Scaffolded instruction remediates Wisconsin Card Sorting Test deficits in schizophrenia: A comparison to other techniques

This study compared the efficacy of two instructional techniques, scaffolding and direct instruction, with a practice control condition in the remediation of Wisconsin Card Sorting Test (WCST) deficits among 45 highly chronic schizophrenic patients. The extent to which learning of the WCST generalised to other cognitive tests, including an object sorting task, the Short Category Test, Trail Making and Stroop tests, was also examined. The affective experience of the subjects was assessed via Rosenberg's Self-Esteem Scale and the Positive and Negative Affect Schedule (PANAS). Subjects who received scaffolded instruction improved significantly in the number of WCST categories achieved. The improvement was sustained one month later. Generalisation to other cognitive tests was encouraging but limited. The scaffolded group improved in their self-esteem and maintained a high positive affect. These findings have implications for psychosocial and cognitive rehabilitation.