Purpose <p>Spousal caregivers provide critical support for cancer patients but are at high risk for adverse psychological outcomes. We aimed to investigate the associations between resilience and factors related to resilience in partner caregivers with caregiver anxiety, depression, and perceived stress.</p> Methods <p>This cross-sectional study used baseline data from the “Resilient Caregivers” randomized trial testing a resilience-based group intervention in distressed spousal cancer caregivers. Participants were spouses of cancer patients undergoing treatment (regardless of stage and type) and scored ≥ 4 on the Distress Thermometer. All participants completed questionnaires assessing resilience, social support, valued living, rumination, attention to threat, coping behaviors, metacognitive beliefs, anxiety, depression, and perceived stress.</p> Results <p>Seventy-nine spouses of cancer patients undergoing treatment were included, with the majority being female (75%), over 50&#xa0;years old (80%), and with at least an undergraduate education (86%). Obstruction to valued living, rumination, and attention to threat were significantly negatively correlated with resilience (<i>p</i> ≤ 0.05). Low resilience, obstruction to valued living, rumination, and attention to threat were significantly associated with anxiety, depression, and perceived stress (<i>p</i> ≤ 0.01), while maladaptive coping was significantly associated with depression and perceived stress (<i>p</i> ≤ 0.05) and maladaptive metacognitive beliefs were significantly associated with anxiety (<i>p</i> = 0.03).</p> Conclusions <p>We found that obstruction to valued living, rumination, and attention to threat were associated with lower resilience and higher levels of anxiety, depression, and stress. These factors may be potential targets in future interventions to strengthen caregiver resilience and improve psychological outcomes among spousal caregivers.</p>