Using Ecological Momentary Assessment to Improve Self-Reported Cognitive Functioning among Adults with Comorbid HIV/AIDS and Heavy Alcohol Use

使用生态瞬时评估来改善患有艾滋病毒/艾滋病和酗酒的成人的自我报告认知功能

• 批准号: 9793988
• 负责人: Emily Paolillo
• 金额: $ 3.88万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2020-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9793988
• 关键词: AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Activities of Daily Living; Adult; Age; Alcohol consumption; Alcoholic beverage heavy drinker; Brain; CD4 Lymphocyte Count; Cellular Phone; Characteristics; Clinical; Cognitive; Cognitive deficits; Comorbidity; Consumption; Corpus Callosum; Data; Data Collection; Dependence; Depressed mood; Development; Diagnostic; Disease; Disease Management; Disease Progression; Early Diagnosis; Ecological momentary assessment; Education; Ethnic Origin; European; Evaluation; Frequencies; Future; Goals; HIV; HIV Infections; Health; Heavy Drinking; Impairment; Individual; Infection; International; Knowledge; Lead; Measurement; Measures; Medical; Memory Loss; Mental Depression; Methods; Monitor; Moods; Motor Skills; National Institute on Alcohol Abuse and Alcoholism; Nature; Neurocognition; Neurocognitive; Neurocognitive Deficit; Neuropsychology; Outcome; Paper; Patient Self-Report; Performance; Persons; Plasma; Population; Prevalence; Property; Psychometrics; Reporting; Research; Risk; Risk Factors; Severities; Short-Term Memory; Social Desirability; Societies; Surveys; Target Populations; Techniques; Thinness; Time; Ventricular; Viral Load result; Visuospatial; antiretroviral therapy; base; clinical care; clinical risk; cognitive ability; cognitive function; demographics; density; drinking; executive function; high risk; improved; innovation; neurocognitive disorder; neurocognitive test; neurotoxic; novel; pre-doctoral; processing speed; response; screening; sex; skills; success; therapy adherence; tool; tv watching; white matter

PROJECT SUMMARY/ABSTRACT HIV/AIDS and heavy alcohol use are highly comorbid, and the combination greatly increases the likelihood of adverse health outcomes. The neurotoxic effects of comorbid HIV and heavy alcohol use preferentially impact the corpus callosum and frontal white matter, leading to increased prevalence of neurocognitive disorders characterized by deficits in motor skills, verbal working memory, visuospatial skills, and executive functioning. Although often mild in severity, these neurocognitive impairments subsequently lead to greater risk for dependence in activities of daily living, poor HIV disease management, and accelerated HIV disease progression. Despite the significant consequences of neurocognitive impairment in this population, there is a general lack of reliable and valid tools to identify those who may be at risk for these impairments. Self-report assessments of cognitive functioning are often used to briefly assess for neurocognitive impairment in many clinical populations; however, the retrospective nature of all current measures of self-reported cognitive functioning reduces accuracy due to recall errors, social desirability effects, cognitive deficits, or state dependent bias. For example, the internationally recommended European AIDS Clinical Society (EACS) neurocognitive screening questions are retrospective and may be improved by repeated administration via ecological momentary assessment (EMA). EMA is an innovative mobile assessment method that increases ecological validity and reduces retrospective recall errors by collecting real-time, real-world data. EMA thus represents a potentially powerful technique to improve measurement of self-reported cognitive functioning and detect risk for neurocognitive impairment in high-risk clinical populations such as people with HIV who drink heavily. Accordingly, the proposed F31 dissertation project aims to: 1) evaluate psychometric properties of the EMA-administered EACS screening questions; 2) examine temporal relationships among EMA self-reported alcohol use, mood, and cognitive complaints; and 3) examine potential effects of demographics, HIV disease characteristics, and cognitive complexity of daily activities on self-reported cognitive complaints. Given the current absence of such assessment techniques in this population, results from this study will inform future development of novel mobile assessment methods to detect neurocognitive impairment in HIV and heavy alcohol use. The opportunities afforded via this F31 mechanism will significantly contribute to the applicant’s long-term goal of becoming an independent academic neuropsychologist dedicated to early detection of neurocognitive impairment among individuals with comorbid HIV infection and heavy alcohol use.

项目摘要/摘要 艾滋病毒/艾滋病和大量饮酒是高度合并的，这种组合大大增加了 不利的健康结果。合并症HIV和大量酒精使用的神经毒性作用优先影响 call体和额叶白质，导致神经认知障碍的患病率增加 以运动技能，口头工作记忆，视觉技能和执行功能定义为特征。 尽管这些神经认知障碍通常在严重程度上轻度，但随后导致更大的风险 依赖日常生活的活动，艾滋病毒疾病管理差和加速艾滋病毒疾病 进展。尽管神经认知障碍在该人群中产生了重大影响，但仍有一个 普遍缺乏可靠且有效的工具来识别可能有危害这些障碍的人。自我报告 认知功能的评估通常用于简要评估许多人的神经认知障碍 临床人群；但是，所有当前自我报告认知措施的回顾性质 功能降低由于回忆错误，社会可取效应，认知缺陷或状态而导致的准确性 依赖性偏见。例如，国际推荐的欧洲艾滋病临床学会（EACS） 神经认知筛查问题是回顾性的，可以通过重复给药来改善 生态瞬时评估（EMA）。 EMA是一种创新的移动评估方法，可增加 生态有效性并通过收集实时的现实世界数据来减少回顾性回忆错误。 ema因此 代表了一种潜在的强大技术，可以提高对自我报告的认知功能的测量和 检测高风险临床人群中神经认知障碍的风险，例如喝酒的人 沉重。据此，拟议的F31论文项目的目的是：1）评估心理测量特性 EMA管理的EACS筛选问题； 2）检查自我报告的EMA之间的临时关系 饮酒，情绪和认知投诉； 3）检查人口统计学，艾滋病毒疾病的潜在影响 日常活动的特征和认知复杂性在自我报告的认知投诉中。鉴于 目前，该研究中的当前缺乏此类评估技术，这将为未来提供信息 开发新的移动评估方法，以检测艾滋病毒和沉重的神经认知障碍 饮酒。通过这种F31机制提供的机会将为申请人的 成为独立的学术神经心理学家的长期目标，致力于早期发现 合并症HIV感染和大量饮酒的人的神经认知障碍。