title: Unmet expectations of adjustment and depressive symptoms among people with chronic traumatic spinal cord injury.
abstract: OBJECTIVE
  We attempted to gain a better understanding of overall adjustment among people with chronic traumatic spinal cord injury (TSCI) by identifying participants who experienced unmet expectations of adjustment to TSCI. We also examined the relationship between unmet expectations and depressive symptoms.
  
  
  METHODS
  This was a prospective cohort study. Participants who survived at least 1 year postinjury (N = 863) were assessed at 2 time points separated by 10 years. Using a 10-point ladder (1 = worst and 10 = best adjustment), self-predicted future adjustment was measured at Time 1. At Time 2, current adjustment was reassessed using the same scale to evaluate differences between predicted and actual adjustment. Adjustment expectations were considered unmet when actual adjustment ratings at Time 2 were lower than predicted adjustment at Time 1. We measured depressive symptoms by using the Older Adult Health and Mood Questionnaire at both time points.
  
  
  RESULTS
  More than half of our participants experienced unmet expectations of adjustment over a 10-year period, and having unmet expectations was positively associated with depressive symptoms.
  
  
  CONCLUSIONS
  Unmet expectations of adjustment after TSCI are common among those injured, and they are important predictors of depressive symptoms.
authors.affiliation: College of Health Professions, Medical University of South Carolina.
authors.forename: Yue
authors.initials: Y
authors.lastname: Cao
authors.affiliation: College of Health Professions, Medical University of South Carolina.
authors.forename: Nicole D
authors.initials: ND
authors.lastname: DiPiro
authors.affiliation: Department of Sociology, University of Akron.
authors.forename: Juan
authors.initials: J
authors.lastname: Xi
authors.affiliation: College of Health Professions, Medical University of South Carolina.
authors.forename: James S
authors.initials: JS
authors.lastname: Krause
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology*; D000328:Adult; D001294:Attitude to Health; D015331:Cohort Studies; D003866:Depressive Disorder / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013119:Spinal Cord Injuries / Q000150:complications / Q000523:psychology* / Q000534:rehabilitation*; D011795:Surveys and Questionnaires