title: Diagnosing symptomatic HIV-associated neurocognitive disorders: self-report versus performance-based assessment of everyday functioning.
abstract: Three types of HIV-associated neurocognitive disorders (HAND) exist that are distinguished by presence and severity of impairment in cognitive and everyday functioning. Although well-validated neurocognitive measures exist, determining impairment in everyday functioning remains a challenge. We aim to determine whether Self-Report measures of everyday functioning are as effective in characterizing HAND as Performance-Based measures. We assessed 674 HIV-infected participants with a comprehensive neurocognitive battery; 233 met criteria for a HAND diagnosis by having at least mild neurocognitive impairment. Functional decline was measured via Self-Report and Performance-Based measures. HAND diagnoses were determined according to published criteria using three approaches to assess functional decline: (1) Self-Report measures only, (2) Performance-Based measures only, and (3) Dual-method combining Self-Report and Performance-Based measures. The Dual-method classified the most symptomatic HAND, compared to either singular method. Singular method classifications were 76% concordant with each other. Participants classified as Performance-Based functionally impaired were more likely to be unemployed and more immunosuppressed, whereas those classified as Self-Report functionally impaired had more depressive symptoms. Multimodal methods of assessing everyday functioning facilitate detection of symptomatic HAND. Singular Performance-Based classifications were associated with objective functional and disease-related factors; reliance on Self-Report classifications may be biased by depressive symptoms.
authors: San Diego State University/University of California-San Diego Joint Doctoral Program in Clinical Psychology; CA, USA.
authors: K
authors: K
authors: Blackstone
authors: D J
authors: DJ
authors: Moore
authors: R K
authors: RK
authors: Heaton
authors: D R
authors: DR
authors: Franklin
authors: S P
authors: SP
authors: Woods
authors: D B
authors: DB
authors: Clifford
authors: A C
authors: AC
authors: Collier
authors: C M
authors: CM
authors: Marra
authors: B B
authors: BB
authors: Gelman
authors: J C
authors: JC
authors: McArthur
authors: S
authors: S
authors: Morgello
authors: D M
authors: DM
authors: Simpson
authors: M
authors: M
authors: Rivera-Mindt
authors: R
authors: R
authors: Deutsch
authors: R J
authors: RJ
authors: Ellis
authors: J
authors: J
authors: Hampton Atkinson
authors: I
authors: I
authors: Grant
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology* / Q000821:virology; D015331:Cohort Studies; D003863:Depression / Q000209:etiology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis; D015707:HN Protein / Q000378:metabolism; D006801:Humans; D007124:Immunoenzyme Techniques; D018950:Lipopolysaccharide Receptors / Q000378:metabolism; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D057566:Self Report; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D055815:Young Adult
chemical_list: D015707:HN Protein; D018950:Lipopolysaccharide Receptors