[image omitted] Depression, Cognition, and Self-Appraisal of Functional Abilities in HIV: An Examination of Subjective Appraisal Versus Objective Performance

Author: Thames April   Becker Brian   Marcotte Thomas   Hines Lindsay   Foley Jessica   Ramezani Amir   Singer Elyse   Castellon Steven   Heaton Robert   Hinkin Charles  

Publisher: Routledge Ltd

ISSN: 1385-4046

Source: The Clinical Neuropsychologist (Neuropsychology, Development and Cognition: Sec, Vol.25, Iss.2, 2011-02, pp. : 224-243

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Abstract

Depression frequently co-occurs with HIV infection and can result in self-reported overestimates of cognitive deficits. Conversely, genuine cognitive dysfunction can lead to an under-appreciation of cognitive deficits. The degree to which depression and cognition influence self-report of capacity for instrumental activities of daily living (IADLs) requires further investigation. This study examined the effects of depression and cognitive deficits on self-appraisal of functional competence among 107 HIV-infected adults. As hypothesized, higher levels of depression were found among those who over-reported problems in medication management, driving, and cognition when compared to those who under-reported or provided accurate self-assessments. In contrast, genuine cognitive dysfunction was predictive of under-reporting of functional deficits. Together, these results suggest that over-reliance on self-reported functional status poses risk for error when diagnoses require documentation of both cognitive impairment and associated functional disability in everyday life.

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