The role of executive dysfunction in diminished awareness of neurocognitive deficits among HIV+ adults

Jennifer G Monzones, Fordham University


This study sought to examine the individual and relative contributions of demographic, psychiatric and neurocognitive factors as they pertain to subjective reports of neurocognitive difficulties, and to explore the correlates of varying degrees of awareness of neurocognitive deficits (diminished, accurate or over-sensitive awareness) within a diverse group of 107 HIV-positive adults. The current study was the first to investigate the influence of a measure of medial orbitofrontal/ventromedial cortex functioning on awareness of neurocognitive deficits (AOD), and was the first to consider the impacts of premorbid functioning, as well as both current mood disturbance and formally diagnosed clinical depression on AOD. Results revealed that depressive symptomatology (both severity of mood and formal diagnosis of Major Depressive Disorder) and premorbid intellectual functioning played a significant role with regard to subjective complaints of neurocognitive deficits and AOD. Depressive symptomatology was the most influential contributor to AOD for participants who over-reported and accurately reported NC deficits. Subcortical-frontal NC processes were associated with diminished AOD, though memory impairment was found to be the only determinant of diminished AOD in this HIV-positive study cohort. Executive function was related to AOD in higher order/complex thinking, with dorsolateral prefrontal cortex functioning being the most influential process. Medial orbitofrontal/ventromedial prefrontal cortex functioning was not significantly associated with AOD. Overall, the current study findings highlight the importance of demographics, psychiatric and neurocognitive functioning on patient reports of NC dysfunction, and provide a broader and deeper understanding of the factors involved in self-awareness of neurocognitive disability.

Subject Area

Neurosciences|Clinical psychology|Cognitive psychology

Recommended Citation

Monzones, Jennifer G, "The role of executive dysfunction in diminished awareness of neurocognitive deficits among HIV+ adults" (2012). ETD Collection for Fordham University. AAI3560130.