The present study focused on the structural validity of the Dutch 13-item sense of coherence (SOC) scale, examined age trends in SOC in adolescence and young adulthood, and investigated the potential impact of chronic disease on SOC. Eight samples of Belgian high school students, college students, and young adult employees were used (total 'N' = 2,781); 380 of them aged 14-18 years were diagnosed with congenital heart disease. The SOC-13 scale proved to be structurally valid, as configural, metric, and scalar invariance was established. In line with salutogenic theory, SOC was found to increase with age through the teens and twenties. Relatedly, whereas high school and college students did not differ on mean SOC scores, employed young adults scored significantly higher. Having congenital heart disease was associated with higher levels of SOC in 14-18 year olds: they displayed similarly high scores on SOC as healthy individuals in their late twenties.