Associations Between Categories of Childhood Adversity and Neurocognitive Outcomes in People With HIV
Kathy Wang1, Shirley Chen1, Karen Torres1, David Prince1, Payal Patel1
1University of Washington
Objective:
Adverse childhood events are usually assessed as a cumulative score. In this study, we examine the relationships between categorical adverse childhood experiences (ACEs): abuse, neglect and family dysfunction, and five domains of cognition: memory, processing speed, executive function, and fine motor function among people living with HIV (PLWH).
Background:
Both human immunodeficiency virus (HIV) and adverse childhood experiences (ACEs) can lead to impaired cognitive function in adulthood. While studies typically evaluate the impact of ACEs by cumulative count, recent research shows that separating ACEs categorically may reveal distinct relationships between experiential categories and cognitive domains.
Design/Methods:
Participants living with virally suppressed HIV (n = 68) self-reported adverse childhood experiences and underwent a neuropsychiatric battery. Pearson’s correlation coefficient was used to determine correlations between cumulative ACE count and cognitive scores. Linear regression was used to determine the mean difference in cognitive scores between groups who had a presence or absence of an ACE category.
Results:
No significant correlation was found between cumulative ACE count and cognitive scores in any cognitive domains. PLWH who experienced abuse in childhood had significantly lower mean fine motor scores compared to PLWH who did not experience abuse in childhood (p = 0.02). PLWH who experienced neglect in childhood had lower mean processing speed scores compared to PLWH who did not experience neglect in childhood (p = 0.06).
Conclusions:
This research demonstrates the utility of distinguishing ACEs by category and examining their independent effects on cognitive domains. Clinicians may use this framework to identify PLWH who are more susceptible to developing cognitive and motor impairments. This is the first study to identify a relationship between childhood abuse and fine motor deficits among PLWH. This study also shows that evaluating ACEs scores cumulatively may not be sufficient to determine who may be susceptible to poor cognitive outcomes.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.