Examined prospective associations among poverty-related family stress, coping, involuntary stress reactivity, and psychological symptoms in a sample of 79 rural, low-income adolescents. Poverty-related family stress predicted adolescents' anxious/depressed and aggressive behavior 8 months later, controlling for prior symptoms. Coping interacted with initial symptoms and involuntary stress reactivity to predict changes in symptoms over time, showing that primary and secondary control coping were most strongly associated with changes in symptoms for adolescents with low initial symptoms and involuntary stress reactivity. The only significant predictor of coping over time was prior coping, suggesting that coping is not symptom-driven and may be somewhat trait-like. Implications for interventions and additional research are offered.