Heterogeneity in behavioral treatment response in severe mental illness

Jason Peer, Eric Strachan, William Spaulding

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


An exploratory investigation of behavioral treatment response during inpatient rehabilitation for severe mental illness is presented. Archival data from 26 weeks of behavioral contingency management (CM) programs targeting treatment nonadherence for 2 cohorts of participants were analyzed. For cohort 1 (N = 39), a multivariate analysis of longitudinal behavioral data identified 4 qualitatively and quantitatively distinct patterns of CM response and these groups differed in verbal memory ability. Analysis of cohort 2 (N = 45) replicated the finding of 4 patterns of CM response. We further clarified behavioral heterogeneity in cohort 2 by using hierarchical linear modeling with neurocognitive and social cognitive covariates. Results indicated that memory, attention, and a high external locus of control (LOC) were associated with level of nonadherence at baseline. Reductions in external locus of control were associated with greater CM response during the course of rehabilitation. Implications for understanding individual responses to the rehabilitation process are discussed.

Original languageEnglish (US)
Pages (from-to)198-206
Number of pages9
JournalJournal of Nervous and Mental Disease
Issue number3
StatePublished - Mar 2008


  • Contingency management
  • Heterogeneity
  • Inpatient psychiatric rehabilitation
  • Severe mental illness

ASJC Scopus subject areas

  • Psychiatry and Mental health


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