Heterogeneity in behavioral treatment response in severe mental illness.
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.
Peer
Jason
J
Department of Psychology, University of Nebraska, Lincoln, Nebraska, USA. jason.peer@va.gov
Strachan
Eric
E
Spaulding
William
W
D000208:Acute Disease; D000328:Adult; D001288:Attention; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004358:Drug Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis / Q000453:epidemiology; D009483:Neuropsychological Tests; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012050:Rehabilitation, Vocational / Q000706:statistics & numerical data; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation*; D012720:Severity of Illness Index; D012938:Social Perception