PIRI’s Research
An Overview of PIRI’s Research
PIRI conducts basic and applied research, develops evidence-based treatment programs to help parents make the transition to parenthood and to support the early parent-infant relationship. More broadly, our research aims to make a difference by advancing the knowledge underpinning care services provided to mothers, fathers and their young children.
Our research focuses on:
- Antenatal and postnatal depression and anxiety
- Prematurity and early developmental outcomes
- Infant mental health and development
- Parent–infant relationships
- Paternal wellbeing in the perinatal period
PIRI’s Research Track Record
Some of PIRI’s cutting-edge research and world-first findings include:
- Online psychological treatments shown to be highly effective for women with postnatal depression (MumMoodBooster)
- Parent sensitivity training that improves brain connectivity in premature infants (Premiestart)
- Evidence that antenatal treatment of depression and anxiety is associated with improved infant developmental outcomes (Beating the Blues before Birth)
- A brief, targeted mother–infant interaction program shown to be effective following postnatal depression (HUGS)
- Improved help-seeking for postnatal depression through specialised training for Maternal and Child Health Nurses (Primer)
- A self-help preparation for parenthood program during pregnancy that reduces depression and anxiety (Towards Parenthood)
Designing and Evaluating Effective Interventions
PIRI has an extensive track record in designing interventions and conducting high-quality randomised controlled trials in the perinatal period. This includes programs targeting both maternal mental health and infant outcomes, such as stress-reduction interventions for preterm infants.
PIRI researchers were among the first to demonstrate that while postnatal depression can be effectively treated, this alone does not reverse the stress processes that mediate many of its negative effects on the mother–infant relationship and infant development. One significant paper linked early interaction difficulties with later cognitive outcomes, highlighting the importance of addressing relational processes alongside symptom reduction.
Tailored Programs Across Populations
PIRI has diversified core treatment materials to meet the needs of specific populations, including pregnant women, couples, fathers, and families experiencing prematurity. Programs have been delivered across multiple formats, including self-help workbooks, distance-based therapies, group programs, and individual treatment.
PIRI’s work places equal emphasis on prevention and treatment and has pioneered interventions for antenatal depression and anxiety aimed at protecting later child development. This work reflects PIRI’s strength in translating complex research into practical, evidence-based interventions.
Foundational and Population-Level Research
A major focus of PIRI’s research has been identifying psychosocial risk factors for postnatal depression. This included a study of 40,333 women, one of the largest and most demographically comprehensive investigations of its kind globally. The study isolated individual risk factors of unique importance and provided the first quantified estimates of perinatal depression risk for Indigenous Australian women.
Additional foundational research has examined the relationships between depression, anxiety, sleep, and maternal and child weight.
Screening, Policy and National Impact
PIRI has published key research on the acceptability and effectiveness of screening for postnatal depression, addressing a longstanding gap in the evidence base. This included rigorous estimates of the predictive value of widely used screening instruments.
More recently, PIRI’s Dr Alan Gemmill and Professor Jeannette Milgrom edited an international academic text on identifying and managing perinatal depression.
Since 2000, PIRI has maintained a longstanding collaboration with beyondblue and has received funding from the beyondblue Victorian Centre of Excellence. PIRI played a central role in the National Postnatal Depression Project (2001–2005), which involved over 43 health services and more than 40,000 women across Australia. PIRI alone screened over 10,000 women in Victoria and Tasmania.
This work culminated in the National Action Plan for Perinatal Mental Health and later contributed to the development of the beyondblue Clinical Practice Guidelines for depression and related disorders in the perinatal period. PIRI led the development of associated online training modules for health professionals.
Collectively, this sustained body of work underpinned the National Perinatal Depression Initiative, resulting in a $85 million government commitment to universal perinatal screening. This initiative mandates psychosocial assessment, including depression screening, at least once during pregnancy and once in the first year postpartum for all Australian women.
PIRI continues to support national implementation through workforce training and evidence-based resource development.
PIRI’s Grant Support and Acknowledgements
PIRI has received more than 90 competitive research grants to date. We gratefully acknowledge the support of the following research funding bodies:
Major national and international funders
- National Health and Medical Research Council (NHMRC)
- National Institutes of Health, USA (NIH)
- Australian Research Council (ARC)
- Medical Research Future Fund (MRFF)
- NSW Government Translational Research Grants Scheme
Foundations and philanthropic supporters
- beyondblue
- Australian Rotary Health
- Ian Potter Foundation
- Baker Foundation
- Austin Medical Research Foundation
- Bupa Foundation (Australia)
- Helen Macpherson Smith Trust
- Urquhart Charitable Trust
- MBF Foundation
- Telstra Foundation Community Development Fund
- WCF Thomas Charitable Trust
- Financial Markets Foundation for Children
- Windermere Foundation Limited
- Medical Research Foundation for Women and Babies
- Collier Trust
- Victorian Women’s Trust
- Perpetual Impact Philanthropy
- Equity Trustees
- Men of Malvern
Professional and industry partners
- Royal Australian and New Zealand College of Psychiatrists
- Pfizer
International Collaboration Support
PIRI has also received support through international collaborations, including:
- Two research partnerships in the United Kingdom funded by the National Institute for Health Research and Policy Research Programme
- A fellowship funded by the Antonio Meneghetti Scientific and Humanistic Research Foundation (Italy)
Implementation and Translation Support
We also acknowledge the following organisations for supporting the implementation and translation of PIRI’s research into practice:
- Australian Government Department of Health
- Jack Brockhoff Foundation
- Alfred Felton Bequest
- William Angliss (Victoria) Charitable Fund
- Lord Mayor’s Charitable Fund
- Department of Education and Early Childhood Development (DEECD)
Current PIRI Projects and Research Collaborations
- Mum 2B Mood Booster- Development of an Online Treatment for Antenatal Depression funded by the Ian Potter Foundation
- Does Treating maternal antenatal depression and anxiety prevent adverse infant neurodevelopmental outcomes? funded by Australian Rotary Health and Bupa
- Chief Investigators: Prof. J. Milgrom, Dr C. Schembri, Dr A. Gemmill, & Dr C. Holt
- Development of a Web-based Cognitive Behavioural Therapy for Women with Postnatal Depression funded by National Health and Medical Research Council (NHMRC)
- Chief Investigators: Prof. J. Milgrom, Dr B. Danaher, & Dr J. Seeley.
- Randomised Trial of a Web-based Cognitive Behavioural Therapy for Women with Postnatal Depression funded by beyondblue and Windermere Foundation
- Chief Investigators: Prof. J. Milgrom, Dr B. Danaher, & Dr J. Seeley.
- Help-seeking for postnatal depression as a major public health problem: A Cluster Randomised Controlled Trial of Motivational Interviewing funded by Australian Rotary Health
- Chief Investigators: Prof. J. Milgrom & Dr C. Schembri
- Improving Neurobehavioural Development in Preterm Infants: Identifying Long-Term benefits of Early Stress Reduction funded by the National Health and Medical Research Council (NHMRC)
- Chief Investigator: Prof. J. Milgrom & P. Martin
- Improving Neurobehavioural Development in Preterm Infants: Long-term Benefits of an Intervention in the NICU Compared to a Full-term Cohort. Funded by Austin Medical Research Foundation
- Chief Investigator: Prof. J. Milgrom,, Dr A. Gemmill, Dr C. Holt, Dr C. Newnham & C. Ferretti.
- Early Intervention to Protect the Mother-Infant relationship Following Postnatal Depression- A Randomised Controlled Trial funded by beyondblue
- Chief Investigators: Prof. J. Milgrom & Dr C. Schembri
- Mum2BMoodBooster: Consumer Testing of a New Online Treatment for Antenatal Depression. Funded by the Ian Potter Foundation
- Chief Investigators: Prof. J. Milgrom, Dr A.W. Gemmill
- Perinatal Identification, Referral and Integrated Management for Improving Depression: the PIRIMID study. National Health and Medical Research Council (NHMRC) and Beyond Blue
- Chief Investigators: Prof J. Milgrom, Dr A.W. Gemmill & Prof D Storey
- Reaching Isolated Women in NSW: An implementation research study for delivering an online treatment program for postnatal Depression and Anxiety. Funded by NSW Department of Health’s Translational Research Grants Scheme
- Chief Investigators: K de Haan, M Bernoth, C. Hunt, Andre Rodrigues, Prof.J.Milgrom, Dr.A.W.Gemmill
- Prevention of Adverse Child Behavioural Development Following Maternal Depression in Pregnancy. This a large RCT funded by the National Health and Medical Research Council (NHMRC)
- Chief Investigators: Prof J. Milgrom, Prof H. Skouteris, Prof M. Galbally, Prof C. East, Prof V. Glover
- The effects of a parental sensitivity intervention in the NICU on preterm children’s brain development and neurocognitive outcomes at 9 years. Funded by Austin Medical Research Foundation (AMRF)e
- Chief Investigators: Prof. J. Milgrom, Dr A.W. Gemmill, Dr C. Ferretti
Do stressful experiences in the NICU affect the brain development of preterm infants? Chief Investigators: Dr. C. Newnham & Prof. J. Milgrom
In this study, funded by The Helen McPherson Smith Trust, we assess the relationship between stress experienced in intensive care units by very preterm infants (born < 30 weeks of pregnancy) and infant brain development measured using MRI scans. The study uses our Neonatal Infant Stressor Scale (NISS) to measure the accumulated stress experienced from invasive but necessary medical procedures in the very earliest days of life and asks if this is linked to developing brain tissue volumes and to the quality of white matter development.
1. PIRI collaboration with Oregon Research Institute (ORI), US
Development of the MumMoodBooster intervention to its delivery-ready stage was led and supported by a team of international experts. Prof. Milgrom (CI), a leading expert in the identification and treatment of PND, has worked in close collaboration with Drs. Danaher and Seeley at the Oregon Research Institute (ORI) who have very considerable expertise in the innovative design and evaluation of Web-based behavioural interventions
With NIMH funding, over the course of almost three years the MumMoodBooster Web-based CBT intervention for PND was developed. The PIRI team worked together with Dr Brian Danaher and Dr John Seeley at ORI. Drawing on our Getting Ahead of Postnatal Depression program, a systematic, iterative development process followed the Science Panel on Interactive Communications and Health guidelines (Henderson et al., 1999) consistent with a staged approach for the development and testing of behavioural interventions. MumMoodBooster has been evaluated and has found to be effective in a randomised controlled trial as compared to treatment as usual. Ongoing trials are comparing MumMoodBooster directly to face-to-face psychological therapy and establishing the feasibility of an antenatal version (funded by NHMRC and Ian Potter Foundation).
2. PIRI Collaboration with Deakin University, A/Prof Helen Skouteris
PIRI has collaborated on a number of projects investigating the treatment and impact of weight gain on postpartum women and their children.
A Randomised Controlled Trial to Prevent Primigravid Excessive Gestational Weight Gain and Postpartum Weight Retention. Chief Investigators: Dr H. Skouteris, Prof. M. McCabe, Prof. J. Milgrom, Prof. B. Kent. National Health and Medical Research Council (NHMRC) funding.
How do parenting and parent-child interactions impact on preschool children’s eating, physical activity habits, and subsequent patterns of weight gain? Chief Investigators: Dr H. Skouteris, Prof. M. McCabe, A/Prof. L. Ricciardelli, Prof. J. Milgrom, Prof. L. Baur. Australian Research Council Discovery Research Project funding.
Healthy Mums and Bubs
This new program is being developed to provide healthy eating and physical activity from infancy. This prevention program aims to help mothers and babies develop healthy infant feeding habits to prevent unnecessary weight gain at the start of life, and also manage post-pregnancy weight gain in the mother. The program:
- Uses a parenting support approach to enhance knowledge (psychoeducation), skill and confidence of parents supported by reference materials on child feeding, eating practices, and physical activity.
- Promotes behaviour change in a fun setting and explores feeding habits in the context of the mother-infant interaction.
- Explores the relationships between maternal mood and unhealthy eating traps.
- Uses health coaching principles to promote healthy behaviour and identify barriers to changing physical and eating habits, empowering parents to find their own solutions.
3. PIRI Collaborations with the UK
Two major UK trials have drawn on PIRI’s successful ‘Towards Parenthood’ program and involved PIRI staff:
Howard, L., Abel, K., Bick, D., Byford, S., Davidson, S., Hunter, M., Johnson, S., Jones, I, Milgrom, J., Morgan, C., Pariante, C., Pawlby, S., Pickles, A., Rose, D., Stanley, N., Wieck, A. The Effectiveness and Cost- effectiveness of Perinatal Psychiatry Services, National Institute for Health Research & Policy Research Programme, 2012-2016.
Ramchandani, P., O’Mahen, H., Dunkley-Bent, J., Fearon, P., Halligan, S., Lewis, L., Adapting and testing a brief intervention to reduce maternal anxiety during pregnancy. National Institute for Health Research, 2014-2016. Consultants: J. Milgrom & J. Ericksen.
4. Mental Health of Men in the Perinatal Period
PIRI has previously developed evidence-based resources including parenting DVDs for fathers; intervention sessions for partners of women with PND and an online partner’s support portal.
PIRI currently contributes to the research activities and the Advisory Committee of the Paternal Perinatal Depression Initiative. This multi-group research initiative aims to improve identification, awareness and support for new fathers experiencing depression, anxiety or other distress in ways that men can readily engage with. Current projects include development of SMS-based psycho-education and support services to give men the information they need to appreciate and care for their own mental health and to successfully link men with appropriate help. Lead Investigator Dr Richard Fletcher, University of Newcastle.
5. Raising Premmies information online
Collaboration project with the Parenting Research Centre in the development of a Raising Premmies corner on the Raising Children’s Network site.
Click here for more information
6. Collaboration with beyondblue.
We have worked closely with beyondblue on research-related questions for several years to deliver various research projects and research-informed resources and publications, for example:
- Perinatal Depression and Anxiety – Evidence relating to infant cognitive and emotional development (available online at www.beyondblue.org.au );
- Highet, N. J., Gemmill, A. W., & Milgrom, J. (2011). Depression in the perinatal period: awareness, attitudes and knowledge in the Australian population. Australian & New Zealand Journal of Psychiatry, 45(223-231).
https://www.ncbi.nlm.nih.gov/pubmed/21438748
Online training for screening with the Edinburgh Postnatal Depression Scale (collaborative project with beyondblue and Genesis)
Maternal sensitivity and its influence on neurodevelopmental outcomes in preterm infants. Carmel Ferretti PhD, Department of Psychology, University of Melbourne.
Health and Wellbeing during Pregnancy and After Birth. Kim Yiong Wee (Alvin), Latrobe University.
Psychological distress across pregnancy and postpartum: A prospective study. Sofia Rallis, Deakin University.
An exploratory study of coding mother-infant interactions with preterm infants at 30 weeks. Claire Corbett, Masters in Psychology (Clinical), Psychological Sciences, University of Melbourne.
The transition to motherhood: A multifacet group program for primiparous women. Melissa Buultjens
The role of mediating factors in physical and psychological distress during pregnancy and postpartum. Soledad Coo, University of Melbourne.
Longitudinal Outcome of a Preterm Birth: Evaluation of an Intervention Program and an Exploration of Effects of Maternal Environment on Preschool Children Born Preterm. Lisa Milne PhD, Department of Psychology, University of Melbourne.
Developing a Risk Screening Tool for Vulnerable Families. Caroline Murphy (De Paola) PhD., Department of Psychology, University of Melbourne.