一项关于 HIV 感染中多重任务处理的神经心理学研究：对日常功能的影响。
A neuropsychological investigation of multitasking in HIV infection: implications for everyday functioning.
机构信息
San Diego State University and University of California, San Diego, CA, USA.
出版信息
Neuropsychology. 2011 Jul;25(4):511-9. doi: 10.1037/a0022491.
OBJECTIVE
A subset of individuals with HIV-associated neurocognitive impairment experience related deficits in "real world" functioning (i.e., independently performing instrumental activities of daily living [IADL]). While performance-based tests of everyday functioning are reasonably sensitive to HIV-associated IADL declines, questions remain regarding the extent to which these tests' highly structured nature fully captures the inherent complexities of daily life. The aim of this study was to assess the predictive and ecological validity of a novel multitasking measure in HIV infection.
METHOD
Participants included 60 individuals with HIV infection (HIV+) and 25 demographically comparable seronegative adults (HIV-). Participants were administered a comprehensive neuropsychological battery, questionnaires assessing mood and everyday functioning, and a novel standardized test of multitasking, which involved balancing the demands of four interconnected performance-based functional tasks (i.e., financial management, cooking, medication management, and telephone communication).
RESULTS
HIV+ individuals demonstrated significantly worse overall performance, fewer simultaneous task attempts, and increased errors on the multitasking test as compared to the HIV- group. Within the HIV+ sample, multitasking impairments were modestly associated with deficits on standard neuropsychological measures of executive functions, episodic memory, attention/working memory, and information processing speed, providing preliminary evidence for convergent validity. More importantly, multivariate prediction models revealed that multitasking deficits were uniquely predictive of IADL dependence beyond the effects of depression and global neurocognitive impairment, with excellent sensitivity (86%), but modest specificity (57%).
CONCLUSIONS
Taken together, these data indicate that multitasking ability may play an important role in successful everyday functioning in HIV+ individuals.
目的
一部分 HIV 相关认知障碍个体在“现实世界”的功能（即独立进行日常工具性活动[IADL]）中存在相关缺陷。虽然基于表现的日常功能测试对 HIV 相关 IADL 下降具有相当的敏感性，但这些测试的高度结构化性质是否完全捕捉到日常生活的固有复杂性仍存在疑问。本研究旨在评估一种新的 HIV 感染多重任务测量的预测和生态有效性。
方法
参与者包括 60 名 HIV 感染个体（HIV+）和 25 名在人口统计学上可比的血清阴性成年人（HIV-）。参与者接受了全面的神经心理学测试、情绪和日常功能评估问卷以及一项新的标准化多重任务测试，该测试涉及平衡四项相互关联的基于表现的功能任务（即财务管理、烹饪、药物管理和电话沟通）的需求。
结果
与 HIV-组相比，HIV+个体在总体表现、同时尝试的任务次数较少以及多重任务测试中的错误增加方面表现出明显更差的表现。在 HIV+样本中，多重任务障碍与标准神经心理学执行功能、情景记忆、注意力/工作记忆和信息处理速度测试中的缺陷有一定的相关性，提供了初步的收敛有效性证据。更重要的是，多元预测模型表明，多重任务障碍除了抑郁和整体神经认知障碍的影响外，对 IADL 依赖具有独特的预测作用，具有良好的敏感性（86%），但特异性适中（57%）。
结论
综上所述，这些数据表明，在 HIV+个体中，多重任务能力可能在成功的日常功能中发挥重要作用。
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