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Neuropsychological functioning as a predictor of employment activity in a longitudinal study of HIV-infected adults contemplating workforce reentry

Published online by Cambridge University Press:  21 September 2009

ROBERT A. CHERNOFF
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, Cedars Sinai Medical Center, Los Angeles, California
DAVID J. MARTIN*
Affiliation:
Department of Psychiatry, Harbor–University of California Los Angeles Medical Center, Torrance, California Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
DARYL A. SCHROCK
Affiliation:
Department of Psychiatry, Los Angeles Biomedical Research Institute at Harbor–University of California Los Angeles Medical Center, Torrance, California
MELISSA P. HUY
Affiliation:
The Neurobehavioral Group, Costa Mesa, California
*
*Correspondence and reprint requests to: David J. Martin, Harbor–UCLA Medical Center, 1000 W. Carson Street, Box 488, Torrance, CA 90509. E-mail: [email protected]

Abstract

Cognitive deficits are associated with HIV disease, and HIV-related cognitive deficits have been associated with declines in everyday functioning and vocational status. We administered a baseline neuropsychological (NP) test battery designed to assess estimated full-scale IQ, achievement, attention/concentration, executive function, language, mental speed, motor function, nonverbal memory, verbal memory, and visual-spatial function to a sample of 174 disabled, HIV-positive individuals enrolled in a randomized, controlled trial of a vocational-rehabilitation program. We then used these NP scores to predict employment at the end of participants’ study participation, using both hierarchical multiple regression and ordinal logistic regression models. The hierarchical multiple regression analyses did not predict participants’ employment activities at the end of study participation. In the ordinal logistic regression model, executive functioning weakly predicted employment status at the end of study participation and inspection of the predicted classifications revealed that 63% of the participants were incorrectly classified using this model. These results suggest that although predicting workforce reentry from NP testing may be statistically significant, NP testing may be of limited clinical value for informing the workforce reentry of disabled people with HIV who are interested in returning to work. (JINS, 2010, 16, 38–48.)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 2009

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References

REFERENCES

Albert, S.M., Marder, K., Dooneief, G., Bell, K., Sano, M., Todak, G., & Stern, Y. (1995). Neuropsychologic impairment in early HIV infection: A risk factor for work disability. Archives of Neurology, 52, 525530.CrossRefGoogle ScholarPubMed
Bornstein, R.A. (1985). Normative data on selected neuropsychological measures from a nonclinical sample. Journal of Clinical Psychology, 41, 651658.3.0.CO;2-C>CrossRefGoogle Scholar
Cohen, J., Cohen, P., West, S.G., & Aiken, L.S. (2003). Applied multiple regression/correlation analysis for the behavioral sciences (3rd ed.). Mahwah, NJ: Erlbaum.Google Scholar
Cysique, L.A., Maruff, P., & Brew, B.J. (2006). The neuropsychological profile of symptomatic AIDS and ADC patients in the pre-HAART era: A meta-analysis. Journal of the International Neuropsychological Society, 12, 368382.CrossRefGoogle ScholarPubMed
Demick, J., & Harkins, D. (1997). Role of cognitive style in the driving skills of young, middle-aged, and older adults (American Association of Retired Persons Andrus Foundation Final Grant Report). Washington, DC: AARP.Google Scholar
Farmer, A. (1990). Performance of normal males on the Boston Naming Test and the Word Test. Aphasiology, 4(3), 293296.CrossRefGoogle Scholar
First, M.B., Spitzer, R.L., Gibbon, M., & Williams, J.B.W. (1995). Structured clinical interview for DSM-IV axis I disorders (patient edition). New York: Biometrics Research.Google Scholar
Geffen, G., Moar, K.J., O’Hanlon, A.P., Clark, C.R., & Geffen, L.B. (1990). Performance measures of 16 to 86 year-old males and females on the auditory verbal learning test. The Clinical Neuropsychologist, 4, 4563.CrossRefGoogle ScholarPubMed
Heaton, R.K., Chelune, G.J., Talley, J.L., Kay, G.G., & Curtiss, G. (1983). Wisconsin Card Sorting Test: Revised and expanded. Lutz, FL: Psychological Assessment Resources.Google Scholar
Heaton, R.K., Marcotte, T.D., Mindt, M.R., Sadek, J., Moore, D.J., Bentley, H., et al. (2004). The impact of HIV-associated neuropsychological impairment on everyday functioning. Journal of the International Neuropsychological Society, 10, 317331.CrossRefGoogle ScholarPubMed
Heaton, R.K., Marcotte, T.D., White, D.A., Ross, D., Meredith, K., Taylor, M.J., et al. (1996). Special presentation: Nature and vocational significance of neuropsychological impairment associated with HIV infection. The Clinical Neuropsychologist, 10, 114.CrossRefGoogle Scholar
Heaton, R.K., & Pendleton, M.G. (1981). Use of neuropsychological tests to predict adult patients’ everyday functioning. Journal of Consulting and Clinical Psychology, 49, 807821.CrossRefGoogle ScholarPubMed
Heaton, R.K., Velin, R.A., McCutchan, A., Gulevich, S.J., Atkinson, J.H., Wallace, M.R., et al. (1994). Neuropsychological impairment in human immunodeficiency virus-infection: Implications for employment. Psychosomatic Medicine, 56, 817.CrossRefGoogle ScholarPubMed
Kalechstein, A.D., Newton, T.F., & van Gorp, W.G. (2003). Neurocognitive functioning is associated with employment status: A quantitative review. Journal of Clinical and Experimental Neuropsychology, 25, 11861191.CrossRefGoogle ScholarPubMed
Miller, E.N. (2003). An update on the 1991 article by Selnes, Jacobson, Machado, Becker, Wesch, Miller, Visscher, and McArthur. Unpublished manuscript. As cited in Mitrushina, M., Boone, K.B., Razani, J., & D’Elia, L.F. (2005). Handbook of normative data for neuropsychological assessment (2nd edition). New York: Oxford University Press.Google Scholar
Mindt, M.R., Cherner, M., Marcotte, T.D., Moore, D.J., Bentley, H., Esquivel, M.M., Lopez, Y., Grant, I., & Heaton, R.K. (2003) The functional impact of HIV-associated neuropsychological impairment in Spanish-speaking adults: A pilot study. Journal of Clinical and Experimental Neuropsychology, 25, 122132.CrossRefGoogle ScholarPubMed
Mitrushina, M., Boone, K.B., Razani, J., & D’Elia, L.F. (2005). Handbook of normative data for neuropsychological assessment (2nd edition). New York: Oxford University Press.Google Scholar
NOVA Research Company (2003). QDS Version 2.1 Manual. Available online at http://www.novaresearch.com/products/QDS/QDS_Manual_2-1.pdf.Google Scholar
Pilgrim, B., Meyers, J., & Whetstone, M. (1999). Validity of the Ward seven-subtest WAIS-III short form in a neuropsychological population. Applied Neuropsychology, 6(4), 243246.CrossRefGoogle Scholar
Rabkin, J.G., McElhiney, M., Ferrando, S.J., van Gorp, W., & Lin, S.H. (2004). Predictors of employment of men with HIV/AIDS: A longitudinal study. Psychosomatic Medicine, 66, 7278.CrossRefGoogle ScholarPubMed
Reger, M., Welsh, R., Razani, J., Martin, D.J., & Boone, K.B. (2002). A meta-analysis of the neuropsychological sequelae of HIV infection. Journal of the International Neuropsychological Society, 8, 410424.CrossRefGoogle ScholarPubMed
Ruff, R.M., Light, R.H., Parker, S.B., & Levin, H.S. (1996). Benton controlled oral word association test: Reliability and updated norms. Archives of Clinical Neuropsychology, 11, 329338.CrossRefGoogle ScholarPubMed
Smith, M.B. (2000). Moral foundations of research with human participants. In Sales, B.D. & Folkman, S. (Eds.), Ethics in research with human participants. Washington, DC: American Psychological Association.Google Scholar
Turner-Bowker, D.M., Bayliss, M.S., Ware, J.E. Jr, & Kosinski, M. (2003). Usefulness of the SF-8-super(TM) health survey for comparing the impact of migraine and other conditions. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care & Rehabilitation, 12(8), 10031012.CrossRefGoogle Scholar
van Gorp, W.G., Baerwald, J.P., Ferrando, S.J., McElhiney, M.C., & Rabkin, J.G. (1999). The relationship between employment and neuropsychological impairment in HIV infection. Journal of the International Neuropsychological Society, 5, 534539.CrossRefGoogle ScholarPubMed
van Gorp, W.G., Rabkin, J.G., Ferrando, S.J., Mintz, J., Ryan, E., Borkowski, T., & McElhiney, M. (2007). Neuropsychiatric predictors of return to work in HIV/AIDS. Journal of the International Neuropsychological Society, 13, 8089.CrossRefGoogle ScholarPubMed
Wachtel, T., Piette, J., Mor, V., Stein, M., Fleishman, J., & Carpenter, C. (1992). Quality of life in persons with human immunodeficiency virus infection: Measurement by the Medical Outcomes Study instrument. Annals of Internal Medicine, 116, 129137.CrossRefGoogle ScholarPubMed
Ware, J.E., Snow, K.K., Kosinki, M., & Gandek, B. (1993). SF-36 health survey manual and interpretation guide. Boston: The Health Institute, New England Medical Center.Google Scholar
Wechsler, D. (1997a). Wechsler Adult Intelligence Scale (3rd edition). San Antonio, TX: The Psychological Corporation.Google Scholar
Wechsler, D. (1997b). Wechsler Memory Scale (3rd edition). San Antonio, TX: The Psychological Corporation.Google Scholar
Wen, J.H., Boone, K., & Kim, K. (2006). Ecological validity of neuropsychological assessment and perceived employability. Journal of Clinical and Experimental Neuropsychology, 28, 14231434.CrossRefGoogle ScholarPubMed
Wilkinson, G. (1993). Wide Range Achievement Test administration manual. Wilmington, DE: Wide Range, Inc.Google Scholar