The authors examined the relation of social problem-solving abilities to trajectories of adjustment of family caregivers in the initial year of their caregiving role. Persons who recently assumed the caregiver role for a family member with a recent-onset spinal cord injury completed measures of problem solving, depression, anxiety, and health during the inpatient rehabilitation program and at 3 other times throughout the year. Hierarchical linear modeling showed that negative problem orientation explained significant variation in the rates of change in caregiver depressive behavior, anxiety, and health complaints. Caregivers with a greater negative orientation were at risk to develop psychological and health problems at a significantly higher rate over the year. Implications for psychological interventions and health policy concerning the needs of family caregivers and their care recipients are discussed.