Publication Abstract Display
Type: Poster
Title: Overconfidence is associated with risky decision making in HIV-infected individuals with bipolar disorder.
Authors: Rooney A, Blackstone K, Badiee J, Atkinson JH, Moore DJ, and the HNRP Group
Date: 02-12-2014
Abstract:Objective: HIV infection and bipolar disorder (BD) may adversely impact frontostriatal systems leading to executive dysfunction, impulsive behaviors, risky decisions, and decreased cognitive insight. We hypothesized that dually-affected HIV+/BD+ individuals would demonstrate worse cognitive insight than HIV+/BD- individuals and that poorer cognitive insight would predict risky decision-making behaviors. Methods: Fifty HIV+/BD+ and 41 HIV+/BD- participants were administered the Iowa Gambling Task (IGT) and the 6-item Self-Certainty subscale of the Beck Cognitive Insight Scale to assess participants’ certainty about their judgment (a higher score indicates disproportionate overconfidence). The outcome variable for the IGT was advantageous minus disadvantageous decks; higher scores indicate less risky card choices. Results: Contrary to our hypothesis, the HIV+/BD+ group did not differ from the HIV+/BD- group on overconfidence nor IGT score; however, overconfidence was significantly correlated with IGT total in the dually affected HIV+/BD+ group (Rho = -0.42, p<0.01) but not within the HIV+/BD- group (Rho = -0.06, p=0.73). As expected, the groups differed on the Beck Depression Inventory-I or II (BDI) (p<0.04) and the Young Mania Rating Scale (YMRS) (p<0.01), with the HIV+/BD+ group reporting increased mood symptoms. In a multivariable model, controlling for YMRS and BDI, overconfidence remained the strongest predictor of IGT performance. The groups did not differ on demographic (i.e., gender, age, education, ethnicity), substance use diagnoses, or HIV disease variables. Conclusions: Disproportionate overconfidence in ones’ judgment is associated with riskier decision making among HIV+/BD+ individuals but not HIV+/BD- persons. Lack of cognitive insight among persons with both HIV and BD may have broad public health implications (e.g., unprotected sex). Targeting excessive overconfidence among persons with bipolar disorder may serve to reduce risk of HIV acquisition or transmission.

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