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The development of a Q-sort behavioral rating procedure for pediatric HIV patients
H A Moss1, P Brouwers, P L Wolters
1Pediatric Branch, National Cancer Institute, Bethesda, Maryland.
Insights
Pediatric HIV patients with central nervous system disease show altered social and emotional behaviors. Treatment with AZT may improve these behavioral symptoms in some children.
Area of Science:
- Neuroscience
- Pediatric Psychology
- Infectious Diseases
Background:
- Pediatric HIV infection can lead to central nervous system (CNS) disease.
- CNS involvement impacts neurodevelopment and behavior in children.
- Understanding these behavioral changes is crucial for effective patient management.
Purpose of the Study:
- To develop and validate a Q-sort procedure for assessing behavioral changes in pediatric HIV patients with CNS disease.
- To identify specific social, emotional, and motivational behavioral patterns associated with HIV-associated encephalopathy.
- To evaluate the impact of antiretroviral therapy on these behaviors.
Main Methods:
- A Q-sort procedure was developed to assess behavior in 180 HIV-infected pediatric patients.
- Factor analysis was used to derive behavioral scales from the Q-sort ratings.
- Behavioral data were compared between patients with and without HIV-associated encephalopathy across different age groups.
Main Results:
- Younger encephalopathic patients exhibited more apathy and less social behavior than non-encephalopathic peers.
- Older encephalopathic patients showed higher scores for depression, autism, and irritability.
- A subgroup of 26 patients demonstrated significant improvement in these elevated scores after 6 months of AZT treatment.
Conclusions:
- HIV-associated encephalopathy significantly alters social, emotional, and motivational behaviors in pediatric patients.
- Behavioral deficits are age-dependent, with distinct patterns observed in younger and older children.
- AZT treatment shows potential for mitigating some of the negative behavioral consequences of HIV-CNS disease.
Abstract:
Developed a Q-sort procedure to assess social, emotional, and motivational behavior associated with central nervous system disease among 180 HIV-infected pediatric patients. These ratings were factor analyzed and scales were derived based on the factor structure. Younger (M age = 1.03 years) patients with HIV-associated encephalopathy were rated as more apathetic and nonsocial in their behavior than nonencephalopathic younger patients. Older (M age = 7.8 years) encephalopathic patients had significantly higher scores on scales measuring depression, autism, and irritability compared to nonencephalopathic patients from this age group. A subgroup (26 patients) showed a significant decrease in these elevated scores after a 6-month course of AZT.