Mental Flexibility

Mental flexibility requires the capacity to shift a course of thought or action according to rapidly changing situational demands. The Wisconsin Card Sorting Test (WCST) is a popular neuropsychological measure used to assess concept formation, abstract reasoning, and the ability to shift cognitive strategies in response to changing environmental contingencies. The subject is presented with four stimulus cards depicting figures of varying forms, colors, and numbers of figures (one red triangle, two green stars, three yellow crosses, and four blue circles). The task is to match each consecutive card from a deck of similar stimulus cards with one of the four key cards. In response to each matching, the subject is told only whether his or her choice was correct or incorrect. After the subject makes a specified number of correct matches, without warning the sorting strategy is changed. The subject is therefore required to use the examiner's feedback to develop a new sorting strategy.

Patients with frontal lobe damage have been found to perform more poorly on the WCST task than patients with nonfrontal damage. The required shifting response is particularly challenging for these patients because it entails the use of mental flexibility and reasoning skills. Frontal lobe patients commonly make perseverative errors by continuing to sort by a certain principle (e.g., by color) long after that sorting principle has been changed (e.g., to form). In some cases, patients appear almost oblivious to feedback and continue to make erroneous perseverations, despite their ability to verbalize the correct sorting strategy. Recent work by Kyle Boone suggests that perseverations on the WCST are more strongly associated with right frontal damage than left frontal damage.

The California Card Sorting Test is another useful measure of concept formation, shifting, and reasoning.

This unique card-sorting task was designed to isolate and measure specific components of problem-solving ability. The subject is asked to sort six cards spontaneously into two groups of three cards each, according to as many different rules as possible, and to report the rule after each sort. In another condition, subjects are required to report the rules for correct sorts performed by the examiner. This test examines several executive components, including the ability to generate and initiate different sorts, the ability to verbalize the principles of accurate sorts, and the ability to inhibit perseverative sorts. In 1992, Dean Dellis and colleagues found that patients with focal frontal lobe lesions and patients with Korsakoff's syndrome were impaired on eight of nine components of the task. Based on these results, the authors suggested that a wide array of deficits in abstract thinking, cognitive flexibility, and use of knowledge to regulate behavior contribute to the problem-solving impairment of patients with frontal lobe dysfunction.

Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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