Subjective cognitive complaints in HIV infection: Utility in predicting neuropsychological deficits.

The main objective of this retrospective study was to clarify the nature of the relationship between subjective cognitive complaints and actual neuropsychological skills in HIV-infected individuals. The sample consisted of 156 HIV-positive adults (148 men; 8 women), of whom 18 were asymptomatic (CDC-A), 61 were mildly symptomatic (CDC-B), and 76 had AIDS-defining illnesses or CD4 counts less than 200 (CDC-C). Neuropsychological functioning was assessed by clinical ratings based on neuropsychological test performance. In Part One of the study, the interrelationships among variables affecting cognitive complaints were examined using a structural equation model. Cognitive complaints independently predicted poorer neuropsychological performance, despite the influence of depressed mood and systemic illness on cognitive complaints. In Part Two, the utility of specific cognitive complaints in predicting HIV-associated neuropsychological impairment was evaluated. Cognitive complaints were most strongly associated with psychomotor skills. Spatial complaints, lexical complaints, and some memory complaints significantly predicted neuropsychological impairment. In Part Three of the study, a decision tree analysis was used to develop a screening protocol for HIV-related impairment. The Symbol Digit Modalities Test was the best predictor of global neuropsychological impairment in HIV infection. When neuropsychological performance was not included in the decision tree, increased total cognitive complaints predicted neuropsychological impairment. Overall, however, cognitive complaints did not demonstrate a strong relationship with neuropsychological impairment. The implications for the predictive value of cognitive complaints and the identification of individuals at risk for HIV-associated neuropsychological impairment are discussed.Dept. of Psychology. Paper copy at Leddy Library: Theses & Major Papers - Basement, West Bldg. / Call Number: Thesis2001 .C375. Source: Dissertation Abstracts International, Volume: 63-04, Section: B, page: 2050. Adviser: Douglas Shore. Thesis (Ph.D.)--University of Windsor (Canada), 2001