• Developed to measure coping after a sudden onset SCI
  • Made up of three domains:
    1) Acceptance of Injury
    2) Social Reliance
    3) Fighting Spirit
  • The acceptance domain measures the extent of reevaluation of life values, fighting spirit domain measures efforts to behave independently, and the social reliance domain measures the tendency towards dependent behaviour.

Clinical Considerations

  • The results of the SCL CSQ are to be used to advise clinicians about specific coping  mechanisms of acceptance, fighting spirit and social reliance. Coping strategies have been shown to be associated with emotional well-being. The SCL CSQ is a measure to assess coping efforts, rather than the outcomes of coping which is more typically measured, and may be a more pertinent tool to assess emotional well-being.
  • The scale was originally developed for the SCI population.
  • The SCL CSQ can be completed online, over the telephone or in person. It is short and simple to complete, and represents no significant burden to the respondent. The scale is simple to administer and score.

ICF Domain

Body Function ▶ General Functions


  • Self-report scale; can be completed in hard copy, online or over the telephone
  • Participants are asked to answer each question on a 4-point Likert scale (1 = strongly disagree, 2 = disagree, 3 = agree, 4 = strongly agree).

Number of Items





Domain scores are summed and then averaged. Scores range between 1 and 4 for each domain.


Swedish, English

Training Required

Does not require advanced training


Can be found here.

# of studies reporting psychometric properties: 4


  • Higher scores indicate greater affirmation of the domain to coping.
  • No cut scores or norms for the SCI population have been reported at this time.
  • Published data for the SCI population is available for comparison (see Interpretability section of Study Details sheet)

MCID: not established in SCI
SEM: not established in SCI
MDC: not established in SCI


The SCL-CSQ subscale has Moderate to High test-retest reliability (ICC = 0.74-0.89), and Low to High internal consistency (alpha = 0.69-0.88).

(Elfstrom et al. 2002, Elfstrom et al. 2007, Paker et al. 2014, Saffari et al. 2015, Saurí et al. 2014)


  • Correlation between SCL-CSQ subscales is Low for:
    • Acceptance & Fighting Spirit (Pearson’s r = 0.37)
    • Acceptance & Social Reliance (Pearson’s r = -0.14)
    • Fighting Spirit & Social Reliance (Pearson’s r = -0.13).
  • Correlations between the SCL-CSQ subscales Acceptance and Fighting Spirit are negative, as expected, with the HADS subscales Anxiety and Depression.
  • Correlation of the SCL-CSQ Acceptance subscale is Moderate with the Hospital Anxiety and Depression Scale subscales – Anxiety (Pearson’s r = -0.45) and Depression (Pearson’s r = -0.58).
  • Correlation of the SCL-CSQ Fighting Spirit subscale is Moderate with the Hospital Anxiety and Depression Scale subscales – Anxiety (Pearson’s r = -0.40) and Depression (Pearson’s r = -0.49).
  • Correlation of the SCL-CSQ  is Low to Moderate with the SCIM-III and Community Integration Questionnaire (r = 0.16-0.33).

(Elfstrom et al. 2002, Elfstrom et al. 2007, Migliorini et al. 2018, Saffari et al. 2015)


No values were reported for the responsiveness of the SCL-CSQ for the SCI population.

Floor/Ceiling Effect

No values were reported for the presence of floor/ceiling effects in the SCL-CSQ for the SCI population.


Dr. Vanessa Noonan, John Zhu, Jeremy Mak, Matthew Querée, Risa Fox

Date Last Updated

3 August 2020

Elfstrom, ML, Ryden A, Kreuter M, Persson L-O, Sullivan M. Linkages between coping and psychological outcome in the spinal cord lesioned: development of SCL-related measures. Spinal Cord, 2002; 40: 23-29.

Elfstrom ML, Kennedy P, Lude P, Taylor N. Condition-related coping strategies in persons with spinal cord injury: a cross-national validation of the Spinal Cord Lesion-related Coping Strategies Questionnaire in four community samples. Spinal Cord, 2007; 45: 420-428.

Migliorini CE, Elfstom ML, Tonge BJ. Translation and Australian validation of the spinal cord lesion-related coping strategies and emotional wellbeing questionnaires. Spinal Cord 2008:46;690-695.

Paker N, Bugdayci D, Kesiktas N, Sahin M, Elfström ML. Reliability and validity of the Turkish version of spinal cord lesion-related coping strategies. Spinal Cord. 2014;52(5):383-7.

Saffari M, Pakpour AH, Yaghobidoot M, Al zaben F, Koenige HG. Cross-cultural adaptation of the spinal cord lesion-related coping strategies questionnaire for use in Iran. Injury. 2015;46(8):1539-44.

Saurí J, Umaña MC, Chamarro A, Soler MD, Gilabert A, Elfström ML. Adaptation and validation of the Spanish version of the Spinal Cord Lesion-related Coping Strategies Questionnaire (SCL CSQ-S). Spinal Cord. 2014;52(11):842-9.