brain lesioned patients
opment and formation of concepts was an important area of the German neurologist Kurt Goldstein (1878–1965).
of research within the Würzburg School (Hoffmann, Stock, Much has been written about Goldstein and we will not
& Deutsch, 1996). Abstraction experiments were used to attempt to give a complete picture of his life and works
establish which object features are relevant to individuals here; we refer the reader to sources like Goldstein (1967),
at various stages of their development. For instance, when Shakow (1966), and Simmel (1968). In this section, we will
will a child call an animal a dog? examine some factors that may reveal why and how he
For the investigation of thinking, Külpe developed the came to study this issue. We will focus on the period lead-
so-called Ausfragen (Questioning) method. The experi- ing to the crucial publication of Gelb and Goldstein on
menter asked a question to an observer (usually a trained patient Th. in 1920.
fellow researcher), for example, to produce an association Goldstein studied medicine in Breslau, having a special
to a given word. Afterwards, the observer had to describe interest in psychiatry, and he was taught by Carl Wernicke.
the processes that occurred between the question and the He received his M.D. in 1903 and that same year he fin-
answer; in other words, he was to describe his thought pro- ished his dissertation on eye movements in schizophrenics.
cesses. The primary conclusion from this research program In 1904 he joined the Senkenbergische Neurologische Insti-
was that thinking can occur without images. Another tut in Frankfurt-am-Main as assistant to Ludwig Edinger.
important claim was the rejection of associationism as In 1906 he became a staff member of the Psychiatric Clinic
the fundamental mechanism for thinking. One of the argu- of the University of Königsberg. It should be noted that
ments was the following: In response to the question ‘Give Ach became Professor in Königsberg in 1907 and worked
the superodinate category for bird’ a subject will say ‘Ani- there until 1922. In 1914 he returned to Frankfurt as first
mal’, rather than ‘Canary’ which might be produced in a assistant to Edinger. With Adhémar Gelb he founded in
free association situation. It was hard to see how this 1916 a research institute for brain-injured soldiers, the
behavior could be explained along associationistic lines. Institut zur Erforschung der Folgeerscheinungen von Hirnv-
The students of the Würzburg School argued that the task erletzungen. His collaboration with Gelb was fruitful and
itself, rather than the stimulus, directs the thinking process resulted, among other things, in a book, The Psychologi-
and thus activates the concepts that come to mind. They sche Analyse hirnpathologischer Fälle (1920), which con-
referred to this mechanism as mental set (Humphrey, 1951). tains 16 studies, mostly dealing with perceptual problems.
 P. Eling et al. / Brain and Cognition 67 (2008) 247–253 249

Among them is the study on Th., in which sorting tasks indeed Husserl’s views had been corroborated by Goldstein
were used and the notions of concrete and abstract attitude and Gelb’s studies of brain-injured patients.
were developed.
The question we want to address is: How is the work of 4. Adhémar Gelb
Goldstein related to the line of research on thinking psy-
chology in general and the work of Ach in particular. Trying to find the link between the work of Narziss Ach
Goldstein and the American psychologist Martin Scheerer and Goldstein, one might also suspect that the ideas were
(1941) wrote: transferred via Adhémar Gelb (1887–1936). The Russian
Gelb studied Philosophy and worked as a voluntary assis-
The problem (of impairments in abstract behavior in
tant at the Psychological Institute in Berlin, working under
brain-injured patients, P. Eling et al.) was first discov-
supervision of Carl Stumpf, with Max Wertheimer and
ered and experimentally attacked by Gelb and Gold-
Kurt Koffka. After finishing his dissertation there in
stein, who, during and after the World War,
1910, he became an assistant at the Psychological Institute
introduced a number of methods for determining the
in Frankfurt am Main in 1912. During WW I a long and
capacity status of patients suffering from brain injuries.
fruitful collaboration started with Goldstein in his institute
These authors and their collaborators devised special
for soldiers with traumatic brain injuries.
sorting tests, e.g., color and object sorting tests for that
It appears then there were close personal ties between
purpose (p. 1).
Goldstein and Gelb on the one hand, and some important
In this chapter, Goldstein indicated that, in his work in Gestalt psychologists on the other. However, Ach also had
Frankfurt, the emphasis was on working with patients connections with some of the pioneers of Gestalt psychol-
rather than on experimental research in the laboratory ogy. According to Mandler and Mandler (1964), there is
designed to address theoretical questions. A considerable a line of development that stretches from the Würzburgers
part of his research was directed towards the problem of to Gestalt psychology. They also argue that Gestalt psy-
helping patients to find a new organization for their lives. chology did not become concerned with problems of think-
The activities of the normal and pathological organism ing until 1920.
can be understood only if looked upon as determined by Returning to the question of the link between the work
the basic trend to realize itself in the world as completely of Goldstein and Gelb and the thinking psychology of Ach,
as possible under the given conditions. To understand the it seems that we cannot unequivocally demonstrate when,
behavior of a patient, one should not focus on a specific where, or how either Goldstein or Gelb were informed
deficit, but study all aspects and try to understand how about the experimental approaches to the study of concept
they work simultaneously. Interestingly, Goldstein contin- formation or abstraction. Although there are conceptual
ues by arguing that ‘the holistic approach did not originate relations between the Würzburg School and the Gestalt
from any idea’ (p. 157). He then indicates that the ideas of psychologists, it seems likely that Goldstein and Gelb bor-
internists like Kraus, Krehl, and Christian were relevant in rowed the sorting task as a paradigm for the investigation
this respect, and even more so Ludwig Binswanger. Fur- of concept formation or abstraction from the Würzburg
thermore, the English neurologist Hughlings-Jackson’s tradition, in particular from Ach.
views also were relevant, but not generally known until
Head wrote about them. Goldstein felt comforted by some 5. Goldstein and the abstract attitude
ideas of the French physician Claude Bernard (1913–1878),
for instance his statement that ‘in the organism. . ..we have Gelb and Goldstein (1920) originally used a sorting task
to consider an ensemble, a harmony of phenomena’, and in the examination of a patient Th. who suffered from color
‘one should always return to the ensemble [of phenomena] amnesia. This was the Holmgren-test, a test for color blind-
before one draws definite conclusions’ (p. 158). Apparently, ness (see below for a more detailed description). Goldstein
Goldstein considered this to be the background of his con- noticed that neurological and psychiatric patients per-
ception of the concrete and abstract attitude. formed it in a way that differed remarkably from that of
It is remarkable that Goldstein did not mention the healthy persons. He also saw that patients tended to look
work of Narziss Ach. In the period of 1907 until 1914 they at individual objects; they apparently cannot avoid the con-
were both in Königsberg, so it is plausible that they met crete object and detect similarities between objects with
there. Indeed, according to one short biography it was in respect to a particular feature. These observations led to
Königsberg that Goldstein ‘became acquainted with the the notions of concrete and abstract attitude, for which
Würzburg School of experimental psychology, which Goldstein became so famous. Healthy individuals have
emphasizes ‘‘imageless thought”’ (Anonymous). the abstract attitude, enabling them to abstract features,
Later, on learning about the work of the philosopher choose concepts with which the environment can be struc-
Edmund Husserl, Goldstein wrote that he felt ‘vaguely that tured and organized. Brain-damaged patients are limited to
my interpretation of the behavior of patients may prove to the concrete attitude and, therefore, are dependent on
be similar to the results of the ‘‘phenomenological analysis” external stimuli, which can lead to rigidity or a lack of
(p. 162). And his friend Gurwitsch (1949) claimed that abstract attitude as a fundamental way of dealing with
250 P. Eling et al. / Brain and Cognition 67 (2008) 247–253

the environment, determining perception as well as think- word were located in the four corners of a large board (lag,
ing and action. Especially for that reason, one cannot bik, ruur, cev). The subject was told that the set of objects
assess attitude with a simple test and summarize perfor- consisted of four types of blocks, each with its own name,
mance with a simple test score. and that he had to discover which block belonged to which
name. Hanfmann and Kasanin (1937) introduced Vygot-
6. Sorting tasks sky’s test in the United States in their research on schizo-
phrenic patients (see also Hanfmann, 1968).
In this section, we will focus on the various sorting tasks
that have been developed and used, in particular for the 7. Wisconsin Card Sorting Task
study of brain-injured individuals and patients with schizo-
phrenia. Here, we will mainly concentrate on procedural We have followed the development of the psychological
aspects, first of some tasks used by Goldstein and follow- investigation of thinking and the introduction of sorting
ers, and then the Wisconsin Card Sorting Test and the Hal- tasks. We have seen how Goldstein and Gelb, followed
stead’s Category Test. Subsequently we will discuss how by others, applied the task in their studies on patients.
performance on these tests were interpreted. After emigrating to the United States, Goldstein also intro-
To analyze disorders in abstract behavior, Goldstein spe- duced this task in his clinical work (for instance, see Bolles
cifically used sorting tasks. Goldstein and Scheerer (1941) & Goldstein, 1938). We now will discuss the development
provided an analytical description of a number of these of the Wisconsin Card Sorting Test.
tasks. The first variant, the Gelb–Goldstein color sorting In 1946, Myra Zable and the American psychologist
test, was derived from the Holmgren test. It was designed Harry Harlow (1905–1981; Suomi & Leroy, 1982) exam-
by Gelb and Goldstein in 1924 to examine their patient ined discrimination learning of object features in rhesus
Th. In a first condition, the patient was asked to select monkeys, with and without brain lesion, in the primate
one from a series of colored strings and subsequently to center of the University of Wisconsin. They also studied
select those strings that were similar to the first one. In a sec- whether these animals could learn another discrimination
ond condition three strings were presented; the left and mid- after having mastered a first rule, the shifting procedure.
dle string matched in color, the right and middle string In their studies, they developed a paradigm for collecting
matched in brightness. The patient had to indicate which quantitative data. Harlow later became known for his stud-
string matched the middle one. In a third condition, two ies on the effect of terrycloth mothers on the development
rows of six strings were presented, one row varying from of infant monkeys, a research program on love or affection.
light to dark red and a second row with strings varying in Originally, he had been trained in Stanford as an experi-
color, but all with the same clarity. The subject had to select mental psychologists and after finishing his dissertation,
the strings that matched to each other. In a fourth condi- he moved to the University of Wisconsin where he founded
tion, the subject had to formulate the reasoning underlying the Psychology Primate Center in 1930. The financial
his responses. There was no quantitative scoring procedure aspects at his primates center there caused him some con-
because Goldstein was convinced that the specific attitude cern and he asked his colleague, David Grant, professor
could not be expressed in a single test score; the experi- of Psychology at the University of Wisconsin, whether they
menter had to observe how the subject performed the tasks. could collaborate (Hake, 1979). Together they formulated
Egon Weigl (1901–1979) developed a variant, the Gelb– a research project for designing a paradigm, similar to
Goldstein–Weigl–Scheerer Sorting Test. He used it in his the one used in the primate studies, in order to investigate
study, performed at Goldstein’s institute in Frankfurt in human subjects. Esther Berg, a psychology graduate stu-
1927, on a patient with frontal brain damage (Weigl, dent, was given the opportunity in 1945 to write her mas-
1942). The test consisted of a set of common objects, used ters thesis on this project under supervision of Grant.
in daily life activities, which the patient had to sort in dif- The thesis was approved by Grant in January 1946.
ferent groups, for instance, according to color, material, or The main question in this project was, Can some
usage. He subsequently had to sort them according to a method be found that will lend itself to both quantitative
new criterion and, therefore, had to shift. In the Weigl– and qualitative analyses? The materials consisted of a set
Goldstein–Scheerer–Color Form Sorting Test the patient of 60 response cards with, on each card, one to four iden-
had to sort geometrical objects (triangles, squares, and cir- tical patterns (stars, crosses, triangles, and circles) all in the
cles in the colors red, green, yellow, and blue) according to same color (red, yellow, green, or blue). The participant
color or form. was requested to put each card under one of four stimulus
The Russian psychologist Lev Vygostky (1896–1934) cards and to deduce the sorting principle on the basis of
was also interested in concept formation, especially in chil- feedback (correct, incorrect). Responses were scored in
dren, but also in schizophrenic patients. He published a terms of errors, latency, and degree of perseveration and,
short note on sorting behavior in these patients in 1932 according to Berg, provided a reliable and objective mea-
(see Hanfmann, 1968). His test consisted of 22 wooden sure of the capacity to shift.
blocks in five different colors, six forms, two heights and The thesis, with minor adaptations, was submitted and
two sizes of the ground surface. Four cards with a nonsense accepted for publication in the Journal of Experimental
 P. Eling et al. / Brain and Cognition 67 (2008) 247–253 251

Psychology in 1948, followed quickly by a study by Grant sured simply and adequately. She referred to this capacity
and Berg (1948), in which already the name ‘‘University of as flexibility in thinking. In the discussion section of her
Wisconsin Card Sorting Test” was used. The materials and report, she addressed the question of what is exactly mea-
procedures of Berg’s study formed the basis of the WSCT sured and her answer simply was ‘‘the interpretation of
as it has been used by clinical neuropsychologists, starting these scores depends on further experimentation”. Grant
with Milner in 1963 (see below). and Berg (1948) referred with a single sentence to the tests
of Goldstein and his co-workers as ‘tests for abstract rea-
8. Category Test soning’, but immediately discussed the task in terms, famil-
iar to the behaviorist tradition, as studies on the effect of
Another sorting test may be mentioned here, namely the reward (feedback for a correct response) during learning.
Category Test from Halstead, a subtest of the Halstead– In the discussion section, they argued that this feedback
Reitan test battery (Choca et al.,1997; Reitan, 1994; see perhaps can be seen as a reward that enhances the abstract
also Parsons, 1986). Ward Halstead (1908–1969) developed attitude, but one can also look at it as a kind of stimulus–
the test with Paul Settlage in 1943, who was working in response learning. In their later papers, Grant and his co-
Harlow’s primate center (Choca, Laatsch, Wetzel, & workers focused on whether discovering the number rule
Agresti, 1997). Already early in his career (around 1935), is easier than the color, or whether the configuration of
Halstead examined patients with brain lesions at the Med- the elements on the cards (regular vs. random pattern)
ical School at the University of Chicago. Originally he used influences discrimination learning. In these papers one no
an object sorting test, resembling the test of Goldstein and longer finds any comments or speculation about the under-
Scheerer. However, he wanted to have an objective score lying psychological functions or mechanisms.
and decided to design a new version. The original version Some less orthodox adherents of the learning theory
of his Category Test had 360 geometrical pictures grouped approach, like Tolman and Krechevski, did attempt to
in nine subtests. After each subtest the relevant sorting rule show in the 1940s that there had to be mediators, repre-
changed. For each picture the subject had to indicate to sented somehow in the brain (Tolman, 1966). For instance,
which group it belonged by pressing one of four buttons. Krechevsky (1932) referred to hypothesis learning; he
Many variants of this Category Test have been developed assumed that in a discrimination learning task an organism
and they appear to be equivalent (Choca et al., 1997). uses a sort of hypothesis, that is, an idea about the rule
relating a stimulus to a reward. However, this approach
9. Wisconsin Card Sorting Test: abstracting, reasoning, or was not very popular in behaviorist circles, and Grant does
discrimination learning? not refer to this literature. We therefore conclude that for
Grant the WCST was an instrument to investigate discrim-
We have seen how the WCST was developed as a kind of ination learning within the behaviorist tradition.
sorting task, originally introduced within the tradition of
the ‘Denkpsychologie’. We will now discuss what the per- 10. WCST as a neuropsychological test
formance of individuals on these kinds of tasks was
assumed or claimed to reflect. According to Goldstein We will now briefly describe the final phase of the
(Goldstein & Scheerer, 1941), sorting tasks mainly are WCST, in which it was introduced as a neuropsychological
designed to assess conceptual thinking, and he emphasized instrument, first for the evaluation of frontal lobe lesions,
that the test primarily evaluates the categorial or abstract and later for the assessment of the so-called executive func-
attitude. The abstract attitude implies that a person should tions. Harlow, Grant, and Berg developed a discrimination
be able to abstract from the concrete object to note similar- paradigm that could be applied in human studies. Despite
ities between objects with respect to a particular feature. the fact that Goldstein and others had used sorting tasks in
According to Goldstein, the person also must have insight patient studies, it took some 15 years before the WCST was
in the potential choices. The classification principle is introduced as a test to study patients with brain lesions. In
unknown and the subject’s task is to discover this rule by 1963, the psychologist Brenda Milner used the WCST in
trying various possibilities. This applies to discovering a her well known study Effects of different brain lesions on
sorting rule, but also to finding a new rule when an old rule card sorting: the role of the frontal lobes. In the introduction
no longer seems to apply, that is, after a ‘shift’. The value of section of the paper she referred to sorting tasks. She men-
the test, according to Goldstein, lies in the qualitative anal- tioned Goldstein and Weigl, but did not discuss the notion
ysis of the subject’s approach in this task. He argues also of abstract attitude or any other cognitive processes. The
that the quantitative scoring procedure used in other mental data showed that in particular lesions in the dorsolateral
tests (e.g., subtests of an intelligence scale) is not useful for part of the frontal lobe result in problems with shifting to
these sorting tasks, not because a procedure for calculating a new sorting rule. Milner interpreted this as perservation.
a score had not yet been developed, but because the nature In an attempt to specify the nature of the disorder she
of the thinking disorder cannot be expressed in a number. argued that frontal lobe lesions result in a loss of response
Berg (1946) showed that, using the WCST procedure, inhibition. Like Grant, Milner seemed to prefer to describe
both learning a rule and shifting to a new rule can be mea- behavior on this test in S–R-terms.
252 P. Eling et al. / Brain and Cognition 67 (2008) 247–253

In the last quarter of the 20th century, interest in the task-irrelevant dimension values affected task performance
study of the effects of frontal lesions has increased tremen- without the participants having any explicit memory for
dously (see for recent overviews, Miller & Cummings, 2007; these values. In other words, implicit or unconscious infor-
Stuss & Knight, 2002). The reason was not that the frontal mation processing does appear to play an important role in
lobes were terra incognita (although that was true to some sorting or category-learning tasks. And this, of course,
extent in comparison to other cortical areas), but that would be completely in contrast with the generally accepted
investigators realized that it played a crucial role in the view that thinking, executive functions, and the WCST all
control of behavior, planning and organization as Luria are associated with controlled, conscious processing.
(1966) had demonstrated. The British psychologists Badde- Regardless of these theoretical and empirical consider-
ley and Hitch (1974) introduced the notion of Central ations, it is striking how a procedure, developed by Narziss
Executive and the British psychologist Shallice (1988) that Ach to investigate thinking, and also used for this purpose
of Supervisory Attentional System. According to Baddeley by Goldstein and others in neurological and psychiatric
(1986), the two concepts overlap considerably. This system patients, is regarded by the behaviorist-oriented Grant,
is generally regarded to be involved in controlled rather Harlow, and Berg as a quantitative procedure for examin-
than automatic cognitive processing and, hence, may well ing discrimination learning. In subsequent neuropsycho-
be related to conscious processing, or even consciousness. logical research, it (again) has been used as a test for
Research on cognitive disorders often addresses aspects executive functions (i.e., thinking), now relying on the
of controlled behavior, and, therefore, it is not surprising quantitative results rather than the qualitative analysis of
that the study of executive functions in almost every kind a subject’s attitude. However, recent findings suggest we
of neurological and psychiatric syndrome has become so may yet return to an associative network approach, devel-
popular. Nearly always the WCST is used, together with oped within the behaviorist tradition.
other tests, as an instrument to study executive functioning.
Perhaps one can say that the WCST is now the golden stan-
Acknowledgments
dard for disorders of the frontal lobe or in executive
functioning.
We are very grateful to Joseph Kemnitz of the Primate
More recently, however, some studies have shown that
Center in Wisconsin, Joe Newman, head of the Psychology
the WCST has some limitations. One may question to what
Department in Wisconsin and Carol Allen, also working at
extent the WCST adequately assesses frontal lobe function-
the Psychology Department for tracking down and sending
ing and executive functioning. Modern imaging studies
me a copy of the masters thesis of Esther Berg. We also
have shown that the frontal lobes are, functionally seen,
thank Helmut Hildebrandt and Lauren Harris for their
heterogeneous, suggesting that the WCST, at best, can only
comments on an earlier version.
reveal specific aspects of frontal lobe processing (see chap-
ters in Miller & Cummings, 2007). Also, the notion of Exec-
References
utive Functioning refers to a rather complex set of processes
that appears to be necessary for nonautomatic behavior. Ach, N. (1921). Ueber die Begriffsbildung. Bamberg: Buchners Verlag.
Andres (2003) indicates it is time to revise our views on Andres, P. (2003). Frontal cortex as the central executive of working
the functional role of the frontal lobes. The WCST, at best, memory: Time to revise our view. Cortex, 39, 871–895.
may only tap specific aspects, in particular the shift from Anonymous. Available from http://genealogy.metastudies.net/PS05/
PS05_101.HTM.
using an old rule to a new rule. However, the issue becomes
Baddeley, A. D. (1986). Working memory. Oxford: Oxford University
even more complicated, when looking at studies examining Press.
mechanisms involved in shifting. For instance, Owen et al. Baddeley, A., & Hitch, G. (1974). Working memory. In G. Bower (Ed.),
(1993) have demonstrated that perseveration is not the The psychology of learning and motivation (pp. 47–89). New York:
major factor causing errors, but learned irrelevance is. Academic Press.
Baddeley, A., & Wilson, B. (1988). Frontal amnesia and the dysexecutive
Learned irrelevance refers to the phenomenon that a fea-
syndrome. Brain and Cognition, 7, 212–230.
ture, which a subject has learned is irrelevant in a specific Berg, E. (1946). An objective technique for the measurement of flexibility in
discrimination task, takes longer to become detected as thinking. MA thesis, University of Wisconsin.
the relevant feature after a shift. Traditionally, persevera- Berg, E. A. (1948). A simple objective for measuring flexibility in thinking.
tion has been regarded as the significant indicator for Journal of General Psychology, 39, 15–22.
Bolles, M., & Goldstein, K. (1938). A study of the impairment of ‘‘abstract
impaired executive functioning. However, in the WCST it
behavior” in schizophrenic patients. Psychiatric Quarterly, 12, 42–65.
is not possible to dissociate between these two potential Bringmann, W., & Tweney, R. (1980). Wundt studies. Toronto: Hogrefe.
sources of errors. Maes, Damen, and Eling (2004), Maes, Choca, J., Laatsch, L., Wetzel, L., & Agresti, A. (1997). The Halstead
Vich, and Eling (2006) have replicated this finding. More- Category Test: A fifty year perspective. Neuropsychology Review, 7,
over, Reed and Means (2004) found that participants, per- 61–75.
Fray, P., Robbins, T., & Sahakian, B. (1996). Neuropsychiatric applica-
forming a category-learning task, responded slower on
tions of CANTAB. International Journal of Geriatric Psychiatry, 11,
successive trials when the value of task-irrelevant stimulus 329–336.
dimensions changed, relative to when these values did not Gelb, A., & Goldstein, K. (1920). Psychologische Analysen hirnpatholog-
change across trials. Interestingly, this manipulation of ischer Fälle. Leipzig: Barth.
 P. Eling et al. / Brain and Cognition 67 (2008) 247–253 253

Goldstein, K. (1967). Kurt Goldstein. In E. G. Boring & G. Lindzey Maes, J., Vich, J., & Eling, P. (2006). Learned irrelevance and response
(Eds.). A history of psychology in autobiography (Vol. 5). New York: perseveration in a total change dimensional shift task. Brain and
Appleton-Century-Crofts. Cognition, 62, 74–79.
Goldstein, K., & Scheerer, M. (1941). Abstract and concrete behavior: An Mandler, J. M., & Mandler, G. (1964). Thinking: From association to
experimental study with special tests. Psychological Monographs, 53, Gestalt. New York: John Wiley.
1–151. Miller, B., & Cummings, J. (2007). The human frontal lobes (2nd ed.). New
Grant, D. A., & Berg, E. (1948). A behavioral analysis of degree of York: The Guilford Press.
reinforcement and ease of shifting to new responses in a Weigl-type Milner, B. (1963). Effects of different brain lesions on card sorting: The
card-sorting problem. Journal of Experimental Psychology, 38, role of the frontal lobes. Archives of Neurology, 9, 100–110.
404–411. Nelson, H. E. (1976). A modified card sorting test sensitive to frontal lobe
Gurwitsch, A. (1949). Gelb-Goldstein’s concepts of ‘‘Concrete” and defects. Cortex, 12, 313–324.
‘‘categorial” attitude and the phenomenology of idealism. Philosophy Ogden, R. M. (1951). Oswald Külpe and the Würzburg School. The
and Phenomenological Research, 10, 172–196. American Journal of Psychology, 64, 4–19.
Hake, H. (1979). David A. Grant (1916–1977). American Psychologist, 34, Owen, A. M., Roberts, A. C., Hodges, J. R., Summers, B. A., Polkey, C.
631–632. E., & Robbins, T. W. (1993). Contrasting mechanisms of impaired
Hanfmann, E. (1968). Goldstein and Vygotsky. In M. Simmel (Ed.), The attentional set-shifting in patients with frontal lobe damage or
reach of mind. New York: Springer. Parkinson’s disease. Brain, 116, 1159–1175.
Hanfmann, E., & Kasanin, J. (1937). A method for the study of concept Parsons, O. (1986). Overview of the Halstead–Reitan Battery. In G.
formation. Journal of Psychology, 3, 521–540. Goldstein, Th. Incagnoli, & Ch. Golden (Eds.), Clinical application of
Heaton, R. K., Curtiss, G., & Tuttle, K. (1993). Wisconsin Card Sorting neuropsychological test batteries. New York: Plenum Press.
Test: Computer version-2 Research edition. Odessa: Psychological Reed, J., & Means, L. (2004). Human implicit memory for irrelevant
Assessment Resources Inc.. dimension values is similar to rats’ incidental memory in simultaneous
Hoffmann, J., Stock, A., & Deutsch, R. (1996). The Würzburg School. In discrimination tasks. Behavioural Processes, 67, 383–393.
J. Hoffmann, A. Sebald (Eds.), Cognitive psychology in Europe: Reitan, R. (1994). Ward Halstead’s contributions to neuropsychology and
proceedings of the ninth conference of the european society for cognitive the Halstead–Reitan neuropsychological test battery. Journal of
psychology (pp. 147–172). Lengerich: Pabst Science Publishers. Clinical Psychology, 50, 47–70.
Humphrey, G. (1951). Thinking. An introduction to its experimental Shakow, D. (1966). Kurt Goldstein: 1878–1965. The American Journal of
psychology. London: Methuen. Psychology, 79, 150–154.
Krechevsky, I. (1932). ‘‘Hypothesis” versus ‘‘chance” in the presolution Shallice, T. (1988). From neuropsychology to mental structure. Cambridge:
period in sensory discrimination learning. University of California Cambridge University Press.
Publications in Psychology, 6, 27–44. Simmel, M. (1968). The reach of mind. New York: Springer.
Külpe, O. (1895). Outlines of psychology. Based upon the results of Stuss, D., & Knight, R. (2002). Principles of frontal lobe function. New
experimental investigation. London: Swan Sonnenschein. York: Oxford University Press.
Leahey, Th. (2001). A history of modern psychology. London: Prentice Suomi, S. J., & Leroy, H. A. (1982). In memoriam: Harry F. Harlow
Hall. (1905–1981).. American Journal of Primatology, 2, 319–342.
Lezak, M. (2004). Neuropsychological assessment (4th ed.). Oxford: Tolman, E. C. (1966). Behavior and psychological man. Berkeley: Univer-
Oxford University Press. sity of California Press.
Luria, A. (1966). Higher cortical functions in man. New York: Basic Books. Weigl, E. (1942). On the psychology of so-called processes of abstraction.
Maes, J., Damen, M., & Eling, P. (2004). More learned irrelevance than Journal of Abnormal and Social psychology, 36, 1–33.
perseveration errors in rule shifting in healthy subjects. Brain and Wundt, W. M. (1873). Grundzüge der physiologischen Psychologie. Leipzig:
Cognition, 54, 201–211. Wilhelm Engelmann.