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In a mailed survey, 125 persons with spinal cord injury responded to questions on the SCI Quality of Life Index (QOLI) , and the Reciprocal Social Support Scale. The results indicated that people with SCI who believe that they receive support from the community, compared to those who believed they received less support (1) perceived themselves to be better adjusted to their injury, and (2) had significantly fewer health problems (fewer spinal cysts, lower blood pres sure, shorter recovery time from decubitus ulcers, less pain below the level of injury, and fewer hospital admissions). The results also showed that people who believe that they contribute to the community in some way, compared to those who believed they contributed little or nothing (1) perceived themselves to be better adjusted to their injury, and (2) had significantly fewer health problems (fewer urinary tract infections, fewer decubitus ulcers, less severe decubiti, less pain above the level of injury, and fewer hospital admissions). A community support score, a summary score of support given and received, was also related to adjustment and health.

The study of psychological adjustment after spinal cord injury (SCI) has been limited by the use of easy-to-obtain participant samples that have included mostly young Caucasian males and by the lack of refined measures of adjustment. The two primary goals of the current study were: (1) to generate data on gender and race differences on subjective well-being (life satisfaction, adjustment, and problems) and (2) to develop an improved measure of subjective outcomes after SCI. A total of 362 participants from a southeastern rehabilitation center who were stratified according to gender, race, and age at injury onset completed the Multidimensional Adjustment Profile (MAP). Ten subjective adjustment scales were developed from the MAP, nine of which were based on factor analysis of sets of 20 life satisfaction items and 31 problem items. Compared with minority participants, Caucasian participants reported significantly higher levels of Career Satisfaction and fewer problems with Skills Deficit and Financial Limitations. Interactions between gender and race were observed for three scales (Emotional Distress, Physical Discomfort, and Adjustment), with more positive scores reported by minority males and Caucasian females. Results pointed to the importance of race differences in adaptation after SCI.

To identify special characteristics of the pediatric spinal cord-injured (SCI) population, we analyzed a database of 1,770 traumatic SCI patients; 88 (5%) fell into the two pediatric subgroups: 0-12 years (n = 26) and 13-15 years (n = 62) at time of injury. Differences between age groups were identified with regard to demographics, neurologic characteristics, associated injuries and complications, and management. Mode level of bony injury was C2 in preteens, C4 in teens, and C4-C5 in adults. Scoliosis developed far more frequently in children, particularly preteens (23%), than in adults (5%). Violent etiologies, predominantly gunshots, accounted for a disproportionate share of injuries to preteens (19%) and African-Americans (28%), as compared with adults (12%) and Caucasians (7%). This last finding underscores the urgent need to mount a response to the nationwide proliferation of gunshot-related SCI in children and minorities.