• Developed to measure emotional consequences after SCI
  • Consists of three domains:
  1. Positive emotional outcome of person growth (which determines current positive changes)
  2. Negative outcomes of helplessness (which determines the level of perplexity, out of control and low self-esteem)
  3. Intrusion (which determines the level of bitterness and brooding)

Clinical Considerations

  • The results of the SCL EWQ are used to advise clinicians about specific emotional consequences of a traumatic SCI.
  • The SCL EWQ is short and simple to complete. There is no significant respondent burden. The scale is simple to administer and score.
  • The scale was originally developed for the SCI population.

ICF Domain

Body Functions ▶ General Functions


  • Self-report scale; can be self-completed in hard copy, online or by telephone interview.
  • 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: 1


  • Higher scores indicate greater affirmation of the domain. So, higher scores on the personal growth scale indicate more positive emotional consequences of the SCI and higher scores on the helplessness or intrusion scale indicate more negative emotional consequences.
  • No cut scores or norms for the SCI population have been reported.

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


Internal consistency for the SCL-EWQ subscales is:

  • High for the Helplessness subscale (Cronbach’s a = 0.84)
  • High for the Intrusion subscale (Cronbach’s a = 0.86)
  • Moderate for the Personal Growth subscale (Cronbach’s a = 0.75).

(Elfstrom et al. 2002)


Correlation between SCL-EWQ subscales is (with correlation direction (positive/negative) as expected):

  • Moderate for Helplessness & Intrusion (Pearson’s r = 0.63)
  • Low for Helplessness & Personal Growth (Pearson’s r = -0.30)
  • Low for Intrusion & Personal Growth (Pearson’s r = -0.23)

(Elfstrom et al. 2002)


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

Floor/Ceiling Effect

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


Dr. Vanessa Noonan, 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.

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.