Actual versus Self-reported Cognitive Dysfunction in HIV-1 Infection: Memory-Metamemory Dissociations

• Published in: Journal of clinical and experimental neuropsychology 1996-06, Vol.18 (3), p.431-443
• Main Authors: Hinkin, Charles H., van Gorp, Wilfred G., Satz, Paul, Marcotte, Thomas, Durvasula, Ramani S., Wood, Stacey, Campbell, Lionel, Baluda, Marc R.
• Format: Article
• Language: English
• Subjects: Acquired Immunodeficiency Syndrome - psychology; Adult; AIDS/HIV; Cognition - physiology; Female; HIV-1 - physiology; Humans; Male; Memory - physiology; Middle Aged; Neuropsychological Tests; Self-Assessment
• ISSN: 1380-3395; 1744-411X
• DOI: 10.1080/01688639608408999

The relationship between subjective awareness and objective neuropsychological status in HIV-1 infection remains unclear. Forty-six HIV-1 seropositive males were administered a battery of neuropsychological measures assessing episodic memory, metacognition, and depression. Results of ANOVA revealed a dissociation between subjects' self-complaint of neuropsychological impairment and objective performance, with subjects who denied cognitive impairment performing worse on memory testing. Three subgroups were identified: A group whose self-reported cognitive impairment exceeded deficits demonstrated on memory testing (37% of subjects); a group who denied impairment but evidenced deficits on memory testing (26% of subjects); and a group whose self-appraisal was consistent with performance (37% of subjects). These data suggest that self-report of cognitive dysfunction among HIV-1 infected subjects is frequently at variance with objective neuropsychological testing and that diminished awareness of decline among medically symptomatic HIV-1 infected subjects can be identified.