Effects of Early-Life Adversities on Neuropsychiatric and Executive Functions in HIV-Positive Adults

Abstract

Objective: Adverse childhood experiences (ACEs) contribute to elevations in neuropsychiatric and neurocognitive symptoms in HIV+ adults. Emerging data suggest that exposures to threat-related and deprivation-related ACEs may have differential impacts on function, with threat exposure contributing to neuropsychiatric symptoms, and deprivation contributing to executive dysfunction. Yet, it remains unclear how specific types of ACEs impact neuropsychiatric and neurocognitive symptoms in HIV+ adults. Hence, the current study examined whether these two dimensions of adversity contribute differentially to neuropsychiatric symptoms and executive dysfunction in HIV+ adults. Methods: We included a sample of demographically matched HIV+ (N = 72) and HIV-negative (N = 85) adults. Standardized self-report measures assessed threat-related (interpersonal violence) and deprivation-related (poverty/neglect) ACEs, as well as neuropsychiatric symptoms (depression, anxiety, apathy). A brief battery of neuropsychological tests assessed executive functions. Results: Compared to HIV-negative participants, HIV+ participants reported significantly higher rates of threat exposure (51% vs. 67%, p = .04), while rates of deprivation did not differ significantly (8% vs. 13%, p = .38). In the HIV+ sample, threat exposure was associated with neuropsychiatric symptoms (p < .01) but not executive dysfunction (p = .75). By contrast, deprivation was associated with executive dysfunction, at a trend level (p = .09), but not with neuropsychiatric symptoms (p = .70). Conclusions: Our data suggest that, relative to HIV-negative samples, HIV+ samples experience higher rates of threat-related ACEs, which contribute to neuropsychiatric symptom elevations. Moreover, our preliminary findings suggest that different types of ACEs could be associated with different profiles of neuropsychiatric and neurocognitive difficulty in HIV+ adults, highlighting the importance of considering dimensions of adversity in future studies.

Association of Adverse Childhood Experiences and Social Isolation With Later-Life Cognitive Function Among Adults in China

“… 12 These results are also supported by a case-control study among adults with HIV. 15 The present study further extends the findings of previous research by demonstrating the long-term association of deprivation-related ACEs, but not threat-related ACEs, with the rate of annual cognitive decline in later life. These findings may provide insight into early identification of the vulnerable group and prioritization of interventions for individuals with experience of childhood deprivation to preserve their cognitive function.…”

“…Although the association of ACEs with cognitive function has been consistently reported in different cultural contexts, 6 , 7 , 8 , 9 , 15 few studies have investigated the independent role of threat-related and deprivation-related ACEs on later-life cognitive decline in the general population. A cross-sectional study in the US has shown that childhood deprivation, but not threat, was associated with poor cognitive control in adolescents.…”

“…Likewise, evidence from a meta-analysis has demonstrated that early-life deprivation had a stronger association with executive functioning in children compared with their counterparts with experience of threat . These results are also supported by a case-control study among adults with HIV . The present study further extends the findings of previous research by demonstrating the long-term association of deprivation-related ACEs, but not threat-related ACEs, with the rate of annual cognitive decline in later life.…”

“…In contrast, deprivation-related ACEs refer to the lack of expected environmental inputs or cognitive stimuli (eg, neglect and absence of a parent) that might affect brain networks associated with language development and executive function . Although several previous studies have revealed stronger associations of deprivation-related ACEs with executive function and cognitive control than threat-related ACEs among children or the population with HIV, whether these 2 dimensions of ACEs exert a different association with cognitive decline in later life among the general population has not been well-articulated.…”

Synergistic effects of high early-life stress exposure and HIV infection on reaction time variability

“…Several factors are known to contribute to the risk of cognitive impairment in adults living with HIV, including diabetes, hepatitis C virus (HCV) coinfection, and alcohol/substance misuse (e.g., Heaton et al, 2010 ). Emerging data indicate that psychosocial risk factors, such as early-life stress (ELS), also contribute to cognitive impairment among PLWH ( Clark et al, 2012 , 2017 , 2023 ; Spies et al, 2012 , 2016 , 2017 ). High ELS exposure is associated with cognitive impairment among non-HIV samples ( Philip et al, 2013 ).…”