Long-term adjustment to physical disability: the role of social support, perceived control, and self-blame.

One hundred middle-aged and elderly spinal-cord-injured persons were interviewed an average of 20 years after the disability occurred. Respondents answered questions concerning perceived control, attributions of blame, and the nature of the social comparisons they made. Three existing standardized instruments were used to measure adjustment: Index of Psychological Well-Being, Life Satisfaction Index, and the Center for Epidemiologic Studies Depression Scale. For all three outcome measures, respondents reported levels of well-being only slightly lower than population means of nondisabled persons of similar age. Controlling for health status and current income, we found that persons who have high levels of social support, who are satisfied with their social contacts, and who feel they have high levels of perceived control report high levels of well-being. Self-blame and the perceived avoidability of the cause of the disability correlated only moderately with the three measures of adjustment, suggesting that there are important differences between coping successfully immediately after a traumatic event has occurred and coping successfully many years later.