The authors prospectively tested the hypothesis that emotional expressivity would moderate the predictive relationship between patient neuroticism and spousal constraints among 120 individuals with cancer. The authors also examined whether patient gender further moderated the hypothesized relationships. After we controlled for Time 1 constraints, results revealed a significant emotional Expressivity [times] Neuroticism effect on Time 2 spousal constraints. This moderator effect was qualified by a significant Gender [times] Emotional Expressivity [times] Neuroticism effect, such that neuroticism predicted the greatest levels of spousal constraints among female but not male patients reporting higher levels of emotional expressivity. Thus, female, but not male, patients who report the tendency to both experience and express high levels of distress appear most likely to trigger constraints from their spouses.