Establishing a functional relationship between the independent and the dependent variable is the primary focus of applied behavior analysis. Accurate and reliable description and observation of both the independent and dependent variables are necessary to achieve this goal. Although considerable attention has been focused on ensuring the integrity of the dependent variable in the operant literature, similar effort has not been directed at ensuring the integrity of the independent variable. Inaccurate descriptions of the application of the independent variable may threaten the reliability and validity of operant research data. A survey of articles in the Journal of Applied Behavior Analysis demonstrated that the majority of articles published do not use any assessment of the actual occurrence of the independent variable and a sizable minority do not provide operational definitions of the independent variable. The feasibility and utility of ensuring the integrity of the independent variable is described.

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This Special Series integrates recent progress in coping processes with the challenges of behavioral medicine. The term coping implies a reaction to stress; this series of articles considers stressors such as chronic disease (hypertension, heart disease, and arthritis), disability and death, and medical procedures (radiation therapy, childbirth, surgery, and invasive diagnostic procedures). Each study has derived a unique set of conclusions, with the common theme that preconceived notions about coping effectiveness should be replaced by empirical exploration.

The current study examined the role of health beliefs in diabetic regimen adherence and metabolic control. The subjects were 143 insulin-dependent diabetic outpatients, including 54 from a university juvenile diabetes care clinic with a mean age of 18 and 89 from a private practice clinic with a mean age of 37. Subject age and knowledge about diabetes were statistically controlled for in the multiple regression equations used to analyze the data. Overall, health beliefs accounted for a statistically significant portion of the variance in both self-reported adherence and metabolic control, as measured by level of glycosylated hemoglobin. For older patients from the private practice clinic, the most important aspects of health beliefs related to both reported adherence and metabolic control were those associated with the perceived benefits of adhering to the diabetic regimen. For younger patients from the university clinic, although perceived costs figured most prominently in their reports of adherence, perceived severity and susceptibility were the most important health beliefs associated with their actual levels of metabolic control. These findings suggest that health beliefs may play an important role in diabetic regimen adherence and metabolic control.Diabetes mellitus affects over 5 million Americans (Karam, 1981). Treatment of this chronic condition requires careful regulation of diet, exercise, and (often) drug or insulin dosage, along with frequent monitoring of blood or urine sugar levels to maintain blood glucose levels within as near normal a range as possible. Most diabetics manage their disease well enough to avoid serious effects from acute complications. However, there are a number of long-term complications associated with chronically elevated blood glucose levels (Brownlee & Cerami, 1981;Pirart, 1978) that make diabetes the leading cause of blindness in the United States and contribute to a markedly shortened life span among diabetics (Lipsett, 1980; U.S. Department of Health, Education, and Welfare, 1979). Although diabetic blood glucose levels are influenced by physiological factors, behavioral adherence to the complicated diabetes care regimen is a major determinant of blood sugar control. 1 As with other medical regimens, adherence to the diabetic regimen is often inadequate (Cerkoney& Hart, 1980;Ruff, 1983;Wiholm, This article is based on a master's thesis by the first author conducted under the supervision of the second author. Thanks are due to Judy Broughton for her comments on the Diabetes Knowledge Questionnaire and to Don Diner for his help with data analysis. Special appreciation is also extended to Michael A. Brownlee for his advice throughout this project and to the participating patients who made the study possible.

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Investigated problem-solving ability and reported regimen adherence among children, early adolescents, and middle adolescents with IDDM in response to hypothetical social situations where a choice between diabetes regimen adherence and peer desires must be made. Sixty-seven 8- to 17-year-olds with IDDM from two distinct U.S. geographical areas participated. Results indicated that compared to children with IDDM, adolescents with IDDM had better problem-solving abilities in response to social pressure situations, possibly reflecting their greater cognitive maturity. However, adolescents were also more likely to choose behaviors that are less regimen adherent. Differences in levels of problem-solving ability and adherence between the two regional subsamples were also found. Similar developmental patterns were found in both groups, showing the robust nature of the observed age-related trend of decreasing adherence in social situations despite increasing problem-solving abilities. Findings were interpreted in the context of normal adolescent development. Results are conceptually important for those interested in the transaction between peer and social influences and adherence for children and adolescents with IDDM, as well as other health behaviors.

This study provides an examination of violence occurring in the couple relationships of female survivors of childhood sexual abuse (CSA). Participants were 240 low-income women, 113 of whom (47%) reported some history of CSA. Compared with non-sexually abused women, those who had experienced CSA reported that their couple relationships were more likely to have involved several severe forms of violence, including hitting, kicking, and beating. Comparisons of the directional patterns of partner violence revealed that a greater proportion of CSA survivors' relationships had involved at least one incident of both man-to-woman and woman-to-man aggression. An unexpected finding was that a significant number of all intimate relationships were reported by women to have involved one or more acts of woman-to-man violence only. Findings are discussed in the context of current knowledge about CSA and intimate partner violence; directions for future research are suggested.