title: Continuing with life as normal:: positive psychological outcomes following spinal cord injury.
abstract: BACKGROUND
  Research into the psychological sequelae of spinal cord injury (SCI) has focused on reports of psychological distress, despite the low prevalence rates of mental health difficulties. Positive psychological frameworks have begun to explore how some individuals do not report psychological distress, while appraisals have been posited as possible mediators of psychological outcome. Research into positive psychological outcomes in people with SCI is still in its infancy.
  
  
  OBJECTIVE
  To provide a description of the positive psychological outcomes experienced by people reporting low levels of psychological distress, to generate an understanding of how these individuals explain their positive outcomes, and to consider the implications for research, theory, and practice.
  
  
  METHODS
  Six participants (2 female, 4 male) reporting low levels of psychological distress were interviewed using a semi-structured interview schedule exploring their experiences. Interpretative phenomenological analysis was used to analyze data.
  
  
  RESULTS
  THREE SUPERORDINATE THEMES WERE IDENTIFIED: "living a normal life, just doing things differently," "overcoming challenges: determination to succeed," and "using the resources available to me." The description and explanation of a positive psychological outcome was complex. For participants, positive psychological outcomes did not exclude experiencing psychological difficulty; moreover, they described an ability to overcome difficulty. Challenge-focused appraisals, social support, and meaningful activity were identified by participants as being important to psychological outcome.
  
  
  CONCLUSIONS
  Positive psychological outcomes following SCI are complex, and research and theory need to better understand the experience of individuals following SCI in order to inform clinical practice.
authors: Department of Clinical Health Psychology, The Hillingdon Hospital , Uxbridge, London , UK.
authors: H C
authors: HC
authors: Griffiths
authors: D
authors: D
authors: Clinpsy
authors: P
authors: P
authors: Kennedy
keywords: appraisals; posttraumatic growth; psychosocial outcomes; resilience; spinal cord injury