Objective: To test the hypothesis that social problem-solving abilities of persons with recent-onset spinal cord injury (SCI) would be predictive of pressure sore occurrence in the 1st 3 years following discharge from initial inpatient rehabilitation. Design: Prospective study of persons with recently incurred SCI and their subsequent pressure sore evaluations over a 3-year period in annual clinic evaluations. Setting: Inpatient SCI rehabilitation center and outpatient clinic. Participants: 188 persons with recent-onset SCI approaching discharge from initial inpatient SCI rehabilitation, with outpatient pressure sore evaluations for those who returned for pressure sore evaluations. Main Outcome Measure: Pressure sore occurrence as determined in annual outpatient evaluations conducted over the 1st 3 years of SCI. Results: 2 separate statistical models indicated that social problem-solving abilities significantly contributed to the prediction of pressure sore occurrence. Conclusions: Social problem-solving abilities are implicated in the development of pressure sores. Persons with ineffective problem-solving abilities may be at risk for pressure sores; these individuals might require strategic monitoring and training from clinical programs. Copyright 2006 by the American Psychological Association.