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.

Although research subscales have been developed (Buckelew, DeGood, Schwartz, & Kerler, 1986) to assess the cognitive and somatic item patterning among chronic pain patients using the SCL-90-R, no information is available concerning the reliability or validity of those subscales. This study was designed to assess the internal consistency of these experimental subscales, evaluate the validity of these scales using standardized clinical scales measuring similar constructs, and to further examine the item response patterning with a new pain clinic sample and a rehabilitation center patient sample. The SCL-90-R was administered to 78 patients with chronic pain, 52 patients with spinal cord injury, and a control group of 145 college students. Estimates of internal consistency, represented by coefficient alpha, were .69 for the Somatic Depression subscales and .91 for the Cognitive Depression subscales. Data suggestive of construct validity included differential correlations of r=.78 between the experimental Cognitive Depression scale and the SCL-90-R Obsessive Compulsive scale, r=.66 between the experimental Somatic Depression scale and the SCL-90-R Somatization scale. Similar evidence of divergent validity was not clearly demonstrated with the remaining SCL-90-R subscales. Multivariate analysis of variance revealed that previously found item response patterning was replicated with a new chronic pain sample and with a spinal cord injured sample. Refinement of the research subscales and implications for clinical use among medical/rehabilitation samples is discussed.Reports on the prevalence of clinical depression among persons presenting at chronic pain clinics have varied from 10% (Pilowsky, Chapman, & Bonica, 1977) to 100% (Lascelles, 1966). Psychological tests such as the MMPI or SCL-90-R, which are often used in the psychological evaluation of pain patients, provide global scores on depression scales. However, such scales include items reflecting both cognitive and somatic symptoms. It is possible that pain patients may obtain elevated scores on depression scales by endorsing predominantly somatic symptoms of psychopathology while denying psychological distress. Differences in cognitive vs somatic symptom pattern-

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Individuals who are physically disabled are often expected to be depressed and to mourn their condition. It is relatively unknown, however, how these expectations influence psychologists' inferences about the emotional status of those who have a physically stigmatizing condition. Sixty-nine doctoral students in American Psychological Association approved clinical and counseling psychology programs rated their expectations for depression in a person after viewing a videotape of the person in varied conditions of physique and aifect. The results indicate that the presence of physical disability did not moderate the assessment of depression.The assessment of depression among persons who have physical disabilities is a particularly important area for research. Many disabling conditions have been shown to be associated with a prevalence of depressive disorders higher than that found in the population in general; incidence estimates vary from 40% to 50% (