{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T08:51:54Z","timestamp":1791276714588,"version":"4.1.0"},"reference-count":15,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["26dk0307132s0203"],"award-info":[{"award-number":["26dk0307132s0203"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neuropsychopharm Rep"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Treatment\u2010resistant schizophrenia (TRS) is a clinically important subtype of schizophrenia, but its cognitive characteristics remain incompletely understood. The Wisconsin Card Sorting Test (WCST) is widely used to assess executive dysfunction in schizophrenia, although conventional summary analyses may overlook trial\u2010by\u2010trial behavioral adaptation. This study aimed to examine whether recent trial outcome modulates subsequent responding differently between TRS and non\u2010TRS patients during the WCST.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed WCST data from 41 outpatients with schizophrenia, including 13 patients with TRS and 28 with non\u2010TRS. Conventional subject\u2010level indices, including perseveration rate and outcome\u2010dependent reaction time (RT) adjustment, were first compared between groups. We then performed trial\u2010level linear mixed\u2010effects analyses using log\u2010transformed RT as the dependent variable, with previous trial correctness, treatment resistance, their interaction, age, and sex as fixed effects. Additional sensitivity analyses included models with by\u2010subject random slopes for previous trial correctness and analysis in an age\u2010matched sample.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Conventional summary analyses showed no significant group differences in perseveration rate or RT measures. In the primary model, previous trial correctness significantly modulated subsequent RT, and the interaction between previous trial correctness and TRS suggested a group difference in outcome\u2010dependent RT modulation. Specifically, the RT difference between trials following error and correct responses appeared smaller in TRS patients than in non\u2010TRS patients. However, sensitivity analyses using by\u2010subject random slopes and an age\u2010matched sample showed similar directions and magnitudes of the interaction but did not reach statistical significance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Conventional WCST summary analyses did not distinguish TRS from non\u2010TRS patients, whereas trial\u2010level modeling provided preliminary evidence for possible alteration of outcome\u2010dependent response adjustment in TRS. These findings suggest that dynamic behavioral phenotypes may provide a useful complement to standard neuropsychological indices in characterizing cognitive heterogeneity in schizophrenia, but replication in larger samples is needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/npr2.70151","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T06:05:07Z","timestamp":1785823507000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trial\u2010History Effects During\n                    <scp>WCST<\/scp>\n                    in Treatment\u2010Resistant Schizophrenia"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2930-1192","authenticated-orcid":false,"given":"Ryo","family":"Sawagashira","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Graduate School of Medicine Hokkaido University  Sapporo Japan"},{"name":"Health Care Center Hokkaido University  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9333-8833","authenticated-orcid":false,"given":"Atsuhito","family":"Toyomaki","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Graduate School of Medicine Hokkaido University  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1290-5558","authenticated-orcid":false,"given":"Hayato","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Center for Information and Neural Networks, Advanced ICT Research Institute National Institute of Information and Communications Technology  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Graduate School of Medicine Hokkaido University  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro A.","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Graduate School of Medicine Hokkaido University  Sapporo 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