Amsterdam 2015
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| Abstract #2086 - Cognitive development in children and adolescents | ||||
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Session: 16.6: Cognitive development in children and adolescents (Parallel) on Wednesday @ 14.30-16.00 in C001 Chaired by Xiaoming Li, Igor Grant Authors: Presenting Author: Dr Massy Mutumba - University of Michigan, United States |
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| Additional Authors: | ||||
| Aim: Perinatally HIV-infected (PHIV+) and HIV-exposed but uninfected (PHEU) youth exhibit higher rates of mental health disorders compared to youth in the general population. Significant gaps persist in our understanding of the influence of the ecological context of pediatric HIV on the etiology of mental health disorders among PHIV+ and PHEU. The purpose of this study is to compare how PHEU and PHIV+ youth’s mental health symptoms change throughout adolescence, and to identify what additional psychosocial factors beyond HIV infection may be associated with these changes. | ||||
| Method / Issue: Data were drawn from a longitudinal study of PHIV+ and PHEU youth recruited from four medical centers in New York City. Individual interviews were administered at baseline and subsequently administered over a 5 year period to 166 PHIV+ and 114 PHEU youth (49% male, ages 9 – 16 at baseline). Youth’s mental health was assessed using the youth version of the Diagnostic Interview Schedule for Children (DISC-IV), to derive four indicators of psychological distress: DISC total symptom count, Internalizing symptom count, Externalizing symptom count, and Substance use symptoms count. Predictive growth curve analyses were conducted to assess longitudinal changes in youth’s psychological symptomatology and identify factors associated with these changes. Level I (time-varying covariates within-individual changes) predictors included: time, major life events, household poverty (below or above federal poverty line), caregiver mental health (BDI), and urban stressors (City Stress Inventory). Level II (between-individual differences) predictors included: age, sex, race, ethnicity, youth HIV status, type of caregiver (biological vs. non-biological), and youth’s future orientation score at baseline. | ||||
| Results / Comments: The changes in Total symptom, internalizing symptom, and externalizing symptom counts followed a quadratic growth curve. Among the level II variables, only future orientation and youth’s sex were significantly associated with the Total symptom counts. At level I, changes in total symptom counts were positively associated with the number of major negative life events, and urban stressors experienced. Poverty and caregiver mental health were not significant predictors of prospective changes in the total symptom count. Total internalizing symptom counts varied by youth’s sex: males reported greater decreases in internalizing symptoms count over time than females, and were significantly associated with number of major negative life events, and urban stressors experienced. Total externalizing symptom counts were positively associated with youth’s age, sex (female), and lower future orientation, number of major negative life events and urban stressors experienced. The changes in Substance Use (SU) had a curvilinear shape over time: PHIV+ youth increased their SU over time at a greater rate than PHEU. SU was positively associated with youth’s age, HIV status, and number of major negative life events experienced. | ||||
| Discussion: Prospective changes in psychological symptomatology among PHIV+ and PHEU youth are associated with youth age, sex, negative life events, future orientation, and urban stressors, but not caregiver mental health or household poverty. Youth HIV status was unrelated to changes in mental health disorders but played a significant role in SU. There is a need for mental health and SU interventions for both PHIV+ and PHEU youth. | ||||
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