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 Assessm ent of Own Functioning (Chelune, Heaton, & Lehman, 1986) and their memory p erformance on the California Verbal Learning Test (CVLT), were compared on the Beck Depression Inventory (BDI), and on neuropsychological (NP) tests o f attention, language, psychomotor speed, and conceptual problem-solving. S ubjects with low memory complaints and normal CVLT performance (n = 29) had low BDI scores and were normal in all other NP abilities. Subjects with hi gh memory complaints and impaired CVLT performance (n = 20) had elevations on the BDI as well as NP impairments in psychomotor speed and category flue ncy. 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 abiliti es. These results suggest that there are at least two key determinants to m etamemory inaccuracy in HIV-infection, namely, frontal executive impairment s and mood disturbance.