Reflecting on subjective well-being and spinal cord injury.

OBJECTIVE The aim of this study was to examine factors associated with the subjective well-being of individuals with spinal cord injuries, while acknowledging theories that describe the subjective well-being tendency to homeostasis. METHODS A representative community cross-sectional cohort of 443 adults with traumatic and non-traumatic spinal cord injury completed a self-report survey (by internet, telephone or hard copy) that included reliable and valid measures of quality of life, depression, anxiety and stress, post-traumatic stress disorder, coping strategies, and emotional consequences. RESULTS The subjective well-being of half of the population with spinal cord injury lay above the normative subjective well-being set-point threshold. Despite the inclusion of many biopsychosocial factors, only Intimacy, Safety, Acceptance, and Helplessness were significantly associated with normative subjective well-being. CONCLUSION Comparatively few factors were significantly associated with normative subjective well-being, but the results help to explain observed contradictions noted in previous research into subjective well-being after spinal cord injuries. The results highlight the resilience of individuals in general and are in keeping with the disability paradox. However, many individuals with spinal cord injuries do not live satisfactory lives. It is for them that further psychological care and rehabilitation is necessary to create a good life after spinal cord injury.