Neuropsychiatric correlates of memory-metamemory dissociations in HIV-infection

Ninety-one adults with HIV-infection who varied in the concordance between their subjective memory complaints (or metamemory) on the Patient's Assessment of Own Functioning (Chelune, Heaton, & Lehman, 1986) and their memory performance on the California Verbal Learning Test (CVLT), were compared on the Beck Depression Inventory (BDI), and on neuropsychological (NP) tests of attention, language, psychomotor speed, and conceptual problem-solving. Subjects with low memory complaints and normal CVLT performance (n = 29) had low BDI scores and were normal in all other NP abilities. Subjects with high memory complaints and impaired CVLT performance (n = 20) had elevations on the BDI as well as NP impairments in psychomotor speed and category fluency. Subjects with low memory complaints but impaired CVLT performance (n = 16) had low BDI scores and were selectively impaired in conceptual problem-solving. Subjects with high memory complaints but normal CVLT performance (n = 26) had high BDI scores and normal NP functioning in all other abilities. These results suggest that there are at least two key determinants to metamemory inaccuracy in HIV-infection, namely, frontal executive impairments and mood disturbance.