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"Do I Have a Memory Problem? I Can't Recall": An Evaluation of Measurement Invariance in Subjective Reporting of Memory Symptoms among Persons with and without Objective HIV-Associated Memory Impairment. J Int Neuropsychol Soc 2022; 28:166-176. [PMID: 33952370 PMCID: PMC9011384 DOI: 10.1017/s1355617721000448] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Memory symptoms and objective impairment are common in HIV disease and are associated with disability. A paradoxical issue is that objective episodic memory failures can interfere with accurate recall of memory symptoms. The present study assessed whether responses on a self-report scale of memory symptoms demonstrate measurement invariance in persons with and without objective HIV-associated memory impairment. METHOD In total, 505 persons with HIV completed the Prospective and Retrospective Memory Questionnaire (PRMQ). Objective memory impairment (n = 141) was determined using a 1-SD cutoff on clinical tests of episodic memory. PRMQ measurement invariance was assessed by confirmatory factor analyses examining a one-factor model with increasing cross-group equality constraints imposed on factor loadings and item thresholds (i.e., configural, weak, and strong invariance). RESULTS Configural model fit indicated that identical items measured a one-factor model for both groups. Comparison to the weak model indicated that factor loadings were equivalent across groups. However, there was evidence of partial strong invariance, with two PRMQ item thresholds differing across memory impairment groups. Post hoc analyses using a 1.5-SD memory impairment cutoff (n = 77) revealed both partial weak and partial strong invariance, such that PRMQ item loadings differed across memory groups for three items. CONCLUSIONS The PRMQ demonstrated a robust factor structure among persons with and without objective HIV-associated memory impairment. However, on select PRMQ items, individuals with memory impairment reported observed scores that were relatively higher than their latent score, while items were more strongly associated with the memory factor in a group with greater memory impairment.
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Matchanova A, Babicz MA, Johnson B, Loft S, Morgan EE, Woods SP. Prospective memory and spontaneous compensatory mnemonic strategy use in the laboratory and daily life in HIV-associated neurocognitive disorders. J Clin Exp Neuropsychol 2020; 42:952-964. [PMID: 33043812 DOI: 10.1080/13803395.2020.1828835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Older adults with HIV-associated neurocognitive disorders (HAND) are at high risk for deficits in the resource-demanding, strategic aspects of prospective memory (PM) that can adversely affect health outcomes. This study examined the frequency and correlates of spontaneous compensatory strategy use during a laboratory-based PM task and its associations with the use of mnemonic strategies in daily life. METHOD Participants included 53 older adults with HAND, 89 older persons with HIV without HAND, and 62 seronegatives who completed the Cambridge Prospective Memory Test (CAMPROMPT), on which the type, frequency, and quality of their compensatory strategy use was quantified. Participants also completed self-report measures of PM symptoms and the frequency of mnemonic compensatory strategy use in daily life. RESULT There were no significant group-level effects on strategy use during the CAMPROMPT. Persons with HAND had moderately lower time-, but not event-based PM scores. Higher compensatory strategy use was strongly associated with better PM, particularly for time-based cues. Moreover, higher compensatory strategy use on the CAMPROMPT was associated with more frequent general mnemonic strategy use in daily life, and specifically with more frequent use of internal PM strategies (e.g., visualization) for medication adherence. CONCLUSION Spontaneous compensatory mnemonic strategy use can support PM performance among older adults with HAND in the laboratory. Strategy use in the laboratory may be a marker for the extent to which older adults with HAND use other compensatory strategies to support memory in their daily life. Future studies may examine whether compensatory mnemonic strategies can be taught and used to support PM in the daily lives of older persons with HIV disease.
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Affiliation(s)
| | | | - Briana Johnson
- Department of Psychology, University of Houston , Houston, TX, USA
| | - Shayne Loft
- School of Psychological Science, University of Western Australia , Perth, Australia
| | - Erin E Morgan
- Department of Psychiatry, University of California , San Diego, CA, USA
| | - Steven Paul Woods
- Department of Psychology, University of Houston , Houston, TX, USA.,School of Psychological Science, University of Western Australia , Perth, Australia
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Woods SP, Morgan EE, Loft S, Matchanova A, Verduzco M, Cushman C. Supporting strategic processes can improve time-based prospective memory in the laboratory among older adults with HIV disease. Neuropsychology 2019; 34:249-263. [PMID: 31789564 DOI: 10.1037/neu0000602] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Older adults with HIV disease demonstrate moderate deficits in time-based prospective memory (PM), which is the strategically demanding ability of remembering to perform a task at a specific time. Using theories from the PM literature, we hypothesized that supporting strategic processes would improve time-based PM in the laboratory among HIV+ older adults. METHOD One hundred forty-five HIV+ participants were randomly assigned to a control condition or an experimental group in which strategic processing was supported at encoding (i.e., implementation intentions and visualization), monitoring (i.e., content-free cuing), and/or cue detection (i.e., auditory alarm). The HIV+ control group and 58 seronegative participants completed two ongoing language tasks with a time-based PM requirement. The HIV+ experimental groups underwent counterbalanced time-based PM trials under both control and strategically supported conditions. RESULTS The HIV+ cue-detection group showed a large within-subjects improvement, which was strongly related to lower scores on separate clinical time-based PM measure and was accompanied by a large reduction in clock-checking behavior. Results also revealed a small within-subjects improvement in time-based PM in the encoding condition. CONCLUSIONS Supporting strategic encoding and cue-detection processes in the laboratory can improve time-based PM deficits in older HIV+ adults, which may inform the development of more naturalistic PM-based interventions to enhance health behaviors. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | - Erin E Morgan
- Department of Psychiatry, University of California, San Diego
| | - Shayne Loft
- School of Psychological Science, University of Western Australia
| | | | | | - Clint Cushman
- Department of Psychiatry, University of California, San Diego
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Sheppard DP, Matchanova A, Sullivan KL, Kazimi SI, Woods SP. Prospective memory partially mediates the association between aging and everyday functioning. Clin Neuropsychol 2019; 34:755-774. [PMID: 31304859 DOI: 10.1080/13854046.2019.1637461] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective: Older adults commonly experience declines in everyday functioning, the reasons for which are multifactorial. Prospective memory (PM), or remembering to carry out intended actions, can be an executively demanding cognitive process that declines with older age and is independently associated with a variety of everyday functions (e.g. taking medication). This study examined the hypothesis that PM mediates the relationship between older age and poorer everyday functioning.Method: A total of 468 community-dwelling adults (ages 18-75) with a range of medical comorbidities (e.g. viral infection) were classified as dependent on four well-validated measures of manifest everyday functioning: activities of daily living, employment status, the Karnofsky Scale of Performance Status, and self-reported cognitive symptoms. Participants completed the Memory for Intentions Test (MIsT) to measure PM, alongside clinical tests of executive functions and retrospective memory.Results: Controlling for education and comorbidities, bootstrap analysis revealed a significant direct effect of age on everyday functioning and a significant mediated effect of age on everyday functioning through the indirect effect of time-based b = .006 [.003, .010] and event-based PM (b = .005, [.002, .009]), as well as slightly smaller effects for executive functions (b = .003, [.001, .005]) and retrospective memory (b = .002, [.001, .005]).Conclusions: These cross-sectional data suggest that executively demanding aspects of declarative memory play an important partial mediating role between an individual factor (i.e. age) and daily life activities, and highlight the possible benefit of targeting PM for improving everyday functioning in older adults.
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Affiliation(s)
- David P Sheppard
- Department of Psychology, University of Houston, Houston, TX, USA
| | | | - Kelli L Sullivan
- Department of Psychology, University of Houston, Houston, TX, USA
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Pennar A, Naar S, Woods S, Nichols S, Outlaw A, Ellis D. Promoting resilience through neurocognitive functioning in youth living with HIV. AIDS Care 2019; 30:59-64. [PMID: 30714388 DOI: 10.1080/09540121.2019.1576851] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Using a phased model of intervention development, we developed an intervention to promote resilience in youth living with HIV via improved neurocognitive resources. First, youth completed a naturalistic prospective memory (PM) task and were randomized into a visualization condition or control condition. Next, 47 of these participants completed another naturalistic PM task and were randomized into Calendaring condition, an Alarm condition, a Combined condition, or a Control condition. Youth with low PM demonstrated observable gains from the visualization technique. Youth in the Combined Calendaring and Alarm condition demonstrated significantly better performance than participants in the Control and Calendaring conditions. In a Proof-of-Concept study with 16 youth, the previous findings were translated into a single session in-person intervention followed by tailored text messaging to improve adherence and viral load via improved neurocognitive resources. The resulting intervention showed a signal of effect with viral load reductions in youth with available data. Targeting compensatory strategies to enhance neurocognitive functioning may promote resilience and health outcomes. A randomized pilot study with a control condition is the next step.
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Affiliation(s)
- Amy Pennar
- a Center for Translational Behavioral Science , Florida State University , Tallahassee , FL , USA
| | - Sylvie Naar
- a Center for Translational Behavioral Science , Florida State University , Tallahassee , FL , USA
| | - Steven Woods
- b Department of Psychology , University of Houston , Houston , TX , USA.,c Department of Psychiatry , University of California , San Diego , CA , USA
| | - Sharon Nichols
- d Department of Neurosciences , University of California , San Diego , CA , USA
| | - Angulique Outlaw
- e Department of Family Medicine and Public Health Sciences , Wayne State University , Detroit , MI , USA
| | - Deborah Ellis
- e Department of Family Medicine and Public Health Sciences , Wayne State University , Detroit , MI , USA
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Faytell MP, Doyle KL, Naar-King S, Outlaw AY, Nichols SL, Twamley EW, Woods SP. Calendaring and alarms can improve naturalistic time-based prospective memory for youth infected with HIV. Neuropsychol Rehabil 2018; 28:1038-1051. [PMID: 27687290 PMCID: PMC5374028 DOI: 10.1080/09602011.2016.1236733] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Individuals with HIV disease often evidence deficits in prospective memory (PM), which interfere with daily functioning and increase the risk of suboptimal health behaviours. This study examined the benefits of simple encoding and cueing supports on naturalistic time-based PM in 47 HIV-positive young adults. All participants completed a naturalistic time-based PM task in which they were instructed to text the examiner once per day for seven days at a specified time. Participants were randomised into (1) a Calendaring condition in which they created a calendar event in their mobile telephone for the specified texting time; (2) an Alarm condition in which they programmed an alarm into their mobile telephone for the specified texting time; (3) a Combined calendaring and alarm condition; and (4) a Control condition. Participants in the Combined condition demonstrated significantly better naturalistic PM performance than participants in the Control and Calendaring conditions. Findings indicate that HIV-positive young people may benefit from a combined calendaring and alarm supportive strategy for successful execution of future intentions in daily life.
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Affiliation(s)
| | - Katie L. Doyle
- Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California, San Diego, USA
| | - Sylvie Naar-King
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, USA
| | - Angulique Y. Outlaw
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, USA
| | - Sharon L. Nichols
- Department of Neurosciences, University of California, San Diego, CA, USA
| | - Elizabeth W. Twamley
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Steven Paul Woods
- Department of Psychology, University of Houston, Houston, U SA
- Department of Psychiatry, University of California, San Diego, CA, USA
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Pennar A, Naar S, Woods S, Nichols S, Outlaw A, Ellis D. Promoting resilience through neurocognitive functioning in youth living with HIV. AIDS Care 2018. [DOI: https:/doi:10.1080/09540121.2019.1576851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Amy Pennar
- Center for Translational Behavioral Science, Florida State University, Tallahassee, FL, USA
| | - Sylvie Naar
- Center for Translational Behavioral Science, Florida State University, Tallahassee, FL, USA
| | - Steven Woods
- Department of Psychology, University of Houston, Houston, TX, USA
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Sharon Nichols
- Department of Neurosciences, University of California, San Diego, CA, USA
| | - Angulique Outlaw
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, USA
| | - Deborah Ellis
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, USA
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Faytell MP, Doyle KL, Naar-King S, Outlaw AY, Nichols SL, Casaletto KB, Woods SP. Visualisation of future task performance improves naturalistic prospective memory for some younger adults living with HIV disease. Neuropsychol Rehabil 2017; 27:1142-1155. [PMID: 26690580 PMCID: PMC4916011 DOI: 10.1080/09602011.2015.1122636] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Human immunodeficiency virus (HIV) disease is commonly associated with deficits in prospective memory (PM), which increase the risk of suboptimal health behaviours, like medication non-adherence. This study examined the potential benefits of a brief future visualisation exercise during the encoding stage of a naturalistic PM task in 60 young adults (aged 19-24 years) with HIV disease. Participants were administered a brief clinical neuropsychological assessment, which included a standardised performance-based measure of time- and event-based PM. All participants were also given a naturalistic PM task in which they were asked to complete a mock medication management task when the examiner showed them the Grooved Pegboard Test during their neuropsychological evaluation. Participants were randomised into: (1) a visualisation condition in which they spent 30 sec imagining successfully completing the naturalistic PM task; or (2) a control condition in which they repeated the task instructions. Logistic regression analyses revealed significant interactions between clinical neurocognitive functions and visualisation. HIV positive (HIV+) participants with intact retrospective learning and/or low time-based PM demonstrated observable gains from the visualisation technique, while HIV+ participants with impaired learning and/or intact time-based PM did not evidence gains. Findings indicate that individual differences in neurocognitive ability moderate the response to visualisation in HIV+ young adults. The extent to which such cognitive supports improve health-related PM outcomes (e.g., medication adherence) remains to be determined.
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Affiliation(s)
| | - Katie L. Doyle
- Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California, San Diego, USA
| | - Sylvie Naar-King
- Department of Pediatrics, Wayne State University, Detroit, MI, USA
| | | | - Sharon L. Nichols
- Department of Neurosciences, University of California, San Diego, CA, USA
| | - Kaitlin B. Casaletto
- Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California, San Diego, USA
| | - Steven Paul Woods
- Department of Psychology, University of Houston, Houston, USA
- Department of Psychiatry, University of California, San Diego, CA, USA
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9
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Mama Y, Icht M. Production on hold: delaying vocal production enhances the production effect in free recall. Memory 2017; 26:589-602. [PMID: 28974150 DOI: 10.1080/09658211.2017.1384496] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The Production Effect (PE) represents superior memory for produced (read aloud) relative to non-produced (silently read) items. Another method of improving memory is taking a test on the study material - the Testing Effect. We evaluated the combined influence of both effects on free recall memory, using delayed vocal production, in which study words were vocally produced only after their disappearance. Such procedure involves an initial instant test since participants had to vocally retrieve the words (rather than read them aloud). In five experiments, participants were presented with study words that they were instructed to learn by no-production (reading silently), immediate production (reading aloud), delayed reading aloud, or delayed vocal production (instant retrieval). The results showed superior recall for delayed production over all other conditions. We suggest that the source of this superiority is the desirable difficulty induced by the addition of the initial test (retrieval effort) to the vocal production. The novel delayed production condition forms a superior mnemonic.
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Affiliation(s)
- Yaniv Mama
- a Department of Behavioral Science and Psychology , Ariel University , Ariel , Israel
| | - Michal Icht
- a Department of Behavioral Science and Psychology , Ariel University , Ariel , Israel.,b Department of Communication Disorders , Ariel University , Ariel , Israel
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Avci G, Sheppard DP, Tierney SM, Kordovski VM, Sullivan KL, Woods SP. A systematic review of prospective memory in HIV disease: from the laboratory to daily life. Clin Neuropsychol 2017; 32:858-890. [PMID: 28950745 DOI: 10.1080/13854046.2017.1373860] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Prospective memory (PM) is described as the capacity to form and maintain an intention that is executed in response to a specific cue. Neural injury and associated neurocognitive disorders are common among persons living with HIV disease, who might therefore be susceptible to impairment in PM. METHOD This literature review utilized a structured qualitative approach to summarize and evaluate our current understanding of PM functioning in people living with HIV disease. 33 studies of PM in HIV+ persons met criteria for inclusion. RESULTS Findings showed that HIV is associated with moderate deficits in PM, which appear to be largely independent of commonly observed comorbid factors. The pattern of PM deficits reveals dysregulation of strategic processes that is consistent with the frontal systems pathology and associated executive dysfunction that characterizes HIV-associated neural injury. The literature also suggests that HIV-associated PM deficits present a strong risk of concurrent problems in a wide range of health behaviors (e.g. medication non-adherence) and activities of daily living (e.g. employment). Early attempts to improve PM in HIV disease have revealed that supporting strategic processes might be effective for some individuals. CONCLUSIONS HIV-associated PM deficits are common and exert a significant adverse effect on the daily lives and health of infected persons. Much work remains to be done to understand the cognitive architecture of HIV-associated PM deficits and the most efficient means to enhance PM functioning and improve health outcomes in persons living with HIV.
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Affiliation(s)
- Gunes Avci
- a Department of Psychology , University of Houston , Houston , TX , USA
| | - David P Sheppard
- a Department of Psychology , University of Houston , Houston , TX , USA
| | - Savanna M Tierney
- a Department of Psychology , University of Houston , Houston , TX , USA
| | | | - Kelli L Sullivan
- a Department of Psychology , University of Houston , Houston , TX , USA
| | - Steven Paul Woods
- a Department of Psychology , University of Houston , Houston , TX , USA
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Harris LL, Chernoff MC, Nichols SL, Williams PL, Garvie PA, Yildirim C, McCauley SR, Woods SP. Prospective memory in youth with perinatally-acquired HIV infection. Child Neuropsychol 2017; 24:938-958. [PMID: 28782457 DOI: 10.1080/09297049.2017.1360854] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Youth with perinatal HIV infection (PHIV) are at increased risk for neurocognitive impairment (NCI). Prospective memory (PM) is a complex neurocognitive function that has been shown to be impaired in adults with HIV disease and independently associated with poorer daily living skills, including medication nonadherence. The current study sought to determine the presence and extent of PM deficits in youth with PHIV. Participants included 173 youth with PHIV and 85 youth perinatally HIV-exposed but uninfected (PHEU), mean age 14.1 years, 75% black, 18% Hispanic. Among youth with PHIV, 26% had a past AIDS-defining condition (Centers for Disease Control and Prevention [CDC], Class C), 74% did not (non-C). Adjusted generalized estimating equation models were used to compare groups (PHIV/C, PHIV/non-C, and PHEU) on the Naturalistic Event-Based Prospective Memory Test (NEPT) and the Prospective Memory Assessment for Children & Youth (PROMACY). Secondarily, subgroups defined by HIV serostatus and global NCI were compared (PHIV/NCI, PHIV/non-NCI, PHEU). PHIV/C had significantly lower NEPT scores than PHEU, with decreases of 40% in mean scores, but did not differ from PHIV/non-C. PHIV/NCI had 11-32% lower PROMACY scores and 33% lower NEPT scores compared to PHIV/non-NCI (all p < .05); significantly, lower scores for PHIV/NCI versus PHEU also were observed for PROMACY and NEPT indices. Findings suggest a subset of youth with PHIV (those with a prior AIDS-defining diagnosis) is vulnerable to PM deficits. The extent to which PM deficits interfere with development and maintenance of independent living and health-related behaviors during transition to adulthood requires further study.
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Affiliation(s)
- Lynnette L Harris
- a Department of Pediatrics , Baylor College of Medicine , Houston , TX , USA
| | - Miriam C Chernoff
- b Center for Biostatistics in AIDS Research , Harvard T.H. Chan School of Public Health , Boston , MA , USA
| | - Sharon L Nichols
- c Department of Neurosciences , University of California , San Diego , CA , USA
| | - Paige L Williams
- d Center for Biostatistics in AIDS Research & Department of Biostatistics , Harvard T.H. Chan School of Public Health , Boston , MA , USA
| | - Patricia A Garvie
- e Research Department , Children's Diagnostic & Treatment Center , Fort Lauderdale , FL , USA
| | - Cenk Yildirim
- b Center for Biostatistics in AIDS Research , Harvard T.H. Chan School of Public Health , Boston , MA , USA
| | - Stephen R McCauley
- f Departments of Physical Medicine & Rehabilitation, Neurology, and Pediatrics, Baylor College of Medicine , Michael E. DeBakey VA Medical Center , Houston , TX , USA
| | - Steven Paul Woods
- c Department of Neurosciences , University of California , San Diego , CA , USA.,g Department of Psychology , University of Houston , Houston , TX , USA
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McFarland CP, Clark JB, Lee LO, Grande LJ, Marx BP, Vasterling JJ. Event-based prospective memory among veterans: The role of posttraumatic stress disorder symptom severity in executing intentions. J Clin Exp Neuropsychol 2015; 38:251-60. [DOI: 10.1080/13803395.2015.1102203] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Casaletto KB, Doyle KL, Weber E, Woods SP. Self-predictions of prospective memory in HIV-associated neurocognitive disorders: evidence of a metamemory deficit. Arch Clin Neuropsychol 2015; 29:818-27. [PMID: 25404005 DOI: 10.1093/arclin/acu061] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
HIV-associated neurocognitive disorders (HAND) are associated with deficits in prospective memory (PM; "remembering to remember"), conferring risk of daily functioning declines. However, self-perceptions of PM functioning are not reliably associated with PM performance in HIV, suggesting a possible deficit in awareness of PM abilities (meta-PM). Our study examined meta-PM in HAND and its correlates using self-predictions of laboratory-based PM performance. Performance-based PM abilities, self-reported prediction of PM performance, and PM complaints in everyday life were assessed in 49 individuals with HAND, 93 HIV+ without HAND (HIV+ noHAND), and 121 seronegative adults (HIV-). After controlling for group-level differences, HAND was associated with a greater number of PM symptoms in everyday life and worse PM performance when compared with both HIV+ noHAND and HIV- samples. Although HAND individuals reported somewhat lower predictions regarding their laboratory PM performance relative to the other study groups, they nevertheless exhibited significantly greater inaccurate overconfidence in time-based PM abilities. Within the HAND group, overconfidence in time-based meta-PM was associated with executive dysfunction and antiretroviral (ARV) nonadherence. HAND individuals evidenced a moderate deficit in awareness of PM functioning characterized by overconfidence in time-based PM abilities. Overconfidence in PM may result in absence of compensatory strategy use, and lead to increased errors in daily functioning (e.g., ARV nonadherence).
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Affiliation(s)
| | - Katie L Doyle
- SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego 92103, CA, USA
| | - Erica Weber
- SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego 92103, CA, USA
| | - Steven Paul Woods
- Department of Psychiatry, University of California, San Diego, La Jolla 92093, CA, USA Department of Psychology, University of Houston, Houston 77204, TX, USA
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Doyle KL, Weber E, Morgan EE, Loft S, Cushman C, Villalobos J, Johnston E, Woods SP. Habitual prospective memory in HIV disease. Neuropsychology 2015; 29:909-918. [PMID: 25730731 DOI: 10.1037/neu0000180] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE HIV-associated neurocognitive disorders (HAND) are associated with deficits in prospective memory (PM). However, most PM research in HIV has used single-event tasks as opposed to habitual PM paradigms, which may be more relevant to clinical populations for whom many health-care behaviors must be performed both frequently and routinely. METHOD For the current study, we examined habitual PM and its associations with real-world functioning outcomes in 36 HIV+ individuals with HAND (HAND+), 70 HIV+ individuals without HAND (HAND-), and 115 HIV- individuals. The ongoing task consisted of 24 1-min Stroop trial blocks in which the emotive and cognitive load was manipulated. The habitual PM task required participants to press the spacebar once per block, but only after 20 s had elapsed. RESULTS A series of MANOVAs covarying for relevant clinicodemographic factors revealed a main effect of study group on habitual PM, such that the HAND+ cohort made significantly more repetition errors than the HIV- and HAND- groups, particularly during early trial blocks. There was no main effect of ongoing task demands, nor was there an interaction between HAND group and task demands. Within the entire HIV+ sample, poorer habitual PM was associated with deficits in learning and dysfunction in real-world outcomes, including medication nonadherence and failures on a naturalistic health-care task. CONCLUSION Findings indicate that HAND may be associated with deficient internal source monitoring or temporal discrimination for habitual PM output that may play a critical role in real-world functioning, including HIV disease management.
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Affiliation(s)
| | - Erica Weber
- Joint Doctoral Program in Clinical Psychology
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