Objectives: This paper reviews the literature concerning psychological adjustment to spinal cord injury, focusing on the recent methodological developments and new directions in research. Method: Several literature reviews using the search terms Spinal Cord Injury, Paraplegia, Coping and Adjustment were undertaken using the databases in Pubmed, Medline and Embase. The papers that were published from 2001 onwards, written in English and used a sample of adults were included. Results: The literature reviewed lends further support to the importance of appraisals and coping strategies in the adjustment to spinal cord injury. Methodological issues highlighted in earlier reviews are addressed in conjunction with further theoretical explorations. Conclusions: Although many of the methodological criticisms have been addressed, there remains a need for longitudinal research into the process of adjustment to spinal cord injury and the contributory role of appraisals and coping strategies. Measurement tools designed specifically for use within the spinal cord injured population should be utilized in the prevention of maladaptive adjustment issues, whereas able-bodied comparison groups would allow identification of coping strategies unique to the spinal cord injured population.
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