TMARC Pilot Studies - Completed

A Metacognition-based Approach to Improve HIV-associated Neurocognitive Disorders Among METH Users (Blackstone)

Agency: TMARC
PI: Blackstone, Kaitlin, B.A.

Abstract

Methamphetamine (MA) is a major risk factor for HIV infection. The neurotoxic effects of comorbid MA dependence and HIV infection (MA/HIV) preferentially impact frontostriatal regions of the brain leading to increased prevalence of HIV-associated neurocognitive disorders (HAND), particularly disrupting executive functions. In both HIV and MA, executive dysfunction is associated with dependence in instrumental activities of daily living (IADLs; e.g., unemployment). Despite the high risk for and economic burden of HAND-related disability, there are currently no empirically validated techniques to treat HAND among MA users. One cognitive rehabilitation technique that has been effective for improving IADL functioning in other populations with executive dysfunction (e.g., traumatic brain injury) is metacognitive training. Metacognition involves an accurate perception and assessment of one’s everyday performance and its consequences. Metacognition is commonly impaired following brain injury to the prefrontal systems and up to 50% of HIV individuals show poor insight into their cognitive abilities, which is directly associated with poorer IADL outcomes. Impaired metacognition may represent an important mechanism by which executive dysfunction impacts successful IADLs in MA/HIV. Metacognitive training thus represents a potentially powerful technique to improve IADL functioning in MA/HIV. Metacognitive training teaches individuals self-regulation and monitoring skills in order to gain control over behaviors. This project aims to evaluate the efficacy of a brief metacognitive training module for neurocognitive rehabilitation in MA/HIV individuals with executive dysfunction. Due to the absence of such techniques in this population, results from this study will inform future development of interventions to improve HAND among MA users.

Sponsored by NIH/NIDA P50DA026306

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