The Nature and Correlates of Change in Depressive Symptoms With Cancer Diagnosis: Reaction and Adaptation Frank J. Infurna Pennsylvania State University and German Institute for Economic Research (DIW Berlin), Berlin, Germany Denis Gerstorf German Institute for Economic Research (DIW Berlin), Berlin, Germany, and Humboldt University, Berlin Nilam Ram Pennsylvania State University and Max Planck Institute for Human Development, Berlin, Germany Major life events trigger change processes in mental health. We examined how depressive symptoms change in conjunction with cancer diagnosis during adulthood and old age, and whether sociodemo- graphic variables, cognitive and health resources, and cancer-specific mortality risks moderate event- related reaction and adaptation. Specifically, we applied multiphase growth models to prospective longitudinal data from 2,848 participants (age at diagnosis: M = 69, SD = 9.91; 46% women) in the Health and Retirement Study (HRS) who reported receiving a cancer diagnosis while enrolled in the study. On average, individuals experienced a significant increase in depressive symptoms within 2 years of cancer diagnosis, still-elevated levels 2 years postdiagnosis, and smaller increases in depressive symptoms postdiagnosis relative to the increases observed prediagnosis. Better memory and lower cancer-specific mortality risks were protective against increases in depressive symptoms within 2 years of diagnosis and were associated with reporting fewer depressive symptoms 2 years postdiagnosis. Findings suggest that diagnosis-related changes in depressive symptoms are typically characterized by a multiphase pattern, but tremendous between-person differences also emerged within each phase. Follow-up analyses comparing a matched group (N = 2,272) who did not experience cancer provided an additional layer of evidence supporting our inferences. Results indicate that, on average, people adapt and adjust to the challenges accompanying a cancer diagnosis, and illustrate the utility of using natural experiments such as major life events as a paradigm for studying developmental change processes. Keywords: subjective well-being, cancer diagnosis, Health and Retirement Study, adulthood and old age, reaction and adaptation to major life events Major life events, such as experiencing a severe illness, are among the “nonnormative” experiences that often substantially shape the development of individuals’ mental health and overall functioning (Baltes & Nesselroade, 1979; Birren & Cunningham, 1985; Diener, Lucas, & Scollon, 2006; Gerstorf et al., 2010; Ram, Gerstorf, Fauth, Zarit, & Malmberg, 2010). For example, receipt of a cancer diagnosis is a central life experience that has profound implications for functioning across cognitive, physical health, and well-being domains (Aspinwall & MacNamara, 2005; Costanzo, Ryff, & Singer, 2009; Coughlin, 2008; Stanton, Revenson, & Tennen, 2007). In this study, we focus on changes in mental health as processes that unfold in the years prior to, within 2 years of (reaction), and the years subsequently following the incidence of a cancer diagnosis (adaptation). Insights into the mental health changes in relation to pathology-related processes have largely accumulated from studies on disability (Fauth, Gerstorf, Ram, & Malmberg, 2012; Lucas, 2007b; Ormel, Rijsdijk, Sullivan, van Sonderen, & Kempen, 2002; Penninx, Leveille, Ferrucci, van Eijk, & Guralnik, 1999; Verbrugge & Jette, 1994). In contrast, relatively little is known about whether and how mental health changes as cancer-related processes evolve (for notable exception, see Costanzo et al., 2009). Here, we use prospective multiwave lon- gitudinal data from the Health and Retirement Study (HRS) to examine how depressive symptoms change in relation to cancer diagnosis and whether sociodemographics, cognitive and health resources, and cancer-specific mortality risks moderate reaction and adaptation to diagnosis. This article was published Online First September 17, 2012. Frank J. Infurna, Department of Human Development and Family Stud- ies, Pennsylvania State University, and German Socio-Economic Panel Study, German Institute for Economic Research, Berlin, Germany; Denis Gerstorf, German Socio-Economic Panel Study, German Institute for Eco- nomic Research, Berlin, Germany, and Institute for Psychology, Humboldt University, Berlin; Nilam Ram, Department of Human Development and Family Studies, Pennsylvania State University, and Max Planck Institute for Human Development, Berlin, Germany. The authors gratefully acknowledge the support provided by the National Institute on Aging (NIA) NIA R21-AG032379 and NIA R21-AG033109. The Health and Retirement Study was supported by a cooperative agreement (Grant U01 AG09740) between the NIA and the University of Michigan. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies. Special thanks to Laura Cousino Klein, Katie Gates, Salvatore Ferro, and Max Crowley for thought- provoking discussions regarding this paper. Correspondence concerning this article should be addressed to Frank J. Infurna, Humboldt University Berlin, Institute of Psychology, Unter den Linden 6, 10099, Berlin, Germany. E-mail: frank.j.infurna@hu-berlin.de This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. Psychology and Aging © 2012 American Psychological Association 2013, Vol. 28, No. 2, 386 – 401 0882-7974/13/$12.00 DOI: 10.1037/a0029775 386