This study assessed the stability of multiple aspects of adaptation af
ter spinal cord injury (SCI). One hundred fourteen participants with S
CI completed the Life Situation Questionnaire on 4 separate occasions
over a 20-year interval. Changes in the outcomes over time were measur
ed. Time engaged in employment activities, sitting tolerance, and numb
er of years of education increased, and the number of hospitalizations
and total days hospitalized decreased. However, self-rated adjustment
decreased over the same time period. The results indicate a divergenc
e between changes in objective and subjective aspects of life over the
20-year period. These findings suggest that people with SCI generally
do not feel more positive about their lives than they did 20 years pr
ior, despite an increase in employment opportunities and a decrease in
hospitalizations.