The purpose of this study was to examine the relation between attributional cognitions, coping behavior, and self-esteem of inpatients with severe spinal cord injuries. Thirty inpatients from rehabilitation centers were interviewed. Their coping behavior was assessed by a physician, a nurse, and a psychologist. The results showed sometimes different tendencies for the recently vs. long-disabled patients with respect to the direction of the relation between attributional cognitions and rehabilitation outcome (coping behavior and self-esteem). Especially noteworthy is the evident adaptiveness in the group of the long-disabled inpatients with regard to being concerned with the causes of the accident and being concerned with the avoidability of the accident that led to the injury, while in the recently disabled group these cognitions are related to nonadaptiveness. To be concerned with the question, "Why did this have to occur to me?" was strongly related for the long-disabled inpatients with poor coping behavior, while this was not the case for the recently disabled.