Psychologic adjustment to spinal cord injury during first postdischarge year

A considerable body of clinical literature discusses patient adjustment to spinal cord injury (SCI) but there are few empirical data, particularly about postrehabilitation hospital adjustment. The present study targets changes in psychologic adjustment after initial rehabilitation hospitalization. Thirty-six persons with SCI completed a questionnaire designed to study such adjustment at 3 weeks, 3 months, and 1 year postdischarge. Twenty-nine able-bodied controls completed the same questionnaire at similar time intervals. Outcome measures used were the Beck Depression Inventory, the Wiggins Hostility Scale, and the Handicap Problems Inventory. Moderately increased depression and hostility in the SCI group compared to the able-bodied were found immediately postdischarge, but these differences were gone within a year. On a specific measure of adjustment to disability, the SCI group showed significantly increasing comfort with disability status over the same period. While there are reports of psychologic adjustment difficulties for persons with SCI postdischarge, the severity of these difficulties may have been overestimated and our findings suggest that problems appearing immediately after discharge appear to resolve rapidly.