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The effect of self-monitoring on Wisconsin Card Sorting Test performance in euthymic patients with bipolar disorder: a pilot study

Lookup NU author(s): Dr Lucy RobinsonORCiD, Dr John Gray, Emeritus Professor Nicol Ferrier, Dr Peter GallagherORCiD



This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


Objectives: Euthymic patients with bipolar disorder (BD) show executive impairment. Assisting cognitive function with non-pharmacological strategies has not been widely explored in BD. In schizophrenia, concomitant verbalisation (self-monitoring) during executive tests improved performance. The present pilot study assesses the effects of self-monitoring whilst completing the Wisconsin Card Sorting Test (WCST) in BD patients.Methods: Thirty-six euthymic BD patients and 42 healthy controls participated. Twenty patients with BD and 20 controls received standard administration and 16 patients and 22 controls used self-monitoring during the test.Results: ANCOVA revealed a significant "group by administration" interaction. Patients who received the standard administration were significantly worse than healthy controls (trials administered: p = .012, eta(2)(p) = 0.17; trials to first category: p = .046, eta(2)(p) = 0.11; failure to maintain set: p = .003, eta(2)(p) = 0.23). BD patients who self-monitored performed significantly better than patients receiving the standard administration (trials to first category: p = .020, eta(2)(p) = 0.17) and showed no significant differences in performance compared to controls.Conclusion: Self-monitoring deserves further investigation as a tool that may be helpful for patients with BD. Further exploration of the utility, generalisability, and stability of the effects of self-monitoring is needed.

Publication metadata

Author(s): Robinson LJ, Gray JM, Ferrier IN, Gallagher P

Publication type: Article

Publication status: Published

Journal: Cognitive Neuropsychiatry

Year: 2016

Volume: 21

Issue: 3

Pages: 256-270

Online publication date: 25/05/2016

Acceptance date: 22/04/2016

Date deposited: 10/08/2016

ISSN (print): 1354-6805

ISSN (electronic): 1464-0619

Publisher: Routledge


DOI: 10.1080/13546805.2016.1184134


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