Our series of studies in the spectrum of psychosis (schizophrenia, bipolar affective disorder, schizoaffective disorder) is based on the concept of the RDoC system.

In this study, we were interested in knowing whether cross-diagnostic disturbances in cognitive functions can be found in the spectrum and whether they predict clinical symptoms.

In the study, N = 66 schizophrenic (M = 38.2 ± 9.37 years, 26 women), N = 30 bipolar (M = 47.4 ± 9.35 years, 19 women), N = 33 schizoaffective (M = 39.8 years± 11.3 years, 21 women) and N = 28 healthy subjects (M = 36.5 ± 9.9 years, 14 women) participated. All subjects underwent the Wisconsin Card Sorting Test (WCST), Raven Test, Digit Span Test, Visual Patterns Test, Letter and Semantic Fluency tests, Metaphor and Irony Comprehension, Directed Forgetting, Stop Signal Test, and Lexical Decision Task. In addition, symptom rating scales were administered (PANSS, SANS, YMRS, MADRS).

Based on our results, the performance of the WCST-deficient group lagged behind the WCST-non-deficient group and the healthy control group in most executive control tests. Importantly, this effect was independent of diagnosis, so it appeared in all three patient groups. Members of the deficit group had a higher rate of negative symptoms.

Disruption of executive functions is a transdiagnostic feature of the schizophrenia-bipolar spectrum, which could be associated with any diagnosis.

No significant relationships.

Cognitive impairment is a core feature of schizophrenia and other psychotic disorders and executive deficits are within the most impaired cognitive functions The Wisconsin Card Sorting test (WCST) has been extensively used in literature on schizophrenia and psychosis. The underlying structure of executive impairment may have important implications for our understanding of the complex connections between executive dysfunction and the psychopathology and neurofunctional basis of psychosis.

The objective was to empirically validate the dimensions of the WCST network structure of patients regarding antecedent, concurrent and outcome variables.

Subjects were 298 patients with a DSM 5 diagnosis of psychotic disorder. To assess the empirical validation of network structure of the WCST antecedent, concurrent and outcome variables were selected from the CASH interview and other scales of patients.

Pearson coefficient correlations between the 4 network loadings (NL) of WCST, namely perseveration, inefficient sorting, failure to maintain the set and learning, and antecedent, concurrent and outcome validators are shown in the table. PER and IS showed common and strong associations with antecedent, concurrent and outcome validators. LNG dimension was also moderately associated and FMS did not show significant associations.

‘Perseveration’ and ‘Inefficient sorting’ dimensions achieve and share common antecedent, concurrent and outcome validators. While ‘Learning’ dimension achieves partial validation in terms of antecedent and outcome validators and ‘Failure to maintain the set’ dimension was not associated with external validators. These four underlying dysfunctions might help to disentangle the neurofunctional basis of executive deficits in psychosis.

Psychopathological symptoms and cognitive impairment are core features of patients with psychotic disorders. Executive dysfunctions are within the most commonly observed deficits and the Wisconsin Card Sorting Test (WCST) is the test most extensively used for their assessment. Yet, the structure of executive deficits remains unclear, as there may be different underlying processes.

The study’s aims were to explore and compare the network structure of the WCST measures in psychosis and their unaffected siblings.

Subjects were 298 patients with a DSM 5 diagnosis of psychotic disorder and 89 of their healthy siblings. The dimensionality and network structure of the 13 WCST measures were examined by means of the Exploratory Graph Analysis (EGA) and centrality parameters.

The WCST network structure comprised 4 dimensions: Perseveration (PER), Inefficient sorting (IS), Failure to maintain set (FMS) and Learning (LNG). Patient and sibling groups showed a similar network structure and in both cases the network structure was reliably estimated.

Perseveration measures reflect the inability to switch sorting rules when necessary. Scores for the IS dimension can occur when the subject ineffectively tries to test different sorting hypotheses, changing at random the response. FMS reflects the subject’s strategy when he/she is able to find out the sorting rule, but is unable to keep applying that rule long enough. LNG comprised conceptual ability and learning items. The lack of significant difference between network structures is in keeping with results from exploratory and confirmatory studies demonstrating an invariant cognitive factor structure between schizophrenia patients and their unaffected siblings.