The present study focused on the structural validity of the Dutch version of the 13-item sense of coherence (SOC) scale, examined age trends in SOC in adolescence and young adulthood (ages 14-30 years), and investigated the potential impact of chronic disease on SOC. Eight samples of Belgian high school students, college students, and young adult employees collected between 2005 - 2010 were used (total N = 2,781); 380 of these individuals aged 14-18 years were diagnosed with congenital heart disease. The SOC-13 scale proved to be a structurally valid measure in this age-span, as configural, metric, and scalar invariance was established. In line with core tenets of salutogenic theorizing, SOC was found to increase with age through the late teens and twenties. Relatedly, whereas high school and college students did not differ substantially on mean SOC scores, employed young adults scored significantly higher. Further, having congenital heart disease was associated with higher levels of SOC in 14-18 year old adolescents, even to the extent that they displayed similarly high scores on SOC as community individuals in their late twenties.