The Silver Lining Questionnaire (SLQ-38) is purported to measure 10 aspects ofadversarial growth in illness. To date however, no empirical evidence exists to support thisclaim. Hence the aim of this study was to investigate the factor structure of the SLQ-38 ina sample of 560 individuals with multiple sclerosis (MS), cancer, cardiac, and renaldisease. The results demonstrate that 24 SLQ-38 items can be factored into fivesubscales: improved personal relationships, greater appreciation for life, positive influenceon others, personal inner strength and changes in life philosophy, all of which are inaccordance with the literature on adversarial growth. Individuals with MS experiencedlower adversarial growth compared to other illness groups. Gender, age and time sincediagnosis were unrelated to adversarial growth in illness. The utility of the revised SLQ-38is discussed along with suggestions for future research on the convergent and divergentvalidity of this revised instrument.