title: Understanding post-traumatic growth following pediatric-onset spinal cord injury: the critical role of coping strategies for facilitating positive psychological outcomes.
abstract: OBJECTIVE
  The aim of this study was to explore positive psychological growth in individuals who had sustained spinal cord injuries (SCIs) in childhood, and to identify factors correlating with such growth.
  
  
  METHODS
  Data were drawn from ongoing research aimed at assessing the long-term outcomes of pediatric-onset SCIs in adults. Participants were assessed using measures of demographics, coping ability, post-traumatic growth, life satisfaction, happiness, and mental health. The study sample included 161 adults with a mean age of 33 years and 2 months (SD 7y 3mo, range 19-50y). The participants had sustained SCIs between the ages of 7 years and 18 years (mean 14y 10mo, SD 2y 6mo) and were injured for an average of 17 years and 9 months (SD 7y 7mo, range 1-36y). Sixty-four percent of participants were male, 81% were white, 63% had tetraplegia, and 70% had complete injuries.
  
  
  RESULTS
  The vast majority of participants (99%) recognized that at least one positive change had occurred in their life as a result of their SCI. Post-traumatic growth was significantly associated with behavioral (r=0.29, p<0.001) and cognitive (r=0.39, p<0.001) coping strategies, as well as with increased life satisfaction (r=0.18, p=0.024) and happiness (r=0.27, p=0.001), but was unrelated to psychological distress. Additional analyses indicated that post-traumatic growth mediated effects of cognitive coping on happiness, but not on life satisfaction.
  
  
  CONCLUSIONS
  The majority of individuals with pediatric-onset SCIs experienced positive psychological growth. Coping strategies are crucial to this growth process.
authors.affiliation: Department of Clinical Research, Shriners Hospitals for Children, Chicago, IL, USA.|Orthopaedic and Rehabilitation Engineering Center, Marquette University, Milwaukee, WI, USA.
authors.forename: Alicia M
authors.initials: AM
authors.lastname: January
authors.affiliation: Department of Psychology, Shriners Hospitals for Children, Chicago, IL, USA.|Department of Psychology, Loyola University Chicago, Chicago, IL, USA.
authors.forename: Kathy
authors.initials: K
authors.lastname: Zebracki
authors.affiliation: Department of Clinical Research, Shriners Hospitals for Children, Chicago, IL, USA.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Chlan
authors.affiliation: Department of Pediatrics, Shriners Hospitals for Children, Chicago, IL, USA.|Department of Pediatrics, Rush Medical College, Chicago, IL, USA.
authors.forename: Lawrence C
authors.initials: LC
authors.lastname: Vogel
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D017668:Age of Onset; D005260:Female; D006240:Happiness; D006803:Human Development; D006801:Humans; D055809:Illness Behavior; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D013119:Spinal Cord Injuries / Q000523:psychology*; D055815:Young Adult