Metacognition in HIV-1 seropositive asymptomatic individuals: self-ratings versus objective neuropsychological performance. Multicenter AIDS Cohort Study (MACS).

This study examined the relationship between actual and self-reported neuropsychological deficits, depression, and HIV-1 serostatus. The subjects, who consisted of 479 individuals, 256 who were HIV seronegative (SN) and 233 who were HIV-1 seropositive though still asymptomatic (ASP), were administered a standardized neuropsychological screening battery consisting of measures of attention, motor speed, psychomotor speed, verbal memory, verbal fluency, and depression. To assess subjects' subjective sense of their cognitive status, the Cognitive Failures Questionnaire (CFQ), a 25-item self-report questionnaire, was also administered. The results of MANOVA failed to reveal group differences between the SN and ASP groups on the measures of neuropsychological function. Similarly, the ASP and SN groups did not differ on the number or severity of reported cognitive failures. However, a positive correlation was found between CFQ scores and level of depression. These results do not support the hypothesis that ASP individuals are aware of cognitive decline prior to detection using standard neuropsychologic screening instruments. The data do suggest that the presence of depressed mood, independent of serostatus or actual neuropsychological impairment, is associated with increased cognitive complaints.