The impact of coping on emotional adjustment to spinal cord injury (SCI): review of the literature and application of a stress appraisal and coping formulation

Objectives: This article reviews literature examining the psychological adjustment to Spinal Cord Injury (SCI) and illustrates the applicability of a Stress Appraisal and Coping model (SAC) for rehabilitation of this population. Method: Articles concerning psychological adjustment to SCI from the previous three decades have been reviewed and critiqued. When possible the articles have been discussed in a SAC framework. Results: The literature indicates that psychological adjustment to SCI is largely predictable from psychological variables including coping, appraisal and psychosocial resources. Recent literature has suggested psychological intervention can promote positive psychological adjustment following SCI for those individuals at risk of developing clinical levels of depression. Conclusion: The SAC model provides a comprehensive formulation to incorporate the heterogeneity of populations with SCI. Suggestions for future research include developing assessment and treatment regimes specifically tailored to the strengths and weaknesses of an individual as highlighted in the model.