title: Psychosocial issues in spinal cord injury: a review.
abstract: METHODS
  Review.
  
  
  OBJECTIVE
  To review literature on subjective well-being (SWB; mental health and life satisfaction) and on psychological and social support factors associated with these outcomes in people with spinal cord injury (SCI), in order to identify gaps in scientific knowledge and recommend research priorities.
  
  
  METHODS
  Non applicable.
  
  
  METHODS
  Narrative review of the SCI literature on life satisfaction and mental health (depression, anxiety, post-traumatic stress syndrome) outcomes in people with SCI. Further, reviews were performed of the SCI literature on psychological and social support variables associated with SWB and on psychosocial interventions aimed to improve SWB.
  
  
  RESULTS
  People with SCI experience, on average, higher levels of distress and lower levels of life satisfaction compared with the general population. Individual differences, however, are large, and most people with SCI adapt well to their condition. A set of psychological and social support factors is strongly related to SWB. Intervention studies on cognitive behavioural therapy or coping effectiveness training to improve SWB show promising results, but suffer from methodological weaknesses (for example, lack of randomization and small sample size).
  
  
  CONCLUSIONS
  There is a need for cohort studies with sufficient sample size, which include people early after onset of SCI in order to enhance our understanding of the course of mental health and well-being after SCI. Cohort studies could also identify which people are at risk for long-term impairment of SWB. Finally, intervention studies on psychosocial interventions are needed to identify which interventions may improve SWB of people with SCI.
authors.affiliation: Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht and Center of Excellence in Rehabilitation Medicine, De Hoogstraat, Utrecht, The Netherlands. m.post@dehoogstraat.nl
authors.forename: M W M
authors.initials: MW
authors.lastname: Post
authors.forename: C M C
authors.initials: CM
authors.lastname: van Leeuwen
mesh_terms: D000342:Affective Symptoms / Q000209:etiology / Q000523:psychology; D001521:Behavior Therapy / Q000379:methods*; D006801:Humans; D010549:Personal Satisfaction; D012944:Social Support; D013119:Spinal Cord Injuries / Q000150:complications / Q000523:psychology / Q000534:rehabilitation