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Effects of Early-Life Adversities on Neuropsychiatric and Executive Functions in HIV-Positive Adults

Published online by Cambridge University Press:  02 February 2022

Uraina S. Clark*
Affiliation:
Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Olivia D. Herrington
Affiliation:
Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA Yale School of Medicine, New Haven, CT, USA
Rachal R. Hegde
Affiliation:
Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
*
*Correspondence and reprint requests to: Uraina S. Clark, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Department of Neurology, Box 1052, New York, NY 10029, USA. E-mail: uraina.clark@mssm.edu

Abstract

Objective:

Adverse childhood experiences (ACEs) contribute to elevations in neuropsychiatric and neurocognitive symptoms in HIV+ adults. Emerging data suggest that exposures to threat-related and deprivation-related ACEs may have differential impacts on function, with threat exposure contributing to neuropsychiatric symptoms, and deprivation contributing to executive dysfunction. Yet, it remains unclear how specific types of ACEs impact neuropsychiatric and neurocognitive symptoms in HIV+ adults. Hence, the current study examined whether these two dimensions of adversity contribute differentially to neuropsychiatric symptoms and executive dysfunction in HIV+ adults.

Methods:

We included a sample of demographically matched HIV+ (N = 72) and HIV-negative (N = 85) adults. Standardized self-report measures assessed threat-related (interpersonal violence) and deprivation-related (poverty/neglect) ACEs, as well as neuropsychiatric symptoms (depression, anxiety, apathy). A brief battery of neuropsychological tests assessed executive functions.

Results:

Compared to HIV-negative participants, HIV+ participants reported significantly higher rates of threat exposure (51% vs. 67%, p = .04), while rates of deprivation did not differ significantly (8% vs. 13%, p = .38). In the HIV+ sample, threat exposure was associated with neuropsychiatric symptoms (p < .01) but not executive dysfunction (p = .75). By contrast, deprivation was associated with executive dysfunction, at a trend level (p = .09), but not with neuropsychiatric symptoms (p = .70).

Conclusions:

Our data suggest that, relative to HIV-negative samples, HIV+ samples experience higher rates of threat-related ACEs, which contribute to neuropsychiatric symptom elevations. Moreover, our preliminary findings suggest that different types of ACEs could be associated with different profiles of neuropsychiatric and neurocognitive difficulty in HIV+ adults, highlighting the importance of considering dimensions of adversity in future studies.

Type
Research Article
Copyright
Copyright © INS. Published by Cambridge University Press, 2022

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