Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.
Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.
Schizophr Res. 2021 Nov;237:122-130. doi: 10.1016/j.schres.2021.09.008. Epub 2021 Sep 11.
Psychopathological symptoms and cognitive impairment are core features of patients with psychotic disorders. Executive dysfunctions are commonly observed and typically assessed using tests like the Wisconsin Card Sorting Test (WCST). However, the structure of executive deficits remains unclear, and the underlying processes may be different. This study aimed to explore and compare the network structure of WCST measures in patients with psychosis and their unaffected siblings and to empirically validate the resulting network structure of the patients.
The subjects were 298 patients with a DSM 5 diagnosis of a psychotic disorder and 89 of their healthy siblings. The dimensionality and network structure of the WCST were examined by means of exploratory graph analysis (EGA) and network centrality parameters.
The WCST network structure comprised 4 dimensions: perseveration (PER), inefficient sorting (IS), failure to maintain set (FMS) and learning (LNG). The patient and sibling groups showed a similar network structure, which was reliably estimated. PER and IS showed common and strong associations with antecedent, concurrent and outcome validators. The LNG dimension was also moderately associated with these validators, but FMS did not show significant associations.
Four cognitive processes underlying WCST performance were identified by the network analysis. PER, IS and LNG were associated with and shared common antecedent, concurrent and outcome validators, while FMS was not associated with external validators. These four underlying dysfunctions might help disentangle the neurofunctional basis of executive deficits in psychosis.
精神病理症状和认知损伤是精神病患者的核心特征。执行功能障碍是常见的，通常使用威斯康星卡片分类测试（WCST）等测试进行评估。然而，执行缺陷的结构仍不清楚，潜在的过程可能不同。本研究旨在探索和比较精神病患者及其未受影响的兄弟姐妹的 WCST 测量的网络结构，并对患者的网络结构进行实证验证。
研究对象为 298 名符合 DSM-5 精神病诊断的患者和 89 名健康的兄弟姐妹。通过探索性图分析（EGA）和网络中心性参数来检查 WCST 的维度和网络结构。
WCST 的网络结构包括 4 个维度：坚持性（PER）、低效分类（IS）、无法维持设定（FMS）和学习（LNG）。患者组和对照组的网络结构相似，且具有可靠的估计。PER 和 IS 与先前、同期和后续的有效验证者表现出共同的强关联。LNG 维度也与这些有效验证者有中度关联，但 FMS 与有效验证者没有显著关联。
网络分析确定了 WCST 表现背后的四个认知过程。PER、IS 和 LNG 与先前、同期和后续的有效验证者有关，并共享共同的有效验证者，而 FMS 与外部有效验证者无关。这四个潜在的功能障碍可能有助于厘清精神病患者执行功能缺陷的神经功能基础。
