Exploring Social Cognition and Executive Function in HIV-associated Neurocognitive Disorders (HAND)

With the success of highly active antiretroviral therapy (HAART), people with HIV
are living longer and the incidence and prevalence of HIV-associated disorders,
including neurocognitive impairments (e.g. HIV-associated neurocognitive
disorders; HAND) are increasing. To date, research into social cognition, referring
to the ability to understand other people's internal mental states (such as beliefs,
desires and emotions) has been neglected in individuals with HAND despite social
cognitive impairments being found in individuals with other neurological problems
(e.g. brain injury or dementias involving the frontal lobe). This study sought to
explore whether social cognitive deficits are present in individuals with HAND, and
if so whether this is a specific deficit or occurs as part of, or secondary to other
decline in neuropsychological function, including executive functions which have
been associated with social cognition in the literature. Sixteen participants with
HAND (mean age = 40.9 years, range 23 to 56 years) were recruited from an
inpatient neuro-rehabilitation centre and completed two social cognition tests (a
verbal theory of mind test, and a visual test of emotional perception) and a battery
of neuropsychological assessments including executive function tests.
Group means suggested specific weaknesses on the social cognition tests, and
also on tests of processing speed and immediate memory, but these tests were
not correlated. Case series analysis suggests that social cognition is separate to
other cognitive domains and executive functions since social cognition was
impaired in individuals who are functioning relatively well on other cognitive areas.
The results indicate that social cognition impairment may be a prominent early
problem in individuals with HAND. A task of social cognition on a screening test
for HAND may be beneficial for early detection and diagnosis, and useful for
understanding the impact that social cognitive deficits may have on everyday life
and social functioning. Further research, using bigger samples and better
instruments is required to understand social cognitive functioning in HIV
individuals.

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