Thesis (PhD)--Stellenbosch Univesity, 2011. / ENGLISH ABSTRACT: It is well established that South African women are disproportionately affected by
HIV/AIDS and gender based violence. Research to date has provided evidence for
neurocognitive decline in individuals infected with HIV/AIDS and in individuals who
have experienced early life trauma. However, many gaps remain in our knowledge about
the neurocognitive profile of HIV and childhood trauma in South African women. The
present study focused on the neurocognitive effects of HIV infection and childhood
trauma, both separately and in combination in South African women. The primary aim of
the study was to assess neurocognitive functioning in HIV-positive and matched HIVnegative
controls, with and without a history of childhood trauma. Moreover, the study
sought to assess the synergistic relationship between HIV and childhood trauma in
influencing neurocognitive outcomes, a relationship which has not yet been investigated.
A neuropsychological battery sensitive to HIV-related impairments was administered to
83 HIV-positive and 47 matched HIV-negative women with histories of childhood
trauma. A history of childhood trauma was assessed using the Childhood Trauma
Questionnaire short form (CTQ-SF). Forty eight of the 83 HIV-positive women were
exposed to childhood trauma. Among the control subjects, a total of twenty women were
exposed to childhood trauma.
Findings of the present study revealed neurocognitive deficits in memory and executive
functions. Results demonstrated significant HIV effects in memory (HVLT-R learning
and delay trials), and executive functions (Halstead Category test). Similarly, a trauma effect was evident in delayed recall (HVLT-R delay). Moreover, results revealed a
significant interaction effect between HIV status and trauma status on the WAIS-III
Symbol Search Task, a task of psychomotor speed. However, HIV-negative controls with
a history of childhood trauma scored the highest on this task. Although this finding was
unexpected, it may suggest that psychomotor speed may not be a sensitive or
discriminating test of childhood trauma in healthy adults.
The present study demonstrated evidence for HIV and trauma effects in the ability
domains of learning and delayed recall and executive functions. Although the present
study did not find evidence for a synergistic relationship between HIV and trauma, it did
provide evidence for both HIV and trauma effects on neurocognition, a finding in
keeping with previous studies. Future research should be prospective in nature and should
better delineate the nature, severity, and temporal relationship of childhood trauma to
neurocognitive outcomes, as well as the mediators and moderators of these outcomes. / AFRIKAANSE OPSOMMING: Dit is alombekend dat Suid-Afrikaanse vroue buite verhouding swaar deur MIV/vigs en
geslagsgebaseerde geweld getref word. Navorsing tot dusver lewer bewyse van
neurokognitiewe verswakking by individue met MIV/vigs sowel as individue wat vroeg
in hulle lewe reeds trauma ervaar het. Tog is daar steeds vele gapings in ons kennis oor
die neurokognitiewe profiel met betrekking tot MIV en kindertrauma onder Suid-
Afrikaanse vroue. Hierdie studie konsentreer op die neurokognitiewe uitwerking van
MIV-infeksie en kindertrauma, afsonderlik sowel as gesamentlik, op Suid-Afrikaanse
vroue. Die hoofdoel van die studie was om neurokognitiewe funksionering by MIV-positiewe
vroue te bepaal en dit met gepaste MIV-negatiewe kontrolepersone te vergelyk,
met én sonder 'n geskiedenis van kindertrauma. Daarbenewens wou die studie die
sinergistiese verwantskap tussen MIV en kindertrauma in hul impak op neurokognitiewe
uitkomste bepaal – 'n verwantskap wat tot dusver nog nie ondersoek is nie.
'n Neurosielkundige toetsbattery wat gevoelig is vir MIV-verwante swakhede is onder 83
MIV-positiewe vroue en 47 gepaste MIV-negatiewe kontrolepersone met 'n geskiedenis
van kindertrauma afgeneem. 'n Geskiedenis van kindertrauma is met behulp van die kort
weergawe van die kindertraumavraelys (CTQ-SF) vasgestel. Agt-en-veertig van die 83
MIV-positiewe vroue is as kinders aan trauma blootgestel. Van die kontrolegroep het 20
vroue in hul kindertyd trauma beleef.
Die studie het neurokognitiewe tekorte in korttermyngeheue én uitvoerende funksies aan
die lig gebring. Die resultate het 'n beduidende MIV-verwante uitwerking op korttermyngeheue (hersiene Hopkins- verbale leer-en-vertragingstoets, oftewel HVLT-R)
sowel as uitvoerende funksies (Halstead-kategorietoets) getoon. Eweneens het die studie
op 'n duidelike traumaverwante uitwerking op herinneringsvermoë (HVLT-R-vertraging)
gedui. Daarbenewens het die WAIS-II- (Wechsler-volwassene-intelligensieskaal)
simboolsoekopdrag – 'n psigomotoriese spoedtoets – 'n beduidende wisselwerkingseffek
tussen MIV-status en traumastatus getoon. Tog het MIV-negatiewe kontrolepersone met 'n
geskiedenis van kindertrauma die beste in hierdie opdrag gevaar. Hoewel hierdie bevinding
verrassend was, kan dit daarop dui dat psigomotoriese spoed dalk nie 'n gevoelige of
diskriminerende toets van kindertrauma by gesonde volwassenes is nie.
Die studie het bewys gelewer van MIV- en traumaverwante uitwerkings op
korttermyngeheue en uitvoerende funksies. Hoewel die ondersoek nie bewyse van 'n sinergistiese verwantskap tussen MIV en trauma kon vind nie, het dit wél bevestig dat
MIV en trauma neurokognitiewe werking beïnvloed – 'n bevinding wat in pas is met
vorige studies. Toekomstige navorsing behoort ondersoekend te wees en die aard, felheid
en tydgebondenheid van die verwantskap tussen kindertrauma en neurokognitiewe
uitkomste, sowel as die mediator- en moderatorveranderlikes van hierdie uitkomste, beter te omskryf.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/18097 |
| Date | 12 1900 |
| Creators | Spies, Georgina |
| Contributors | Seedat, Soraya, Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Psychiatry. |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | Unknown |
| Type | Thesis |
| Format | 253 p. |
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