Study design: Longitudinal, multiple wave panel design. Objectives: To investigate the degree to which current thinking in terms of early appraisals and coping predicts adjustment and quality of life outcomes after spinal cord injury, and to what degree social and demographic variables are involved. Setting: Data were analysed from 266 patients recruited as part of an ongoing study from specialist units in selected British, Swiss, German and Irish spinal centres. Method: Questionnaire booklets were administered as soon as possible after injury onset and after 12 weeks to patients with newly acquired spinal cord injuries. Individuals included had sustained their injury between the ages of 16 and 83. Results: Significant improvements in outcome measures were found across the data set within the first 12 weeks after spinal cord injury and changes observed in the appraisals and coping strategies employed. Significant differences were found between participating centres on both outcome measures and in the coping and appraisal processes used. Coping and appraisal processes at 6 weeks after injury were found to contribute significantly to the variation in psychological well-being at 12 weeks after injury. Conclusion: This study shows the process of adjustment to spinal cord injury to begin in the early stages of rehabilitation, and initial appraisals are important to how an individual will cope with their injury and to their psychological well-being. Support is also given to the importance of psychological factors to functional outcomes.

This study provides further evidence in support of previous findings which suggest SOC to have a primary role in long-term psychological well-being. The relationship described here - from SOC to the appraisal of injury and subsequent behavioural responses - suggests SOC to be an influential factor in the long-term adjustment of people with SCI.

Study design: Multi-centre, single cohort. Objectives: To assess the relationship between cognitive appraisals in a spinal cord-injured population living in the community, and examine how these factors affect social participation, life satisfaction and functional outcomes. Setting: The National Spinal Injuries Centre, Stoke Mandeville, UK; Princess Royal Spinal Injuries Centre, Sheffield UK; Midlands Centre for Spinal Injuries, Oswestry, UK. Method: Participants (n ¼ 81) sustaining injury aged 18 or above were recruited from one of three spinal cord injuries units 3-18 months after discharge. Postal packs containing questionnaires, consent forms and information were distributed and a 2-week reminder sent. Results: Participation was found to be strongly related to life satisfaction, negative appraisals of disability were found to explain 12.9% of the variance in total participation scores. The variance in scores on Life Satisfaction Questionnaires was explained by appraisals, participation and secondary complications to a total of 69.6%. Functional Independence Scores were explained by negative perceptions of disability, growth and resilience and total secondary complication scores, explaining 49.4% of the variance in this measure. Conclusion: Participation, functional independence and life satisfaction were significantly related to appraisal styles in this population. Negative perceptions of disability, fearful despondency and overwhelming disbelief were themes that impacted on the likelihood of participation and independence and involved in expressed levels of life satisfaction. Our results suggest the need to tackle cognitive styles of SCI patients before discharge to improve the rehabilitation process.

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