Key words: schizophrenia; neuropsychological tests; Trail Making Test; executive functions.
- Abstract
- References
- How to cite
The aim of the study was to adapt and validate the Trail Making Test (TMT) implemented on the Inquisit computer platform.
Materials and Methods. A total of 69 individuals were examined: 34 conditionally mentally healthy volunteers (12 men and 22 women; mean age 20.6 [20.1; 21.2] years) and 35 schizophrenia patients (12 men and 23 women; mean age 38.7 [34.1; 43.3] years). The test tasks and user interface of the original English-language TMT script were translated into Russian. The correctness of the translation was verified by the Inquisit platform developers, after which the Russian-language version was made available on the platform. The study (testing was performed twice) was conducted using the Russian-language TMT script, the Cancellation Test, the Number Finding Test (Schulte tables), and the 10-Word Learning Test.
Results. Cronbach’s alpha coefficient was 0.96 for the conditionally mentally healthy group and 0.90 for the schizophrenia patient group, indicating sufficient internal consistency of the TMT. Quantitative measures of test-retest reliability reached noticeable to high levels on the Chaddock scale for time-based parameters, while no correlations were found for the number of errors. For both groups, positive statistically significant correlations were found between the time spent on the TMT and the Number Finding Test. In the schizophrenia patients, negative statistically significant correlations were found between the number of lines processed (Cancellation Test) and the time spent (TMT). These findings confirm convergent validity between TMT time scores, classical attention tests, and dynamic characteristics of thinking. At the same time, no significant correlations were found between the number of errors in the TMT and in the Cancellation Test. This might be related to different neuropsychological mechanisms underlying errors in these tests. Discriminant validity was demonstrated by the absence of significant correlations between most TMT measures and the results of the 10-Word Learning Test in both groups.
Conclusion. The adapted TMT has sufficient internal consistency, convergent and discriminant validity, and test-retest reliability. Thus, it can be recommended for use in research to assess executive function deficits in schizophrenia patients. Notably, time spent on TMT tasks is the parameter that most closely corresponds to the assessment of dynamic attention indicators.
1. Petrova N. Neurocognition profile, negative аnd affective symptoms in schizophrenia: structure and relations. Psikhiatriya, psikhoterapiya i klinicheskaya psikhologiya 2023; 14(2): 123–131, https://doi.org/10.34883/pi.2023.14.2.008.
2. Karyakina M., Shmukler A. Network analysis of cognitive deficit in patients with schizophrenia spectrum disorders. Schizophr Res Cogn 2021; 26: 100213, https://doi.org/10.1016/j.scog.2021.100213.
3. Kornetov A.N., Yazykov K.G., Kornetova E.G., Fedorenko O.Yu., Goncharova A.A., Semke A.V., Ivanova S.A., Shmukler A.B., Bokhan N.A. Normative assessment of cognitive functions with on the brief assessment of cognition in schizophrenia (BACS) scale in the Tomsk population: constitutional factors of variability. Sibirskiy psikhologicheskiy zhurnal 2021; 82: 137–152, https://doi.org/10.17223/17267080/82/8.
4. Zorin R.A., Medvedeva Y.I., Kurepina I.S., Lapkin M.M., Zhadnov V.A. Distribution of physiological resources and effectivity of purposeful activity of patients with epilepsy. I.P. Pavlov Russian Medical Biological Herald 2018; 26(3): 369–379, https://doi.org/10.23888/pavlovj2018263369-379.
5. Armitage S.G. An analysis of certain psychological tests used for the evaluation of brain injury. Psychological Monographs 1946; 60(1): i–48, https://doi.org/10.1037/h0093567.
6. Reitan R.M. Validity of the Trail Making Test as an indicator of organic brain damage. Perceptual and Motor Skills 1958; 8(3): 271–276, https://doi.org/10.2466/pms.1958.8.3.271.
7. Laere E., Tee S.F., Tang P.Y. Assessment of cognition in schizophrenia using Trail Making Test: a meta-analysis. Psychiatry Investig 2018; 15(10): 945–955, https://doi.org/10.30773/pi.2018.07.22.
8. Yanovsky T.S. Diagnostics of mental patients and internal picture of the disease. Personality in a Changing World: Health, Adaptation, Development 2017; 5(4): 569–597, https://doi.org/10.23888/humj20174569-597.
9. Sánchez-Cubillo I., Periáñez J.A., Adrover-Roig D., Rodríguez-Sánchez J.M., Ríos-Lago M., Tirapu J., Barceló F. Construct validity of the Trail Making Test: role of task-switching, working memory, inhibition/interference control, and visuomotor abilities. J Int Neuropsychol Soc 2009; 15(3): 438–450, https://doi.org/10.1017/S1355617709090626.
10. Baykara E., Kuhn C., Linz N., Tröger J., Karbach J. Validation of a digital, tablet-based version of the Trail Making Test in the ∆elta platform. Eur J Neurosci 2022; 55(2): 461–467, https://doi.org/10.1111/ejn.15541.
11. Hays J.R. Trail Making Test norms for psychiatric patients. Percept Mot Skills 1995; 80(1): 187–194, https://doi.org/10.2466/pms.1995.80.1.187.
12. Moggi F., Ossola N., Graser Y., Soravia L.M. Trail Making Test: normative data for patients with severe alcohol use disorder. Subst Use Misuse 2020; 55(11): 1790–1799, https://doi.org/10.1080/10826084.2020.1765806.
13. Toda A., Nagami S., Katsumata A., Fukunaga S. Verification of Trail Making Test in elderly people with behavioral and psychological symptoms of dementia. Ageing Int 2022; 47: 491–502, https://doi.org/10.1007/s12126-021-09424-y.
14. Sayed A., Abdelhadi G., Ramadan I., Galeel A.A., Hamed M. Validation of trail making test part A for cognitive screening in multiple sclerosis. Progress in Neurology and Psychiatry 2023; 27(4): 35–38, https://doi.org/10.1002/pnp.814.
15. Ransing R., Sakekar G.Sh., Grigo O., Khairkar P. Bedside assessment of cognitive heterogenety with clock drawing performance among clinical subtypes of schizophrenia — preliminary study. I.P. Pavlov Russian Medical Biological Herald 2025; 33(1): 37–48, https://doi.org/10.17816/pavlovj501723.
16. Sisakhti M., Batouli S.A.H., Delazar E., Farrahi H. Iranian normative data for the Trail-Making Test stratified by age, gender, and education. Frontiers in Biomedical Technologies 2024, https://doi.org/10.18502/fbt.v11i3.15886.
17. Waggestad T.H., Kirsebom B.E., Strobel C., Wallin A., Eckerström M., Fladby T., Egeland J. Improving validity of the trail making test with alphabet support. Front Psychol 2023; 14: 1227578, https://doi.org/10.3389/fpsyg.2023.1227578.
18. Trail Making Test (TMT) (2025). URL: https://www.millisecond.com/library/trailmakingtest.
19. Cognitive disorders in the elderly and older adults. URL: https://cr.minzdrav.gov.ru/view-cr/617_5#doc_g.
20. Giovagnoli A.R., Del Pesce M., Mascheroni S., Simoncelli M., Laiacona M., Capitani E. Trail making test: normative values from 287 normal adult controls. Ital J Neurol Sci 1996; 17(4): 305–309, https://doi.org/10.1007/BF01997792.
21. Laere E., Tee S.F., Tang P.Y. Assessment of cognition in schizophrenia using Trail Making Test: a meta-analysis. Psychiatry Investig 2018; 15(10): 945–955, https://doi.org/10.30773/pi.2018.07.22.