This study examined the correlates of unrealistic beliefs about spinal cord injury (SCI), denial tendencies, and defensiveness over the first year following injury onset (N = 40). Individuals were interviewed at three different times after their return to the community. Specific overly optimistic beliefs about SCI were not associated with any index of adjustment at the first two assessments; however, these beliefs were associated with greater distress and perceived handicap 1 year following return to the community. Greater denial and defensiveness were consistently associated with less distress, hostility, and perceived handicap at each assessment. No self-report variables were associated with the occurrence of preventable secondary complications diagnosed I year following discharge from the rehabilitation unit. Results are discussed as they pertain to models of reality negotiation and adjustment to the onset of severe physical disability.