What factors could underlie the inability or unwillingness of persons to change their behavior?

There are various factors which impact a persons desire or ability to change their behavior. One factor could be motivation from environmental factors. Example: they grew up in a home in which bad behavior was rewarded, hence they have no reason to change as they received a "pleasurable" response from negative behavior. People can change their behaviors in this circumstance, if they choose as it is "learned" behavior. Another reason could be organic, in which they have no control over the cause of their behavior due to brain function, illness, impairment. Individuals in this group require medical treatment/assistance to deal with the primary issue of an organic disorder prior to addressing the behavioral issues.