Ahoo Karimian

Abstract

Within the United States, HIV is a growing epidemic that has important neuropsychological and functional consequences. Early detection and treatment of HIV-associated neurocognitive disorder (HAND) is associated with better outcomes. In major metropolitan areas such Los Angeles County, HIV disproportionately impacts the Latino community. For those individuals who are primarily Spanish-speakers, there may be limited access to comprehensive neuropsychological assessment in the preferred language. Consequently, self-reports of cognitive functioning are often relied on to help determine the presence of HAND. However, self-reports of cognitive decline may be influenced by factors such as depressed mood, variable motivation, and culture, raising important validity questions. To date, relatively few studies have focused on the combined use of Spanish-language, self-report measures of cognitive functioning and mood among primarily Spanish-speaking, HIV-positive individuals. The aim of this study was to explore the relationships among self-reported cognitive decline, neuropsychological functioning, and mood symptoms within this population. Archival data from a sample of 100 HIV+, primarily Spanish-speaking adults who participated in the parent study at a major medical center in Los Angeles were examined. Measures included Spanish-language versions of the Beck Depression Inventory, Cognitive Difficulties Scale- Patient Version, Medical Outcomes HIV Health Survey, and an acculturation measure. An array of neuropsychological measures was used to determine the presence of HAND. It was predicted that depressive symptoms would be positively associated with self-reported cognitive decline. This hypothesis was strongly supported by the results of correlational analysis. The results also showed that for individuals with HAND, the difference in BDI scores between participants with cognitive complaints and those without varied depending on whether the MOS-HIV or the CDS was used to assess cognitive complaints. The analyses revealed no significant impact of acculturation on the relationships among cognitive complaints, neuropsychological functioning, and depressive symptoms. The results of the present study highlight the complex relationship between neuropsychiatric and neuropsychological functioning in Spanish-speaking individuals infected with HIV. Clinical implications and limitations of the study are addressed. Future research that incorporates objective measures of neuropsychological functioning, the input of collateral informants, and self-report measures of mood and functional decline is recommended.

Library of Congress Subject Headings

Dissertations (PsyD) -- Psychology; HIV-positive persons -- California -- Los Angeles; HIV infections -- Complications; Clinical neuropsychology; Hispanic Americans -- Mental health

Date of Award

2016

School Affiliation

Graduate School of Education and Psychology

Department/Program

Psychology

Degree Type

Dissertation

Degree Name

Doctorate

Faculty Advisor

Mitchell, Cary;

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