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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 what degree social and demographic variables are involved.

Setting: Data from 281 patients recruited from specialist units in selected British, Swiss, Swedish, German, Austrian and Irish spinal centres as part of an ongoing study was analysed.

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 following 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 post injury were found to contribute significantly to the variation in psychological well being at 12 weeks post 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 long term psychological well being. Support is also given to the importance of psychological factors to functional outcomes.