title: Factors contributing to impaired self-awareness of cognitive functioning in an HIV positive and at-risk population.
abstract: OBJECTIVE
  To examine the association between self-awareness of cognitive impairment and age, selected mood disorders, and type and severity of cognitive impairment in a sample of individuals with HIV/AIDS and at risk for HIV.
  
  
  METHODS
  75 subjects, 52 HIV+ and 23 at risk for HIV completed a psychosocial interview, the Patient's Assessment of Own Functioning (PAOF) questionnaire, and a battery of neuropsychological tests. Based upon the differences between their clinical impairment and self-reported impairment, subjects were classified as being "Underestimators", "Good Awareness", or "Impaired Awareness" with regard to self-awareness.
  
  
  RESULTS
  Those with more severe cognitive impairment were less aware than those with normal or borderline cognitive impairment. A one-way ANOVA suggested that the Impaired Awareness group differed significantly from the Underestimators on the Rey Figure Immediate and Delayed Recall tasks, and from both the Underestimators and Good Awarenesss groups on the Digit Symbol Substitution Task. There were significant differences among all awareness groups on the test of Simple Reaction Time. Furthermore there is some suggestion that age may contribute to impaired self-awareness. The role of HIV in self-awareness remains unclear, as both, individuals with HIV and at risk, demonstrated impaired self-awareness.
  
  
  CONCLUSIONS
  Overall, impaired awareness was associated with poorer test performance, suggesting a relationship between awareness and sustained complex attention and visual spatial processing. This research has implications for understanding factors contributing to poor awareness among individuals with cognitive impairment.
authors.affiliation: Department of Rehabilitation Sciences and Technology, University of Pittsburgh, Pittsburgh, PA, USA. sbj7@pitt.edu
authors.forename: Shannon
authors.initials: S
authors.lastname: Juengst
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Skidmore
authors.forename: Michael
authors.initials: M
authors.lastname: Pramuka
authors.forename: Michael
authors.initials: M
authors.lastname: McCue
authors.forename: James
authors.initials: J
authors.lastname: Becker
mesh_terms: D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D001364:Awareness; D016009:Chi-Square Distribution; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology* / Q000534:rehabilitation; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000523:psychology* / Q000534:rehabilitation; D012307:Risk Factors