Abstract
Previous research suggests a strong association of health indicators with self-report ability emotional intelligence (EI) and self-report mixed EI, but a weak or moderate association with performance-based ability EI measures. The size of the association for ability EI may be inaccurately estimated, because there has not been enough research on the relationship of ability EI to health outcomes to allow moderator analyses in meta-analyses. Therefore the present review aimed to synthesize results specifically from studies on the relationship of performance-based ability EI with depression and well-being across adult populations in different settings. We found that maximum-performance measures of ability EI are associated negatively with depression and positively with well-being, and that these associations are moderated and mediated by several factors, including gender and self-report EI. Our analysis highlights limitations in the evidence base and leads to recommendations for future research and for ability EI-based training programs.
The literature on the relationship between emotions and health has been expanding rapidly, leading several researchers to meta-analyze available evidence on associations of emotion-related skills with physical and mental health (Martins, Ramalho, & Morin, 2010; Schutte, Malouff, Thorsteinsson, & Rooke, 2007). These meta-analyses suggest a strong association of health indicators with self-report ability emotional intelligence (EI) and self-report mixed EI, but a weak or moderate association with performance-based ability EI measures. While these differences in association strength may reflect real differences in which aspects of EI are being measured, these differences might instead be experimental artifacts reflecting how EI is measured. Self-report measures of mental ability can substantially increase variance unrelated to emotional processing (Mayer, Roberts, & Barsade, 2008). Moreover, the estimates of effect size for performance-based ability measures may not be accurate, because there have not been sufficient studies using performance-based ability EI measures to allow moderator analyses. Because most validated performance-based EI measures have emerged only in the last 10 years, we believe the time has come to review and synthesize the available evidence on relationships between performance-based ability EI and health-related outcomes. We chose to focus on two factors: depression and well-being. When measured over long periods, negative indicators of emotional health, such as depression, and positive indicators, such as subjective well-being, behave as relatively independent constructs (Bradburn, 1969; Diener & Emmons, 1984), involving different mechanisms, mediators, and modulators (Fava & Ruini, 2003).
Therefore we reviewed the English-language peer-reviewed literature on the relationship of ability EI, assessed using performance or knowledge measures, with depression and well-being, in individuals 18 and older. Because the ability EI model of Mayer and Salovey (1997) has generated the most research, only studies based on this model were analyzed; this model is described in detail elsewhere in this special section (Mayer, Caruso, & Salovey, 2016). The present review based on the Mayer and Salovey model identifies several significant effects of ability EI on depression and well-being, suggests moderator factors that may clarify on whom and under what circumstances EI abilities exert differential effects, and generates hypotheses about potential mediators that may help explain why and how EI affects emotional health.
The insights from this review may help guide future research as well as efforts to design ability EI-based training programs to maintain or raise well-being indices.
EI and Depression
Individuals who present with five of the following nine symptoms are considered to have major depressive disorder (MDD), according to the DSM-V (American Psychiatric Association [APA], 2013): depressed mood, diminished pleasure and interest in activities, changes in weight, sleep issues, fatigue, negative feelings, impairments in thinking and concentration, and suicidal ideation and behavior that affect social, occupational, or other important areas of life.
Previous reviews investigating the relationship of depression with emotion perception and social cognition have found that the problems with social interaction observed in MDD may be due to a moderate and stable deficit in the ability to decode emotional stimuli and mental states (Hall, Andrzejewski, & Yopchick, 2009; Kohler, Hoffman, Eastman, Healey, & Moberg, 2011; Manstead, Dosmukhambetova, Shearn, & Clifton, 2013; Weightman, Air, & Baune, 2014). The ability EI model offers a broad framework for analyzing how the emotional ability deficits in MDD relate to mental and social health indicators. This framework encompasses emotional skills to perceive emotions, as well as skills in understanding, using, and regulating emotions.
Studies of nonclinical samples indicate a weak but significant inverse association between scores on the Mayer–Salovey–Caruso Emotional Intelligence Test (MSCEIT; Mayer, Salovey, & Caruso, 2002) and symptoms of depression (Goldenberg, Matheson, & Mantler, 2006). Studies of clinical samples have reported lower total MSCEIT scores for depressed patients than for healthy controls. This reflects a deficit in the ability to understand and manage emotions (Hertel, Schütz, & Lammers, 2009; Kwako, Szanton, Saligan, & Gill, 2011).
Moderating Factors
Gender and self-report ability EI, as well as other variables, have been shown to moderate the relationship between ability EI and MDD. One study associated low levels of ability EI with greater likelihood of depressive symptoms in men but not women (Salguero, Extremera, & Fernández-Berrocal, 2012). Another study showed that MSCEIT scores negatively correlated with depression only in women with high levels of self-report ability EI (Salguero, Extremera, Cabello, & Fernandez-Berrocal, 2015). This result parallels previous research examining the moderator role of perceived EI in the association between ability EI and stress (Gohm, Corser, & Dalsky, 2005).
Mediating Factors
Few studies have examined how ability EI may affect risk of depression or its clinical manifestations. Available evidence suggests that low EI contributes to depression by reducing the ability to understand and manage emotions, which are cognitive skills associated with the prefrontal cortex (Hertel et al., 2009; Kwako et al., 2011; Sawaya et al., 2015). Sawaya et al. (2015) found that, compared to healthy controls, individuals with MDD had fewer functional connections between anteromedial regions of the prefrontal cortex and regions involved in emotional regulation. That same study found MSCEIT scores correlated significantly with functional connectivity in the ventromedial prefrontal cortex. These findings suggest that individuals less able to recognize and manage personal and social emotions are also less able to engage in positive social interactions, which in turn may promote a depressive state.
EI and Subjective Well-Being
Subjective well-being is defined as “a person’s cognitive and affective evaluations of his or her life” (Diener, Oishi, & Lucas, 2002, p. 63). The cognitive component of well-being, termed life satisfaction, reflects individuals’ evaluations of their lives, both past and present (Pavot & Diener, 2008). In contrast, the affective component of well-being, termed affect, reflects the hedonistic balance within individuals based on the frequency with which they experience positive and negative emotions (Diener, Oishi, & Lucas, 2003). Although the cognitive and affective components of subjective well-being show moderate correlation, extensive research suggests that they are structurally distinct, with different predictors (Diener et al., 2003), antecedents, and health effects (Diener & Chan, 2011; Luhmann, Hofmann, Eid, & Lucas, 2012).
The ability to perceive, express, understand, and regulate emotions is considered to play a key role in promoting well-being and positive emotions (Zeidner, Matthews, & Roberts, 2012). Indeed, meta-analyses show that performance-based measures of EI abilities are important for subjective well-being, with effect sizes apparently greater for cognitive than affective components (r = .25 vs. .14; Sánchez-Álvarez, Extremera, & Fernández-Berrocal, 2016).
Ability EI may be predicted to correlate positively with life satisfaction, a cognitive component of subjective well-being that may be the ultimate form of human contentment. Early studies using various performance measures, such as the Multifactor Emotional Intelligence Scale (MEIS; Mayer, Caruso, & Salovey, 1999), found weak to moderate associations of ability EI with life satisfaction, after controlling for other socioemotional variables, cognitive intelligence, and personality traits (Ciarrochi, Chan, & Caputi, 2000; Mayer et al., 1999). More recent studies have reported modest associations between MSCEIT branches and life satisfaction (Brackett, Rivers, Shiffman, Lerner, & Salovey, 2006; Extremera, Ruiz-Aranda, Pineda-Galán, & Salguero, 2011). Some of these associations weaken or disappear altogether after controlling for personality and cognitive intelligence (Bastian, Burns, & Nettelbeck, 2005; Rode et al., 2008). A study using the Situational Test of Emotion Management (STEM; MacCann & Roberts, 2008) failed to find a significant association between EI scores and current life satisfaction, though an association was found between EI and retrospective life satisfaction (MacCann & Roberts, 2008). A recent study found a positive relationship between life satisfaction and emotion management based on emotion regulation ability assessed using the MSCEIT and based on a new video-based version of the STEM (Multimedia Emotion Management Assessment [MEMA]; MacCann, Lievens, Libbrecht, & Roberts, in press).
A smaller number of studies have examined the role of EI abilities on affective well-being, specifically on affect and happiness. For example, Brackett, Palomera, Mojsa-Kaja, Reyes, and Salovey (2010) used the Positive and Negative Affect Scale (PANAS; Watson, Clark, & Tellegen, 1988) to examine EI and trait affect in British secondary school teachers and found emotion regulation ability to be associated more strongly with positive affect than negative affect. Conversely, Rode et al. (2008) studied long-term affect in two undergraduate samples and found EI skills to correlate with negative affect but not positive affect. A plausible explanation for the lack of concordance between the two studies is that Brackett et al. measured long-term affect using the PANAS, while Rode et al. measured it using the Four Dimensional Mood Scale (4DMS) developed by Huelsman, Nemanick, and Munz (1998). PANAS measures only the high poles of positive affect (positive energy) and negative affect (negative arousal), while the latter scale also measures low positive and negative affect.
In sum, the available evidence suggests a greater effect of EI abilities on cognitive well-being than on affective well-being.
Moderating Factors
Gender has been found to influence associations between emotional abilities and some negative mental health outcomes, with ability EI influencing negative outcomes more strongly in males than in females. For example, under conditions of high stress, men with lower emotion regulation ability on the MSCEIT showed lower happiness than those with higher regulation ability, whereas no such association between ability and happiness was observed in women (Brackett et al., 2006; Salguero, Extremera, & Fernández-Berrocal, 2012). A more recent study has examined the moderator role of gender on positive outcomes such as happiness (Extremera & Rey, 2015). This work suggests that emotion regulation ability depends simultaneously on several factors, including emotional state, interpersonal context, and gender-specific coping strategies such as rumination. This work raised the possibility that emotion regulation ability may be more internally determined in women than in men.
Research on EI and well-being is at a much earlier stage than research on EI and psychological maladjustment. Important moderators and mediators of the effects of EI on subjective well-being may remain to be discovered (Salguero et al., 2015). Future studies should examine whether sociodemographic variables such as culture and age moderate the link between ability EI and well-being.
Potential Mediating Variables
The literature, though preliminary, provides several testable hypotheses about how ability EI might promote subjective well-being, through both intrapersonal and interpersonal mechanisms. Perhaps individuals with high EI experience less emotional distress when faced with stressful situations (Gohm et al., 2005), leading to higher positive affect and well-being than in individuals with low EI. Perhaps individuals with high EI are able to maintain higher self-esteem and self-efficacy, enabling them to mitigate the influence of negative events and strengthen the influence of positive events (Salguero et al., 2015). Those with high EI may be more likely than those with low EI to build and maintain close relationships, increasing the availability of social support, which has been shown to improve subjective well-being (Lopes, Salovey, Côté, Beers, & Petty, 2005). Individuals with high EI may also be more likely to use positive coping strategies such as expressing feelings and eliciting social support, instead of maladaptive strategies such as rumination or avoidance (Matthews et al., 2006). Another possibility is that people with high EI experience greater positive affect and life satisfaction because they have fewer or less severe symptoms of depression.
Conclusions
This review of recent literature suggests that performance-based ability EI is associated negatively with depression and positively with subjective well-being, and that these associations are moderated and mediated by several variables.
The available evidence points to ability EI as a protective factor against depression in both clinical and nonclinical samples. This protective effect depends not only on perceiving emotions properly, as underscored by research on emotion perception and social cognition (Hall et al., 2009; Manstead et al., 2013; Weightman et al., 2014), but also on understanding and regulating emotions appropriately (Hertel et al., 2009; Kwako et al., 2011). The ability of EI to protect against depression is moderated by gender and self-report ability EI. It appears, for example, that even when women have emotional skills, they may not implement them if they do not feel competent at doing so. These results highlight the need to integrate both performance-based measures of ability EI and self-report measures of EI, since the two types of measures provide complementary information. Future studies should look at both types of measures to clarify why women with both high performance-based ability EI and high self-report EI show lower negative affect and stronger positive emotions. Perhaps these women use more effective intra- and interpersonal emotion regulation strategies, such as positive reappraisal or social support-seeking behavior.
We caution that these hypotheses are based primarily on cross-sectional studies, making it possible to determine whether depressive episodes caused the observed EI impairment. People with MDD might show lower ability EI as a result of, for example, negative response bias, leading them to pay greater attention, attend more selectively, and show stronger emotional reactions when processing emotional information than those without MDD (Hall et al., 2009; Kohler et al., 2011). Intervention studies indicate that treatment with antidepressants can mitigate some deficits in emotion perception, suggesting that alterations in emotional skills are reversible in depression (e.g., Mikhailova, Vladimirova, Iznak, Tsusulkovskaya, & Sushko, 1996; Weightman et al., 2014). Longitudinal and intervention studies are urgently needed to distinguish between these alternative explanations.
Indeed, much more work needs to be done to explore the mechanisms by which EI affects MDD. Recent work on the neurobiological correlates of performance-based EI shows substantial promise in this respect (Sawaya et al., 2015). Such studies linking functional connectivity in the brain with emotional abilities and depression may be powerful aids for identifying specific impairment of EI abilities and their functional consequences for quality of life and mood in patients with depression. Most intervention studies have focused on healthy populations (Schutte, Malouff, & Thorsteinsson, 2013), highlighting the need to investigate whether insights from clinical research can lead to more effective therapy and training programs for mitigating depression symptoms, reducing recurrence of depressive episodes, and improving the well-being of clinical populations.
The available evidence indicates a significant, albeit small to moderate, association between EI abilities and subjective well-being. The most recent work suggests that this association is stronger for the cognitive component of well-being than for the affective component (Sánchez-Álvarez et al., 2016). Because performance-based instruments assess abilities associated with temporally stable intelligence, whereas positive or negative affect reflects temporary affective reactions and situation-specific experience of daily moods, it makes sense that EI correlates more strongly with temporally stable cognitive indices such as life satisfaction than with mood states.
The literature provides strong indications that gender significantly moderates the effect of emotion regulation ability on well-being. Emotion regulation ability explains a larger proportion of variance in well-being in men than in women, implying that other psychosocial factors in women also contribute substantially to well-being (Extremera & Rey, 2015). As a result, optimal EI interventions may be different for men and women. For instance, health professionals may need to focus on helping men identify and cope with feelings produced by stressful situations, understand and evaluate their negative moods, and increase their emotional abilities in order to increase well-being.
In summary, while the literature provides substantial evidence that ability EI can significantly affect depression and well-being, these conclusions remain tentative because of the small number of studies on depression and well-being that use the performance-based EI measures, such as the MSCEIT and STEM. EI is likely to influence depression and well-being through complex mechanisms involving interrelationships among personal, social, sociodemographic, and cultural factors. Therefore, future research should search systematically for additional mediators and moderators of the link between EI and health-related outcomes.
The concept of EI, proposed a quarter century ago by Peter Salovey and John Mayer, remains more relevant than ever to emotional health and well-being. Research in the last decade has begun to clarify exactly how and why EI abilities are so important, but much more needs to be done to provide a complete understanding, and to translate research insights into effective personal and social interventions.
Footnotes
Acknowledgements
We wish to express our thanks to Kimberly Barchard and anonymous reviewers for their constructive and very helpful suggestions and comments on earlier versions of this manuscript.
This research was supported in part by projects Innovation and Development Agency of Andalusia, Spain (SEJ-07325) and the Spanish Ministry of Economy (PSI2012-37490 and PSI2012-38813).
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.