Cascading effects of partner relationship satisfaction on complete perinatal mental health: An exploratory serial mediation analysis

Low partner relationship satisfaction is a strong predictor of perinatal depression and anxiety symptoms. However, little is known about the potential mechanisms via which partner relationship satisfaction may exert its effects on the mental health of perinatal women. Therefore, the aim of this exploratory study was to examine the direct and indirect effects, via maternal self-efficacy and psychological flexibility in sequence, of partner relationship satisfaction on the complete mental health of women at high risk for postpartum depression (PPD). The sample for this study comprised 963 early postpartum women presenting high-risk for PPD, as determined by the clinical cutoff score obtained through the Postpartum Depression Predictors Inventory-Revised. The assessment protocol further included self-report measures of partner relationship satisfaction, maternal self-efficacy, psychological flexibility, depression, anxiety, and positive mental health. Correlation analyses were conducted to ascertain associations between variables, and structural equation modelling (path analysis) was performed to examine direct and indirect effects. The observed results revealed that higher levels of partner relationship satisfaction were related to lower levels of postpartum psychological distress and higher levels of positive mental health. Moreover, those links were found to be sequentially mediated by maternal self-efficacy and psychological flexibility. These findings suggest that increased maternal self-efficacy, boosted by satisfactory partner relationships, may improve the psychological flexibility of women at high risk for PPD, and ultimately their complete mental health. Accordingly, intervention efforts to prevent PPD may increase their effectiveness by addressing partner relationship satisfaction as a key variable for the promotion of complete perinatal mental health.