The role of social support and emotional intelligence on negative mood states among couples during pregnancy: An actor-partner interdependence model approach

Abstract

Objective: In the field of perinatal psychology, the majority of studies focused on mothers’ psychological and behavioral states during pregnancy, neglecting the role of their partners. This study used an Actor-Partner Interdependence Model approach to evaluate the role of social support and emotional intelligence in both members of marital couples who were expecting a baby. Method: Forty couples who were waiting for their first child were asked to complete questionnaires on social support, trait emotional intelligence, anxiety, and depression. Results: Paternal emotional intelligence was related to paternal depression and anxiety, and maternal emotional intelligence was related to maternal depression and anxiety. Anxiety and depression were not predicted by the other partner’s social support and emotional intelligence. However, emotional intelligence in fathers was linked to perceived social support in mothers. Conclusions: Anxiety and depression are serious problems during pregnancy, and high emotional intelligence in fathers can represent an important variable that might indirectly reduce negative mood states in mothers. This consideration may help in the definition of better preventative actions and psychological interventions during pregnancy.

Full text

Clinical Neuropsychiatry (2018) 15, 1, 19-26
THE ROLE OF SOCIAL SUPPORT AND EMOTIONAL INTELLIGENCE ON NEGATIVE MOOD STATES
AMONG COUPLES DURING PREGNANCY:
AN ACTOR-PARTNER INTERDEPENDENCE MODEL APPROACH
Ivan Formica, Nadia Barberis, Sebastiano Costa, Jessica Nucera, Maria Laura Falduto, Noemi Rosa Maganuco,
Monica Pellerone, Adriano Schimmenti
Abstract
Objective: In the eld of perinatal psychology, the majority of studies focused on mothers’ psychological
and behavioral states during pregnancy, neglecting the role of their partners. This study used an Actor-Partner
Interdependence Model approach to evaluate the role of social support and emotional intelligence in both members of
marital couples who were expecting a baby.
Method: Forty couples who were waiting for their rst child were asked to complete questionnaires on social
support, trait emotional intelligence, anxiety, and depression.
Results: Paternal emotional intelligence was related to paternal depression and anxiety, and maternal emotional
intelligence was related to maternal depression and anxiety. Anxiety and depression were not predicted by the other
partner’s social support and emotional intelligence. However, emotional intelligence in fathers was linked to perceived
social support in mothers.
Conclusions: Anxiety and depression are serious problems during pregnancy, and high emotional intelligence
in fathers can represent an important variable that might indirectly reduce negative mood states in mothers. This
consideration may help in the denition of better preventative actions and psychological interventions during pregnancy.
Key words: emotional intelligence; social support; pregnancy; actor-partner interdependence model; anxiety; depression
Declaration of interest: the authors declare that they have no conicts of interest to disclose
Ivan Formica1, Nadia Barberis2, Sebastiano Costa2, Jessica Nucera1, Maria Laura Falduto1, Noemi Rosa
Maganuco3, Monica Pellerone3, Adriano Schimmenti3
1 Department of Cognitive Sciences, Psychological, Educational and Cultural Studies, University of Messina
2 Department of Clinical and Experimental Medicine, University of Messina
3 Faculty of Human and Social Sciences, UKE - Kore University of Enna
Corresponding author
Prof. Adriano Schimmenti, PhD, DClinPsy
Faculty of Human and Social Sciences, UKE - Kore University of Enna
Cittadella Universitaria s.n.c - 94100 Enna (EN), Italy
E-mail: adriano.schimmenti@unikore.it
Introduction
Pregnancy is a period of particular psychological
vulnerability for future parents, who must cope with the
intense emotional experiences linked to the transition to
parenthood (Milgrom and Gemmill 2015, Silva 2012). In
fact, the transition to parenthood modies the life of the
couple, because the two partners need to develop adequate
parenting skills, have to adjust their life according
to the baby’s needs, and also have to renegotiate their
roles in the family (Beck 1996, Pellerone et al. 2017a,
Wandersman et al. 1980).
In literature, a child’s birth is considered as a critical
event that initiates a new developmental phase of the
family life cycle (Iacolino et al. 2016, Silva et al. 2012).
As far as the “family life cycle” is concerned, critical
events lead to the restructuring of the family and its
relationships, and, if these events are processed and
integrated, they support the development and relational
growth of the family itself; otherwise, the result is the
relational dysfunction of the family (Letornau et al.
2012, Pellerone et al. 2017b).
Given the fact that the birth of a child is a critical
life event that has important effects on the family life,
sometimes pregnancy is accompanied by psychological
symptoms in one or both partners, and anxiety and
depression are the most common of these symptoms
(Gaynes et al. 2005, Leach et al. 2015, Trotta et al. 2013).
In fact, pregnancy can sometimes result in an identity
crisis, because changes in the woman’s body and life
activities can affect the woman’s identity. This potential
crisis requires a reorganization of the mother’s psychic
world (Besser and Priel 2003, Delassus 1995, Laney
et al. 2015, Manzano et al. 1999). The psychological
acquisition of a maternal role implies the creation of a
new mental state in the woman, which has been dened
in terms of “maternal constellation” (Stern 1995). The
maternal constellation starts its structuring during
pregnancy, leading the woman to reorganize her life,
to redene her priorities, values and interests, and to
develop new emotional skills. Therefore, becoming a
mother can be very difcult, but generally ends with a
Submitted November 2017, Accepted JANuAry 2018
© 2018 Giovanni Fioriti Editore s.r.l. 19

Ivan Formica et al.
20 Clinical Neuropsychiatry (2018) 15, 1
Social support
Extensive research has explored the psychosocial risk
factors such as stressful events, marital difculties, and
low social support, which may lead to the development
of perinatal depression (Goodman and Brand 2009,
Milgrom et al. 2008, Paulden et al. 2009, Pignone et al.
2002, Swendsen and Mazure 2000, Verdoux et al. 2002).
Specically, social support has been considered as a
fundamental protective factor for perinatal depression,
as social support seems to promote the mother’s mental
health. Social support consists of help and aid that
an individual receives from people who are in a close
relationship to that person (Barrera and Ainlay 1983).
This construct is multi-dimensional and includes three
typologies of support: emotional, instrumental, and
informational (Schaefer et al. 1981). Emotional support
indicates the possibility to discuss one’s own feelings
with other people and to perceive their acceptance
about such feelings. Instrumental support indicates that
other people are available to provide material aid, e.g.
in terms of time, money, and general assistance with
daily activities. Informational support indicates that
others provide understanding, suggestions, and advice to
cope with problematic events on the basis of available
information.
Some empirical studies attempted to examine which
type of social support might better promote mental
and physical health in people. Research ndings show
that emotional support is often recognized as the most
important variable among the three domains of social
support (Collins et al. 1993, Uchino 2009). Empirical
studies also drew attention to the protective role of social
support in the development of post-partum depression.
For example, it seems that suitable support from the
mother’s parents reduces the odds of post-partum
depression, thanks to the positive effects of the support
itself on the mother’s perception of her self-efcacy
(Haslam et al. 2006). Even the presence of a supportive
partner has been proved to be essential, because it
reduces the negative experiences related to the impact of
childbirth on the woman’s wellness (Lemola et al. 2007,
Silva et al. 2012). Furthermore, the discrepancy between
social support received and social support expected
can predict the level of post-partum depression more
than the actual level of support (Shu-Shya Heh 2003).
The absence of social support also resulted to be a risk
factor in the development of perinatal depression in men
(Castle et al. 2008, Letourneau et al. 2001).
Emotional intelligence
Other psychological features (including self-esteem
and adequate coping strategies) might have a positive
inuence on the process of adjustment to becoming
parents. Among these, emotional intelligence (EI) is an
extensively studied construct that could represent an
important factor in the couple’s adjustment to parenthood.
Surprisingly, current research has barely examined the
relationship between EI and perinatal depression.
EI regards the way the individual perceives the
emotional world. It can be dened in general terms as the
capacity to identify one’s emotions and those of others,
to differentiate them and to use this information to drive
thinking and actions (Salovey and Mayer 1989). The idea
comes from the Multiple Intelligences Theory developed
by Gardner in 1983. Gardner distinguished between
two forms of EI: intrapersonal intelligence, which is
the capacity to consciously access the inner emotional
life; and interpersonal intelligence, which consists in
positive adjustment in the woman’s identity. However,
in the presence of some psychosocial or psychological
risk factors, maternal difculties may result in states of
psychological distress or even psychopathology (Brock
et al. 2015, Gaynes et al. 2005).
Also, transition to parenthood has important psycho-
logical effects on men. Research shows that some men
display emotional problems during their partner’s preg-
nancy that could negatively affect the couple’s life, and
later in life the mother-child relationship, and even the
child’s psychological and physical development (Fletch-
er et al. 2011, Leach et al. 2015, Wee et al. 2011).
These problems in men are often underestimated
and not recognized (Letourneau et al. 2011). Previous
studies (Giallo et al. 2012, O’Brien et al. 2016, Paulson
& Bazemore 2010) have shown a prevalence of
about 10% of paternal perinatal depression in general
population, with paternal depression correlated with
an increased risk for continued or worsened maternal
postpartum depressive symptoms (Paulson et al. 2016).
Paternal postpartum depression has also been linked to
internalizing (e.g., negative affetivity) and externalizing
symptoms (e.g. gambling, alcoholism) or escape
activities (e.g. overwork, extramarital affairs) in fathers
(Condonet al. 2004, Perez et al. 2017, Veskrna 2013).
Perinatal depression and anxiety
One of the psychopathological frameworks most
closely related to the psychological and emotional
suffering experienced by parents during pregnancy
and the puerperium period is the perinatal depression.
Actually, the Diagnostic and Statistical Manual of Mental
Disorders - Fifth Edition (APA 2013) includes the Major
Depressive Disorder (MDD) among the depressive
disorders. The MDD includes a variety of cognitive,
somatic, and behavioral symptoms such as depressed
mood, decreased interest or pleasure for activity, weight
loss or gain, insomnia or hypersomnia, psychomotor
agitation or retardation, asthenia, fatigue, self-blame,
reduction of concentration, thoughts of death, and even
attempted suicide. If such symptoms occur during the
period from the beginning of pregnancy to the rst year
after birth, they dene a condition of perinatal depression
(Milgrom and Gemmill 2015).
Perinatal depression does not only occur in women
(Wee et al. 2011). For some vulnerable parents, regard-
less of their sex, pregnancy and the birth of a child may
represent a potentially traumatic experience, to the point
that the post-partum period has been associated with in-
creased risk for post-traumatic stress disorder symptoms,
sometimes fostered by a whole series of concerns about
the unborn child (Czarnocka and Slade 2000). Moreover,
there is a high risk of comorbid anxiety and depressive
symptoms during the perinatal period, including sleep
disorders, difculties in concentration, fear of the future,
and feelings of helplessness (Beck et al. 1985, Wijma et
al. 1997). In the perinatal period, thoughts, expectations,
desires and doubts concerning the child usually arise
in both partners, and a lack of adequate social support
may increase the anxieties associated with the new role
of parents and the processes of redenition of identity
(Woolhouse et al. 2009). Therefore, anxiety symptoms in
the perinatal period are often co-occurring with depres-
sive symptoms, so perinatal anxiety could be even more
frequent than depression (Austin et al. 2007, Faisa-Cury
and Rossi-Menezes 2007, Heron et al. 2004, Lee at al.
2007, Reck et al. 2008).

Actor partner interdependence model of perinatal depression
Clinical Neuropsychiatry (2018) 15, 1 21
between 25 and 43 years old (M = 32.16, SD = 5.25).
Among them, 33% worked as freelance professionals,
57% were employees and 10% were unemployed.
Sixty-ve percent of men had a bachelor degree, 33%
had a high school diploma and 2% had a middle school
diploma.
The women were aged between 20 and 40 years
old (M = 29.28, SD = 4.13), 10% worked as freelance
professionals, 55% were employees, 10% were
housewives, 10% were unemployed and 15% were
students. Sixty-three percent of women had a bachelor
degree, 34% had a high school diploma and 3% had a
middle school diploma. All the women completed the
measures used in this study between the seventeenth and
twenty-third week of pregnancy.
Procedures
Participation was voluntary. The couples recruited
were acquaintances of the researchers. Inclusion criteria
were: not having had previous pregnancies; being at least
in the fourth month of pregnancy; prospective parents had
to live together; both parents must agree to participate
in the research. The questionnaires were administered
separately to the fathers and mothers at their homes.
Before lling in the questionnaires, the parents signed
an informed consent. Researchers collected data during
a fellowship research program, which was conducted
between 2015 and 2016. The research procedures
described in this article were performed in compliance
with the American Psychological Association and the
Italian Psychological Association ethical guidelines for
research.
Measures
For the measurement of the variables, participants
completed the Italian versions of the following
instruments: the Trait Emotional Intelligence
Questionnaire-Short Form (TEIQ-SF), the MOS
Social Support Survey (MOS-SSS), the Center for
Epidemiologic Studies Depression Scale (CES-D) and
the State-Trait Anxiety Inventory-Y Form (STAI-Y).
The Trait Emotional Intelligence Questionnaire-
Short Form (Petrides and Furnham 2006) is a 30 item
self-reported measure used to assess global trait EI.
Participants are required to rate, their level of agreement
with each item, on a 7-point scale. Higher total scores
indicate higher EI. The Italian version of the Trait
Emotional Intelligence Questionnaire-Short Form (Di
Fabio 2013) was used in this study.
The MOS Social Support Survey (Sherborne and
Stewart 1991) is a 19 item self-reported measure used
to assess social support. The response format is on
5-point Likert scale, from 1 to 5. Higher scores indicate
higher social support. The Italian version of MOS
Social Support Survey (Giangrasso and Casale 2014)
was used in this study.
The Center for Epidemiologic Studies Depression
Scale (Radloff 1977) is a 21 item self-reported measure
used to assess symptoms of depression measured on a
4-point Likert scale, ranging from 0 to 3. Higher scores
indicate higher depression. The Italian version of Center
for Epidemiologic Studies Depression Scale (Fava 1982)
was used in this study, showing good level of reliability
(table 1). To have a direct measure of depression,
without the contamination of the assessment of absence
of positive affect (i.e. anhedonia), in according with
previous studies (Carleton et al. 2013, Stansbury et al.
2006) we used the reduced version by eliminating the
understanding others’ moods, intentions and desires.
The basic idea of Gardner’s theory is that the human
emotional system works by processing information and
perceptions. To summarize, in Gardner’s theory there are
individual differences linked to the capacity of using and
elaborating emotional information, and those differences
depend on the EI level of a person. In line with this
reasoning, EI is formally operationalized in research
as a constellation of emotional perceptions located at
the lower levels of personality hierarchies that can be
measured via questionnaires and rating scales (Perez-
Gonzalez and Sanchez-Ruiz 2014, Petrides et al. 2007).
Individuals with high levels of EI are able to
identify and describe their own feelings and those of
others easily enough, in order to regulate their own
states of emotional activation. They are also able to
use emotions in an adaptive way (Salovey and Mayer
1989). Moreover, individuals with high EI levels have
more social relationships compared to others who have
low EI levels (Lopes et al. 2004). This probably happens
because high levels of EI help individuals to understand
how to behave in order to increase the probability of
reaching personal and social goals (Zeidner et al. 2008).
In fact, understanding one’s own emotional world and
how to relate with the emotional world of other people
is essential for an effective and functional adaptation.
Reduced levels of EI, instead, could increase the risk of
problems in interpersonal relationships (Petrides et al.
2017).
Furthermore, high levels of EI have been linked
with several positive outcomes in many important life
domains, such as positive health conditions (Costa et al.
2014), adequate parenting (Gugliandolo et al. 2015), and
school achievement (Nikooyeh et al. 2017).
Aims of the study
The main objective of this study was to investigate
if emotional intelligence and social support affected the
level of anxiety and depression in couples who were
expecting their rst baby.
In accordance with the literature, in this study we
hypothesized that emotional intelligence and social
support could represent protective factors for the
development of perinatal depression. In particular, we
hypothsized that emotional intelligence and social support
could reduce symptoms of anxiety and depression in the
members of the couple during the pregnancy. Therefore,
it was hypothesized that high levels of emotional
intelligence and social support could positively affect the
mood of the partners during the pregnancy, reducing the
risk of developing anxiety or depressive states. Another
way in which this study aimed to contribute to extant
research was by examining the relative contribution of
emotional intelligence and social support of both future
parents (mothers and fathers) in predicting maternal
and paternal anxiety and depression, using the actor
partner interdependence model (APIM; Kenny et al.
2006). We expected to found same-parent relationships
between social support, trait EI, anxiety and depression;
however, we also expected that emotional intelligence
and social support in one partner could predict anxiety
and depression in the other partner.
Materials and methods
Participants
Forty couples expecting their rst child from Calabria,
Italy, participated in this study. The men were aged

Ivan Formica et al.
22 Clinical Neuropsychiatry (2018) 15, 1
independent nature of dyadic data, and uncovers
interpersonal as well as intrapersonal associations
between variables in distinguishable dyads. Analysis
of covariance matrices was conducted using EQS 6.2,
and solutions were generated on the basis of maximum-
likelihood estimation. Mardia’s coefcient in this study
was 7.84 with a normalized value of 1.60, suggesting
a multivariate normality of the distributions. In this
model, paternal and maternal age were included as
control variables, adding a path from paternal and
maternal age to all the other variables. This estimation
concerned a saturated model, and therefore no t
indices are reported. The analysis showed signicant
and negative paths from paternal emotional intelligence
to paternal depression (β = -.42; p < .05) and paternal
anxiety (β = -.44; p < .05). The paths from paternal trait
EI to maternal anxiety (β = -.21; p > .05) and maternal
depression (β = -.15; p > .05), and the paths from
paternal social support to paternal anxiety (β = -.28; p
> .05), paternal depression (β = -.16; p > .05), maternal
anxiety (β = -.01; p > .05), and maternal depression (β
=.14; p > .05), were not signicant.
Furthermore, maternal emotional intelligence was
negatively related to maternal depression (β = -.30; p
< .05) and anxiety (β = -.44; p < .05). The paths from
maternal trait EI to paternal anxiety (β = -.14; p > .05)
and depression (β = .28; p > .05), as well as the paths
from maternal social support to paternal anxiety (β =
.05; p > .05) and paternal depression (β = -.12; p > .05),
and maternal anxiety (β = -.24; p > .05) and maternal
depression (β = -.23; p > .05) were not signicant.
Finally, a signicant and positive relation was found
between age of father and maternal depression (β =.44;
p < .05), while the other relationships among the age
of the members of the couple and the investigated
constructs were not signicant.
In accordance with common procedure to test the
saturated model, a trimming process was conducted
(Kline 2011), and all non signicant paths were
removed. Goodness-of-t indices indicated that the data
adequately t the nal model (see Figure 1): χ2(35) =
42.54; p = .18, CFI = .93, RMSEA = .07 (90% CI = .00 –
.14). In this model, paternal emotional intelligence was
negatively related to paternal depression (β = - .45; p <
.05) and paternal anxiety (β = - .52; p < .05). Moreover,
similarly to the saturated model, maternal emotional
intelligence was negatively related to maternal
depression (β = -.40; p < .05) and maternal anxiety (β =
-.62; p < .05). Paternal age was positively related with
maternal depression (β = .38; p < .05). Paternal trait
EI was also correlated with perceived paternal social
support (β = .30; p < .05), while maternal trait EI was
reverse item.
The State-Trait Anxiety Inventory-Y Form
(Spielberger et al. 1970) is a 40 item self-reported
measure used to asses state anxiety and trait anxiety.
In our study, only the scale which assesses the trait
anxiety was used. The response system is on 4-point
Likert scale, from 1 to 4. Higher scores indicate higher
anxiety. The Italian version of the State-Trait Anxiety
Inventory-Y Form (Pedrabissi and Santinello 1989) was
used in this study.
Statistical analysis
An Actor–Partner Interdependence Model (APIM,
Kashy and Kenny 2000, Kenny 1996) was used to test
the interdependence of both partners and the effect
of the dyadic relationships on anxiety and depressive
symptoms in the couple. APIM measures the reciprocal
inuence that emotions, cognition and/or the behavior
of one partner have on those of the other partner. This
approach focuses on both the actor’s and the partner’s
effects concurrently and also to test their reciprocal
effects (Cook and Kenny 2005).
Results
Descriptive statistics are presented in table 1.
Furthermore, table 1 shows the internal consistency of
each scale (alpha value) and the Pearson’s r correlations
among the study variables. In the group of fathers, the
paternal trait EI showed a negative correlation with
paternal depression and anxiety, while paternal social
support was negatively related to paternal anxiety. In the
group of mothers, maternal trait EI showed a negative
correlation with maternal depression and anxiety;
furthermore, maternal social support was positively
associated with maternal trait EI and negatively
associated with maternal depression and anxiety.
The paternal trait EI was positively associated with
maternal social support and negatively associated with
maternal anxiety. Trait EI in mothers and fathers were
not associated between them, as it happened with social
support in mothers and fathers. However, paternal and
maternal anxiety were positively associated between
them.
To examine whether emotional intelligence and
social support of both partners could predict anxiety
and depression symptoms in each members of the
couple, a Structural Equation Modeling (SEM) within
the Actor-Partner Interdependence Model (APIM)
was used. The APIM takes into account the non-
Table 1. Descriptive Analyses and Correlations
αM SD Skewness Kurtosis 1 2 3 4 5 67
1 Trait EI Father .85 5.34 .51 -.20 .27
2Support Father .95 4.44 .56 -.94 .63 .35*
3Depression
Father .74 .04 .09 .20 -.29 -.45** -.30
4 Anxiety Father .68 1.48 .23 2.07 2.90 -.52** -.44** .27
5Trait EI Mother .88 5.52 .56 -.74 .74 .23 .27 .05 -.28
6Support Mother .94 3.88 .62 .10 .30 .63** .18 -.24 -.35* .43**
7Depression
Mother .91 .59 .39 .23 .14 -.32* -.13 .13 .10 -.45** -.34*
8 Anxiety Mother .76 1.70 .28 1.04 2.54 -.45** -.27 .24 .41** -.62** -.55** .62**
Note: * p < .05, ** p < .01

Actor partner interdependence model of perinatal depression
Clinical Neuropsychiatry (2018) 15, 1 23
association between paternal trait EI and maternal
anxiety was found in correlational analyses. Therefore,
it is possible that the relationship between EI in fathers
and perinatal symptoms of depression and anxiety in
mothers is indirect, and is modulated by perceived
social support in mothers. In fact, our results seem to
conrm those of previous studies demonstrating the
importance of the partner’s support (Lemola et al. 2007)
to avoid the development of depression and anxiety
during pregnancy.
In fact, the APIM analysis showed that lower levels
of EI in fathers were associated with lower levels of
perceived social support in mothers. In turn, perceived
social support in mothers was linked to her emotional
intelligence, which predicted the levels of anxiety and
depression symptoms. This nding supports the view
that high levels of emotional intelligence in fathers
can promote the perception of adequate social support
in mothers, so that mothers can better focus their own
emotional intelligence in order to cope properly with
stress and negative affects, thus reducing the risk of
developing anxiety or depression. In contrast, when
fathers show low EI, some mothers may be less likely
to perceive adequate social support or even ask their
partners in order to receive it. In such conditions,
mothers appear less likely to use social support for
fostering their own emotional intelligence and for
increasing positive affects that may act as a buffer
against anxiety and depression. Therefore, high levels
of EI allow the father to be more supportive with his
partner, who in turn can cope with the difculties of
pregnancy with lower levels of anxiety and depression.
Conclusions
The ndings of our study conrm that EI is an
important feature for the development of effective
interpersonal relationships. In fact, high levels of EI
make an individual more capable in social relationships,
and positive relationships can lead in turn to adequate
social support during critical life events, such as
pregnancy.
The use of an Actor-Partner Interdependence Model
analysis showed that EI predicted same-parent, but
not other-parent, anxiety and depression in our study.
This suggests that EI has an important direct effect on
the individual’s emotional states, and is not directly
related to the other partner’s states. However, we also
correlated with perceived maternal social support (β =
.55; p < .05). Finally, positive correlations were found
between maternal anxiety and maternal depression (β
= .53; p < .05) and between maternal age and paternal
age (β = .56; p < .05). Another important nding of the
SEM analysis concerned the signicant and positive
association between paternal trait EI and perceived
maternal social support ( = .35; p < .05). The results of
APIM analysis are summarized in gure 1.
Discussion
The aim of the present study was to examine the
role of emotional intelligence and social support in
the development of anxiety and depression symptoms
during pregnancy.
As largely evidenced by literature, pregnancy
represents a critical event that may interact with other
psychological vulnerabilities in future parents and that
may trigger emotional problems, such as symptoms of
depression and anxiety (Milgrom and Gemmill 2015).
However, there are psychological and psychosocial
factors that can be protective for future parents and
can help them to overcome the emotional problems
linked to the pregnancy period. Among such factors,
our research suggests that emotional intelligence and
social support may play a pivotal role in protecting the
pregnant mother and her partner from psychopathology,
in line with previous research (Castle et al. 2008,
Goleman 2005, Haslam et al. 2006, Lemola et al. 2007,
Letourneau et al. 2011).
In detail, the current study examined the relationship
between EI, social support, depression and anxiety in
couples expecting their rst baby, to test our hypothesis
that reduced EI and low social support could be linked
to maternal and paternal depression and anxiety during
pregnancy. In accordance with literature, social support
in our study was moderately and inversely correlated
with levels of anxiety and depression in both fathers
and mothers. Therefore, more social support during
pregnancy could reduce the probability of developing
emotional problems for future parents (Aktan 2012).
Furthermore, in accordance with our hypothesis, we
found that trait EI was directly and negatively linked
to anxiety and depression in the same parent. However,
we did not nd evidence in the APIM analysis that EI
in one parent affected anxiety and depression in the
other parent, even though a moderate and negative
Figure 1. Actor -Partner Interdependence Model of depression and anxiety in couples
Note: Standardized path coefcients are shown in the gure

Ivan Formica et al.
24 Clinical Neuropsychiatry (2018) 15, 1
Carleton RN, Thibodeau MA, Teale MJ, Welch PG, Abrams
MP, Robinson T, Asmundson GJ (2013). The center for
epidemiologic studies depression scale: a review with a
theoretical and empirical examination of item content and
factor structure. Plos One 8, 3, 1-11.
Castle H, Slade P, Barranco-Wadlow M, Rogers M (2008).
Attitudes to emotional expression, social support
and postnatal adjustment in new parents. Journal of
Reproductive and Infant Psychology 26, 3, 180-194.
Collins NL, Dunkel-Schetter C, Lobel M, Scrimshaw SCM
(1993). Social support in pregnancy: psychosocial
correlates of birth outcomes and postpartum depression.
Journal of Personality and Social Psychology 65, 6, 1243-
1258.
Condon J, Boyce P, Corkindale C (2004). The First-Time
Fathers Study: A prospective study of the mental health
and wellbeing of men during the transition to parenthood.
Australian and New Zealand Journal of Psychiatry 38, 1,
2, 56-64.
Cook WL, Kenny DA (2005). The actor-partner interdependence
model: A model of bidirectional effects in developmental
studies. International Journal of Behavioural Development
29, 2, 101-109.
Costa S, Petrides KV, Tillmann T (2014). Trait emotional
intelligence and inammatory diseases. Psychology, Health
& Medicine 19, 2, 180-189.
Czarnocka J, Slade P (2000). Prevalence and predictors of post-
traumatic stress symptoms following childbirth. British
Journal of Clinical Psychology 39, 1, 35-41.
Delassus JM (1995). Le sens de la maternité. Dunod, Paris, FR.
Di Fabio A (2013). Trait emotional intelligence questionnaire
(TEIQue): un contributo alla validazione della versione
italiana [Trait emotional intelligence questionnaire
(TEIQue): A contribution to validation of the Italian
version]. Counseling 6, 3, 87-98.
Faisal-Cury A, Rossi Menezes P (2007). Prevalence of anxiety
and depression during pregnancy in a private setting sample.
Archives of Women’s Mental Health 10, 1, 25-32.
Fava GA (1982). Versione italiana del CES-D per la valutazione
degli stati depressivi. Organizzazioni Speciali, Firenze, IT.
Fletcher RJ, Freeman E, Gareld C, Vimpani G (2011).
The effects of early paternal depression on children’s
development. Medical Journal of Australia 195, 685-689.
Gardner H (1983). Frames of mind. The theory of multiple
intelligences. Basic Books, New York, NY.
Gaynes BN, Gavin N, Meltzer-Brody S, Lohr KN, Swinson
T, Gartlehner G, Brody S, Miller WC (2005). Perinatal
depression: prevalence, screening accuracy, and screening
outcomes. Evidence Report/Technology Assessment
(Summary) 119, 1-8.
Giallo R, D’Esposito F, Christensen D, Mensah F, Cooklin A,
Wade C, Lucas N, Canterford L, Nicholson JM (2012).
Father mental health during the early parenting period:
Results of an Australian population based longitudinal
study. Social Psychiatry and Psychiatric Epidemiology 47,
12, 1907-1916.
Giangrasso B, Casale, S (2014). Psychometric properties of
the Medical Outcome Study Social Support Survey with a
general population sample of undergraduate students. Social
Indicators Research 116, 1, 185-197.
Goleman D (2005). Emotional intelligence: Why it can matter
more than IQ. Bantham, New York, NY.
Goodman SH, Brand SR (2009). Maternal depression and infant
mental health. In Zeanah CH Jr (ed) Handbook of Infant
Mental Health, Third Edition. Guilford, New York, NY.
Gugliandolo MC, Costa S, Cuzzocrea F, Larcan R, Petrides KV
(2015). Trait emotional intelligence and behavioral problems
among adolescents: A cross-informant design. Personality
and Individual Differences 74, 16-21.
Haslam DM, Pakenham KI, Smith A (2006). Social support and
postpartum depressive symptomatology: the mediating role
found that paternal EI was linked to maternal perceived
social support. So, the presence of high levels of EI in
fathers can increase the perception of a sense of safety
and support in mothers. Such feeling of safety in a
close relationship can reduce the risk of developing
psychopathology (Schimmenti 2017a, b), including
perinatal depression or anxiety, and can help mothers to
cope better with physical and psychological problems
that may occur during pregnancy.
However, as with every research, our study comes
with a number of limitations. The sample size was
relatively small, thus our results are not generalizable
to other samples. Moreover, the cross-sectional nature
of the data prevents us from drawing conclusions about
causal direction, even though the relationships between
variables in our study were invoked on a strong
theoretical base, since emotional intelligence as a trait is
thought to precede current anxiety or depressive states.
Hence, longitudinal studies and experimental designs
with large samples are greatly needed to advance this
eld of research. It could also be critical in future
studies to integrate a post-partum assessment of mood
states in the couples, to examine the impact of EI and
social support on potential clinical outcomes.
However, even considering its limitations, the
current study supports the conception that EI and social
support can affect the emotional states of future parents.
Furthermore, the study suggests the importance of
promoting psychoeducational courses and programs
for the development of emotional intelligence
skills and social support with future parents, e.g.
psychoeducational programs during pregnancy that
involve both partners and that are aimed to promote
attunement with the partner’s needs and mentalizing
attitudes in the two partners. The study also suggests
that when clinical intervention for perinatal depression
or anxiety is needed, both partners should be involved
in the treatment, because of the interdependence of
the two partners and the complex relationship linking
anxiety and depression symptoms with a mother’s
and father’s capacity for emotional intelligence and
perceived social support.
References
Aktan NM (2012). Social support and anxiety in pregnant and
postpartum women: a secondary analysis. Clinical Nursing
Research 21, 183-194.
American Psychiatric Association (2013). Diagnostic and
Statistical Manual of Mental Disorders, Fifth Edition,
DSM – 5. American Psychiatric Publishing, Arlington, VA.
Austin MP, Tully L, Parker G (2007). Examining the
relationship between antenatal anxiety and postnatal
depression. Journal of Affective Disorders 101, 169-174.
Barrera M, Ainlay SL (1983). The structure of social support: a
conceptual and empirical analysis. Journal of Community
Psychology 11, 2, 133-143.
Beck AT, Emery GA, Greenberg RL (1985). Anxiety disorders
and phobias: A cognitive perspective. Basic Books, New
York, NY.
Beck CT (1996). A meta-analysis of predictors of postpartum
depression. Nursing Research 45, 5, 297-303.
Besser A, Priel B (2003). Trait vulnerability and coping
strategies in the transition to motherhood. Current
Psychology 22, 1, 57-72.
Brock RL, O’Hara MW, Hart KJ, McCabe-Beane JE,
Williamson JA, Brunet A, Laplante DP, Yu C, King S
(2015). Peritraumatic distress mediates the effect of severity
of disaster exposure on perinatal depression: the iowa ood
study. Journal of Traumatic Stress 28, 6, 515-522.

Actor partner interdependence model of perinatal depression
Clinical Neuropsychiatry (2018) 15, 1 25
depression in fathers and its association with maternal
depression: a meta-analysis. Journal of the American
Medical Association, 303, 19, 1961-1969.
Pedrabissi L, Santinello M (1989). Manuale: inventario
per l’ansia di «Stato» e di «Tratto»: nuova versione
italiana dello STAI Forma Y: Manuale / CD Spielberger.
Organizzazioni Speciali, Firenze, IT.
Pellerone M, Iacolino C, Mannino G, Formica I, Zabbara
SM (2017a). The inuence of parenting on maladaptive
cognitive schema: a cross-sectional research on a group of
adults. Psychology Research and Behavior Management
10, 1-12.
Pellerone M, Ramaci T, Parrello S, Guariglia P, Giaimo F
(2017b). Psychometric properties and validation of the
Italian version of the Family Assessment Measure – short
version – third edition in a nonclinical sample. Psychology
Research and Behavior Management 10, 69-77.
Pérez F, Brahm P, Riquelme S, Rivera C, Jaramillo K, Eickhorst
A (2017). Paternal post-partum depression: How has
it been assessed? A literature review. Mental Health &
Prevention 7, 28-36.
Pérez-Gonzalez JC, Sanchez-Ruiz MJ (2014). Trait emotional
intelligence anchored within the big ve, big two and big
one frameworks. Personality and Individual Differences 65,
53-58.
Petrides KV, Furnham A (2006). The role of trait emotional
intelligence in a gender-specic model of organizational
variables. Journal of Applied Social Psychology 36, 2, 552-
569.
Petrides KV, Gomez MG, Pérez-Gonzalez JC (2017). Pathways
into psychopathology: modeling the effects of trait
emotional intelligence, mindfulness, and irrational beliefs
in a clinical sample. Clinical Psychology & Psychotherapy
24, 5, 1130-1141.
Petrides KV, Pitar R, Kokkinaki F (2007). The location of trait
emotional intelligence in personality factor space. British
Journal of Psychology 98, 273-289.
Pignone MP, Gaynes BN, Rushton JL, Burchell CM, Orleans
CT, Mulrow CD, Lohr K (2002). Screening for depression
in adults: a summary of the evidence for the U. S. Preventive
Services Task Force. Annals of internal medicine 136, 10,
765-776.Radloff LS (1977). The CES-D Scale. A self-report
depression scale for research in the general population.
Applied Psychological Measurement 1, 3, 385-401.
Reck C, Struben K, Beckenstrass M, Stefenelli U, Reinig
K, Fuchs T, Sohn C, Mundt C (2008). Prevalence, onset
and comorbidity of postpartum anxiety and depressive
disorders. Acta Psychiatrica Scandinavica 118, 6, 459-468.
Salovey P, Mayer JD (1989). Emotional Intelligence.
Imagination, Cognition, Personality 9, 185-211.
Schaefer C, Coyne JC, Lazarus RS (1981). The health-related
functions of social support. Journal of Behavioral Medicine
4, 381-406.
Schimmenti A (2017a). The developmental roots of dissociation:
A multiple mediation analysis. Psychoanalytic Psychology,
34, 1, 96-105.
Schimmenti A (2017b). The trauma factor: Examining the
relationships among different types of trauma, dissociation,
and psychopathology. Journal of Trauma & Dissociation.
doi: 10.1080/15299732.2017.1402400.
Sherborne CD, Stewart AL (1991). The MOS social support
survey. Social Science & Medical 32, 6, 705-714.
Shu-Shya Heh (2003). Relationship between Social Support and
Postnatal Depression. Kaohsiung J Med Sci 19, 10, 491-495.
Silva R, Jansen K, Souza L, Quevedo L, Barbarosa L, Moraes I,
Horta B, Pinheiro R (2012). Sociodemographic risk factors
of perinatal depression: a cohort study in the public health
care system. Revista Brasileira de Psiquiatria 34, 2, 143-
148.
Spielberger CD, Gorsuch RL, Lushene RE (1970). The
State-Trait Anxiety Inventory (test manual). Consulting
of maternal self-efcacy. Infant Mental Health Journal 27,
3, 276-291.
Heron L, O’Connor TG, Evans J, Golding J, Glover V (2004).
The course of anxiety and depression through pregnancy
and postpartum in a community sample. Journal of Affective
Disorders 80, 1, 65-73.
Iacolino C, Pellerone M, Pace U, Ramaci T, Castorina V (2016).
Family functioning and disability: a study on Italian parents
of disabled children. European Proceedings of Social and
Behavioural Sciences 8, 39-52.
Kashy DA, Kenny DA (2000). The analysis of data from dyads
and groups. Handbook of Research Methods in Social and
Personality Psychology 38, 451-477.
Kenny DA (1996). Models of non-independence in dyadic
research. Journal of Social and Personal Relationships 13,
2, 279-294.
Kline RB (2011). Principles and practice of structural equation
modeling. The Guilford Press, New York, NY.
Laney EK, Lewis Hall ME, Anderson TL, Willingham MM
(2015). Becoming a mother: the inuence of motherhood
on women’s identity development. Identity 15, 2, 126-145.
Leach LS, Poyser C, Cooklin AR, Giallo R (2015). Prevalence
and course of anxiety disorders (and symptom levels) in men
across the perinatal period: a systematic review. Journal of
Affective Disorders 190, 675-686.
Lee AM, Lam SK, Sze Mun Lau SM, Chong CS, Chui HW,
Fong DY (2007). Prevalence, course, and risk factors
for antenatal anxiety and depression. Obstetrics and
Gynecology 110, 5, 1102-1112.
Lemola S, Stadlmayr W, Grob A (2007). Maternal adjustment
ve months after birth: the impact of the subjective
experience of childbirth and emotional support from the
partner. Journal of Reproductive and Infant Psychology 25,
3, 190-202.
Letourneau NL, Dennis CL, Benzies K, Duffet-Leger L, Stewart
M, Tryphonopoulos PD, Watson W (2012). Postpartum
depression in a family affair: addressing the impact on
mothers, fathers, and children. Mental Health Nursing 33,
7, 445-457.
Letourneau NL, Duffet-Leger L, Dennis CL, Stewart M,
Tryphonopoulos PD (2011). Identifying the support needs
of fathers affected by post-partum depression: a pilot study.
Journal of Psychiatric and Mental Health Nursing 18, 1,
41-47.
Lopes PN, Brackett MA, Nezlek J, Schütz A, Sellin I, Salovey
P (2004). Emotional intelligence and social interaction.
Personality and Social Psychology Bulletin 30, 8, 1018-
1034.
Manzano Palacio Espasa F, Zilkha N (1999). The narcissistic
scenarios of parenthood. International Journal of
Psychoanalysis 80, 3, 465-476.
Milgrom J, Gemmil AW (2015). Identifying perinatal depression
and anxiety evidence-based practice in screening,
psychosocial assessment and management. Wiley and Sons,
Chichester, UK.
Milgrom J, Gemmil AW, Bilszta JL, Hayes B, Barnett B, Brooks
J, Ericksen J, Ellwood D, Buist A (2008). Antenatal risk
factors for postnatal depression: a large prospective study.
Journal of AffectiveDisorders 108, 1-2, 147-157.
Nikooyeh E, Zarani F, Fathabadi J (2017). The mediating role
of social skills and sensation seeking in the relationship
between trait emotional intelligence and school adjustment
in adolescents. Journal of Adolescence 59, 45-50.
O’Brien AP, McNeil KA, Fletcher R, Conrad A, Wilson
AJ, Jones D, Chan, SW (2016). New fathers’ perinatal
depression and anxiety-Treatment options: An integrative
review. American Journal of Men’s Health 11, 4, 863-876.
Paulden M, Palmer S, Hewitt C, Gilbody S (2009). Screening
for postnatal depression in primary care: cost effectiveness
analysis. BMJ 339, B5203.
Paulson JF, Bazemore SD (2010). Prenatal and postpartum

Ivan Formica et al.
26 Clinical Neuropsychiatry (2018) 15, 1
postpartum depressive symptoms: a prospective survey of
the MATQUID cohort. Acta Psychiatrica Scandinavica
106, 3, 212-219.
Veskrna L (2013). Peripartum depression – does it occur in
fathers and does it matter? Journal of Men’s Health 7, 4,
420-430.
Wandersman L, Wandersman A, Kahn S (1980). Social support
in the transition to parenthood. Journal of Community
Psychology 8, 4, 332-342.
Wee KY, Skouteris H, Pier C, Richardson B, Milgrom J (2011).
Correlates of ante and postnatal depression in fathers: a
systematic review. Journal of Affective Disorders 130, 358-
377.
Wijma K, Soderquist J, Wijma B (1997). Posttraumatic stress
disorder after childbirth: A cross sectional study. Journal of
Anxiety Disorders 11, 6, 587-597.
Woolhouse H, Brown S, Krastev A, Perlen S, Gunn J (2009).
Seeking help for anxiety and depression after childbirth:
results of the maternal health study. Archives of women’s
mental health 12, 2, 75-83.
Zeidner M, Roberts RD, Matthews G (2008). The science of
emotional intelligence: Current consensus and controversies.
European Psychologist 13, 64-78.
Psychologists Press, Palo Alto, CA.
Stansbury JP, Ried LD, Velozo CA (2006). Unidimensionality
and bandwidth in the center for epidemiologic studies
depression (CES-D) scale. Journal of Personality
Assessment 86, 10-22.
Stern DN (1995). Motherhood Constellation: A Unied view of
Parent – Infant Psychotherapy. Basic Book, New York, NY.
Swendsen J, Mazure JD (2000). Life stress as a risk factor
for postpartum depression: Current research and
methodological issues. Clinical Psychology Science and
Practice 7, 1, 17-31.
Trotta A, Di Forti M, Mondelli V, Dazzana P, Pariante C, David
A, Mulè A, Ferraro L, Formica I, Murray RM, Fisher HL
(2013). Prevalence of bullying victimisation amongst
rst-episode psychosis patients and unaffected controls.
Schizophrenia Research 150, 169-175.
Uchino BN (2009). Understanding the links between social
support and physical health: a life-span perspective with
emphasis on the separability of perceived and received
support. Perspectives on Psychological Science 4, 3, 236-
255.
Verdoux H, Sutter AL, Glatigny-Dallay E, Minisini A (2002).
Obstetrical complications and the development of