Name of Test: Object Sorting Test

Authors: Work done at NIMHANS; Kasturi, Sharma, Kaur, Murthy, Sujatha (1959-1981) in Mphil/PhD
dissertations

Age: Unspecified

Aim:

Analyses thought disorders

o Form and Stream (qualitatively)

o Deviance (quantitatively) – diagnostic tool for thought disorder
o Types of formal thought disorder (constitute specific indicators of schizophrenia) e.g.
overinclusion
o Thought deviance – thought alienation phenomena
o Concrete thinking – inability to perform inductive reasoning. The Abstract Attitude – to
be able to keep simultaneous thoughts in mind, to be able to break down into parts
o OST is basically a measure of Formal Thought Disorder + concrete thinking
- Other available measures for similar purposes: WCST, Proverbs test, TLC scale (Andrea Sim),
PANSS, Thought Disorder Index (1976), Idiosyncratic Index, CLANG (Chen et al., 1980), Formal
Thought Disorder Scale (Carer & Pt version)

History:

- Gelb-Goldstein-Weigl-Sheerer Object Sorting test (1941). Part of Goldstein-Sheerer tests of

abstract and concrete thinking.
- Payne hypothesized that in schizophrenia, concrete thinking is a result of overinclusive thinking
(sorting which includes objects not belonging with the content of the concept)
- Rapaport (1945) modified the sorting test - Sorting behaviour, in response to the instruction to
'put together those objects which belong together' is an expression of concept formation.
Sorting behaviour, wherein the subject compares objects that belong to the realm and objects
that do not belong to the realm, gives the examiner an opportunity to assess how rigid and
concrete (narrow), or how fluid, vague, and over-generalized (loose), the concept formation of
the subject is.
- Kasturi (1959) adapted the test to suit Indian population & showed that compared to healthy
controls, people with schizophrenia manifested significantly greater thought deviance on the
test

Standardization:

o Study A (Ida Barnabo): 100 participants

 Had IPs and OPs: divided into those with schizophrenia, mania, major
depression, neurotic, healthy (according to DSM III criteria)
  7th std minimum education (depressive group had lower education, which may
have impacted final outcome)
 Outcome: OST could classify 70% of schizophrenia and mania group as thought
deviance; 10% of controls (neurotics, healthy) classified as thought deviance;
false positives decrease to 5% if discriminating versus normal only vs.
schizophrenia and mania
o Study B (Marisa Lobo): 60 participants
 IPs: schizophrenia, mania, healthy controls
 No minimum education
 73% of schizophrenia and mania had thought deviance; no normal people
diagnosed as having thought deviance with OST
o Hence cross-validation done. Sensitivity of test better than previous versions, when it
was only 50%.
o False positives may not necessarily be a function of the tests quality
o Reliability
 Inter-rater reliability for qualitative scores
 Inter-rater reliability for quantitative scores (0.90)
- Limitations
o Norms need to be revised (1988)
o Scoring system lacks qualitative interpretations
o Needs some supplementation by other tools or rating scales

Administration:

- 31 objects carefully scattered in full view of participant; no related objects should be placed
together
- Consists of 2 phases, Active Phase & Passive Phase
- In Active Phase, examiner picks out stimulus object and asks client to pick out all objects they
think can be meaningfully grouped with it (10 stimulus objects)
o Record stimulus, objects grouped (O) and verbalization (V) verbatim
- In Passive Phase, examiner makes sorts and client has to identify whether it is a compatible or
incompatible sort, and the reason for the same

Scoring:

- Quantitative – classify into category; assign score

- Fit refers to the fit between the sort and the verbalization of the client
- Higher the score, higher the pathology, except in Adequate. Higher the score in Adequate,
higher the adequacy.
- Each response can be scored only under one type
- Common – concept is theoretically correct, based on either common use, material or
colour/form
 o Adequate – concept is common; only one concept used OR if several subconcepts used,
together they form single concept; appropriate fit
 3 – material/form/colour
 2 – functional/use-bound,
 1 – Adequate implicit – single conceptual principle is there but not expressed
clearly e.g. all are stationery items but describes them as subconcepts
o Narrow – objects sorted form only a subset of adequate group; does not indicate
significant pathology
 A) The concept is adequate, but all objects are not included (misfit)
 B) Only a subconcept of common concept e.g. pen and diary to write instead of
stationery items
 1: if only one object left out
 2: if 2 or more objects left out OR subconcept used
o Fused - several concepts are combined
 A) Multiple subconcepts, from different common concepts are combined
together
 B) Common concepts/subconcepts are combined with impoverished/peculiar
concepts/subconcepts. Common concepts > impoverished/peculiar.
 4: objects derived from 3 or more different concepts/subconcepts
 3: objects from 2 relatively unrelated concepts
 2: objects from 2 relatively related categories (e.g. stationery and
postage) OR 2 objects added to otherwise adequate sort. If person says
related based on colour/form, can give a 2 – don’t automatically
consider related if two categories are both based on colour, for
example.
 1: only 1 object added to otherwise adequate sort, additional object not
being totally unrelated or far-fetched
 C) Overwide concepts that deal with use
 4: all objects included (all are useful)
 3: e.g. used by men - cigarette for smoking, diary for writing.
 2: used by school children (more specific)
 1: if sort includes objects specifically used by these groups (stereotyped)
- Impoverished – characterized by a poverty of associations. Reason for sorting appears trivial
and inconsequential. Enquiry is important. Akin to concrete thinking but not exactly as it is
distinguished from both common and peculiar responses.
o More common in people with schizophrenia than mania – corresponds to negative
symptoms/negative thought disorder/poverty of content of speech
o May be related to lower levels of education
o The greater the triviality and purposelessness of grouping, the greater the score
 4: absolutely inconsequential or purposeless e.g. cloth can cover ball
 3: lack of purpose not that glaring e.g. small items in plate so they don’t get lost
  2: relatively common use of an object is identified and sticks to that use despite
other possibilities being present e.g. cloth to wipe glass and plate
 1: when the objects placed together frequently occur together in context e.g.
plate can cover glass to prevent dust
- Peculiar – unrealistic use of objects in far-fetched or peculiar circumstances. Unusual, peculiar
and bizarre associations rather than poverty of associations. May occur when sort is adequate,
but peculiar verbalization.
o When an extraordinary or dramatic concept is mentioned
o Verbalization with alternatives/substitutes/different possibilities/conditionals
o Based purely on personal/idiosyncratic significance e.g. I like these objects; personal
flavor added to common use e.g. postage items to write a love letter
o Deeper symbolical or emotional significance is unnecessarily and inappropriately
ascribed
o Fit/misfit are difficult to determine
o Singular
 A) Responses with single peculiar concepts
 4: explanation is bizarre or extremely unusual/far-fetched
 3: Deviant but not bizarre e.g. I like them, they are pretty
 2: suggested relationship is within the realm of possibility and
experience e.g. bangles to decorate the doll
 1: suggested relationship is possible and relatively common, but ignores
more usual or accurate relationships e.g. penknife can break seal of
bottle
 B) Ascribing deeper significance that is idiosyncratic or unwarranted
(symbolism)
 4: symbolism is extremely unusual or unshared
 3
 2
 1
o Disjointed
 A) 2 or more concepts combined, at least one of which is peculiar; relationship
between concepts is difficult to understand
 4: 2 or more peculiar concepts; common concept combined with a
peculiar that receives a score of >=2
 3: common concept combined with peculiar concept that receives
score of 1
 B) Object or objects elicits associations that are at best tangentially related to
it and unwarranted to task requirements; not mere comments. Score of 4, 3
and 2 depending on number of irrelevant details, degree of relatedness of
objects in question and extent of disconnection between statements.
- Rejected stimuli
 o Inability to arrive at concept and hence concrete responses (Goldstein)
o However, clarification needs to be done as to reason for rejection and score ascribed
accordingly e.g. these are not same shade of red = narrow
o If client doesn’t explain, may be due to defensiveness or inadequate motivation
- Scoring (Passive Phase)
o Passive-compatible sorts
 A category (material/colour/form) correctly identified: Adequate 2 score
 B category (use) correctly identified: Adequate 1 score
 Pathological groups manifest greater inadequacy on A category sorts than B
category
 Failure Scores (doesn’t identify principle, says it is incompatible)
 A category sorts: 1
 B category sorts: 2
 If identifies wrong principle, score it under appropriate heading
o Passive Incompatible
 States sort is incompatible/does not state a principle Score under Adequate
type
 Attempts an explanation (Scored as Fused, Impoverished, Singular, Disjointed)
- Computation
o If rejections > 40%, validity is questionable
o Total active pathological, total passive pathological, total pathological (severity of
thought deviance)
o Total fused, impoverished, singular and disjointed in each phase (pattern of thought
deviance)

Interpretation

- Prorate scores
- Calculate Total Singular & Total Disjointed (both phases); Add for Total Peculiar
- Calculate Total Fused and Impoverished combined
- Gross Adequate Scores (Adequacy – Failure Scores)
- Cumulative Active & Cumulative Passive (for pathological); Add for Grand total
- Convert Raw score to Weighted score and interpret according to SD
- There are criteria to identify schizophrenia/mania
o Where MDD is ruled out (any 2/5)
o Where MDD cannot be ruled out
 Identifies 62% schizophrenia/mania, 10% of depressives, 5% of neurotics and
normals as thought deviant (78% accuracy)
o Discriminating between schizophrenia and mania
 Schizophrenia – higher fused and impoverished scores combined and separately
 Discriminations may be statistically significant but not clinically visible
- Total absence of education impacts scores. Healthy people who tend to get thought-deviant
scores are more likely to be non-literate. Those with diagnosis who do not get thought-deviance
scores tend to be more likely to be asymptomatic at time of testing.
- Qualitative Interpretations can be with reference to:
o Cultural significance
o Body language: Person is restless – distractibility/demotivated; person is slow –
depression, negative symptoms of schizophrenia
o Emotional tone
o Comments made by person
o Value system
o Change in responses over time