Research efforts are being made to identify personality and cognitive variables predictive of poor adjustment following myocardial infarction. Sixty-two male patients were examined after a first and uncomplicated myocardial infarction to determine whether dispositional emotional reactivity and debilitating beliefs measured during hospitalization can predict work engagement, social activities involvement, and ambulation/independence six months later. A structural model with direct paths between emotional reactivity, debilitating beliefs, and the above outcomes, as well as partial mediation of emotional distress and illness preoccupation, was tested using the CALIS procedure. The model explained 33%, 48% and 82% of the variance in the three outcomes, respectively. Work engagement was indirectly related through emotional distress to earlier emotional reactivity and debilitating beliefs. Social activities involvement was both directly and indirectly related through emotional distress to debilitating beliefs; and also indirectly related through emotional distress to emotional reactivity. Ambulation/independence was directly and negatively related to debilitating beliefs. Prolonged emotional distress was predicted by emotional reactivity and debilitating beliefs. Illness preoccupation turned out to be an independent outcome that was positively related to emotional reactivity. Thus, measuring dispositional emotional reactivity and debilitating beliefs at the hospitalization stage may be helpful in detecting patients at risk of poor future adjustment.