Andrew J. Lewis

Federation University · Institute of Health and Wellbeing

This paper concerns future policy development and programs of research for the prevention of mental disorders based on research emerging from fetal and early life programming. The current review offers an overview of findings on pregnancy exposures such as maternal mental health, lifestyle factors, and potential teratogenic and neurotoxic exposures...

A significant body of longitudinal research has now been undertaken following the offspring of parents with schizophrenia. This paper presents a systematic review of eighteen longitudinal studies, summarizing findings in 46 papers, following up children who are at familial high-risk of developing psychotic disorders. The studies suggest that these...

Objective The aim of this study was to examine associations between family-based stressors and depressive symptoms in adolescents. Method Participants were 10-14 year olds who participated in a large Australian population study (n=6,552). Depressive symptoms and pubertal development were assessed using the self-report Short Mood and Feelings Questi...

This paper provides an account of the theoretical basis of a family-based intervention called Behaviour Exchange and Systems Therapy (BEST). The model described here has also been applied to adolescents with substance abuse and other mental health problems such as depression and anxiety disorders in both children and adolescents. Evaluative studies...

This paper examines developmental outcomes for children exposed prenatally to maternal methamphetamine use. PSYCHINFO, Scopus, PubMed and ERIC databases were systematically searched for studies up to December 2020. The search identified 38 articles examining cognitive, language, motor and neuroanatomical outcomes in children from birth to 16 years....

Background/Objectives: Parent-child attachment and family relationships have been identified as risk factors for childhood internalising symptoms such as anxiety and depressive symptoms. This mixed-methods evaluation examined the feasibility of a recently developed attachment-based family intervention, Behaviour Exchange Systems Therapy-Foundations...

Emphasis on continuous infant sleep overnight may be driven by parental concern of risk to child mental health outcomes. The Mercy Pregnancy and Emotional Wellbeing Study (MPEWS) examined whether infant sleep at 6 and 12 months postpartum predicts anxiety disorders at 2–4 years, and whether this is moderated by maternal depression, active physical...

This study examines whether gestational age, birth weight, and early term birth is associated with childhood mental disorders in 342 pregnant women recruited at less than 20 weeks gestation and were then followed up until 4 years postpartum, including 93 children born at early term. Women were assessed at recruitment using the Structured Clinical I...

Background Perinatal maternal depression may affect fetal neurodevelopment directly or indirectly via exposures such as smoking, alcohol, or antidepressant use. The relative contribution of these risk factors on child executive function (EF) has not been explored systematically. Methods A prospective pregnancy cohort of 197 women and their childre...

Objectives: Maternal attachment state of mind is an important potential predictor of risk and resilience to perinatal emotional wellbeing and early parenting. To explore maternal attachment in relation to perinatal depression and emotional wellbeing. Methods: This study drew on data collected within an ongoing cohort from 170 women recruited in...

The Parental Reflective Interview Procedure was developed as part of an initial assessment interview for an attachment-based intervention for child mental health conditions. This study was a pilot randomised controlled trial that utilised a parallel, single-blind trial design to evaluate the differences in the effects of the Parental Reflective Int...

Objective: Perinatal emotional well-being is more than the presence or absence of depressive and anxiety disorders; it encompasses a wide range of factors that contribute to emotional well-being. This study compares perinatal well-being between women living in metropolitan and rural regions. Design: Prospective, longitudinal cohort. Participant...

Aim: This paper aims to examine the maternal and child mental health and parenting outcomes in the context of COVID-19 pandemic conditions using a sample from Melbourne, Australia - a city exposed to one of the longest lockdowns world-wide in response to the pandemic. Methods: This study utilises observational data from a prospective, pregnancy...

In examining maternal depression, placental 11β-HSD2 mRNA expression and offspring cortisol regulation as a potential fetal programming pathway in relation to later child emotional disorders, it has become clear that sex differences may be important to consider. This study reports on data obtained from 209 participants in the Mercy Pregnancy and Em...

Therapist factors are generally thought to be important predictors of their capacity to understand and respond to clinical material. However, this assumption has been rarely examined empirically. The current study aims to identify which features of personality and clinical symptomatology predict a trainee therapist’s rating of cognitive-behavioural...

Introduction Placental dysfunction and inefficiency, is important in understanding fetal growth restriction and low birth weight. Two recent studies have examined the relationship between antidepressant use in pregnancy and placental weight ratios; one found lower placental weight ratio associated with antidepressant use and the other found a highe...

Objective: Understanding the relationship between attachment and mental health has an important role in informing management of perinatal mental disorders and for infant mental health. It has been suggested that experiences of attachment are transmitted from one generation to the next. Maternal sensitivity has been proposed as a mediator, although...

Understanding if maternal depression is a predictor of infant-parent attachment classification is important to furthering knowledge about the early pathways and predictors of socio-emotional development. Yet few studies that have utilised the Strange Situation Procedure, the gold standard for measurement of infant-parent attachment, have examined a...

Abstract Background: The Emotional Availability Scales (EAS) are among the most widely reported observational assessment measures of parent-infant interaction and has been of particular interest in understanding differences between samples of depressed and nondepressed mothers and their infants. Despite its widespread use, psychometric validation...

Childhood Anxiety Disorders (CAD) are a common childhood mental disorder and understanding early pathways is key to prevention and early intervention. What is not understood is whether early life stress predictors of CAD might be both mediated by infant cortisol reactivity and moderated by attachment. To address this question this study draws on 19...

Background: The effects of maternal depression on mother-infant relationship quality likely vary according to depression heterogeneity. We investigated the effects of different presentations of major depression on mother-infant emotional availability (EA). Methods: Data were obtained from 115 mother-infant dyads from a longitudinal pregnancy coh...

The ability to sustain a coherent narrative about experiences of trauma and loss is a prominent feature of secure-autonomous attachment states of mind as assessed in narrative tasks such as the Adult Attachment Interview. The current study examines the clinical application of the concepts of narrative coherence and discourse segregation within a th...

BACKGROUND Maternal depression during the perinatal period predicts adverse developmental outcomes for children, via poorly understood mechanisms. One plausible pathway may involve child executive function, a suite of cognitive capacities associated with poorer social, emotional and educational outcomes. Systematic review and meta-analysis are appl...

Background: Social support theory suggests that parental social support may influence the nature of early parenting behaviours and specifically the mother-infant relationship. This study examines whether support from a partner, friends or family is associated with differences in quality of mother-infant interactions in the context of maternal depre...

Abstract Placental 11β-HSD2 has been a focus of research for understanding potential fetal programming associated with maternal emotional disorders. This study examined the pathway from antenatal mental health via placental 11β-HSD2 mRNA to cortisol regulation in the infant offspring. This study reports on data obtained from 236 participants in th...

Background : There is increasing interest in the association between perinatal depression and diet including whether diet may have an impact on depressive symptoms and equally whether depression influences diet. Furthermore, whether pharmacological treatment of depression with antidepressant medication also may influence diet. Methods : We examine...

Objective Poorer mother–infant interaction quality has been identified among women with major depression; however, there is a dearth of research examining the impact of bipolar disorder. This study sought to compare mother–infant emotional availability at 6 months postpartum among women with perinatal major depressive disorder, bipolar disorder and...

In “Attachment Across the Life Cycle”, John Bowlby wrote: “Once we postulate the presence within the organism of an attachment behavioural system regarded as the product of evolution and as having protection as its biological function, many of the puzzles that have perplexed students of human relationships are found to be soluble”. One such puzzle...

Antidepressant treatment of perinatal depression is increasingly common and accepted in clinical guidelines. It has been suggested that serotonergic antidepressants may effect changes in the oxytocinergic system, including oxytocin levels, and that this may be one of the beneficial mechanisms of action for these drugs. Furthermore, oxytocin has bee...

In the postscript to "Attachment Across the Life Cycle", John Bowlby wrote: "Once we postulate the presence within the organism of an attachment behavioural system regarded as the product of evolution and as having protection as its biological function, many of the puzzles that have perplexed students of human relationships are found to be soluble"...

Motor development underlies many aspects of education and learning. There has been uncertainty about the impact of exposure of antidepressant medication in pregnancy on child motor outcomes. This paper examines whether exposure to antidepressants in utero increases the risk of poorer motor development in two areas: sensorimotor and visuospatial pro...

The prevalence of pacifier use is high but when it occurs outside of the recommended sleep context, it becomes more controversial. Using 211 mother-infant dyads recorded as part of the Mercy Pregnancy and Emotional Wellbeing Study, we examined the maternal psychosocial predictors of pacifier use within an interaction task (i.e.,ten minutes face-to-...

Background Substance use disorders (SUDs) have been described as a dysfunctional way to compensate for deficiencies in that person’s underlying attachment system. Furthermore, the neuropeptide oxytocin (OT), which is a critical component of the neurobiology of the attachment system, has been shown to effectively reduce addictive behavior and theref...

Oxytocin has been a hormone of interest in understanding both depression and parenting. Here the role of oxytocin has been explored in understanding the interaction between perinatal depression, the early mother-infant relationship and subsequent longer-term child socio-emotional outcomes. Data were obtained from 203 pregnant women from the Mercy P...

Understanding how a mother’s traumatic experiences might influence her interactions with her infant may have importance for understanding infant development and mental health. Data were drawn from an Australian pregnancy cohort, the Mercy Pregnancy and Emotional Wellbeing Study, in which different types of maternal trauma were examined over pregnan...

Abstract Background: Childhood anxiety disorders (CAD) are likely to be predicated by risk factors and pathways early in life. Identifying these factors is important to the future development of intervention targets to reduce the risk of developing CAD. Methods: Data were obtained from 198 women and children from the Mercy Pregnancy and Emotional...

Objective To explore the association between maternal depression and the screen and reading time experienced by their infants. Methods This study utilises data on 158 women and infants, collected within the Mercy Pregnancy and Emotional Wellbeing Study. Women less than 20 weeks gestation were diagnosed using the Structured Clinical Interview for D...

Background : Both antidepressant use and depression in pregnancy have the potential to impact on outcomes for the women, their mother-infant relationship and their infants. Methods : Data were obtained from 485 pregnant women within Mercy Pregnancy and Emotional Wellbeing Study, a pregnancy cohort study. The sampling frame was in three groups: tho...

Understanding fetal programming pathways that underpin the relationship between maternal and offspring mental health necessitates an exploration of potential role of epigenetic variation in early development. There are two key genes involved in stress regulation, the glucocorticoid and mineralocorticoid receptors (NR3C1 and NR3C2). Data were obtain...

Background: Existing research suggests maternal depression may reduce the quality of early mother-infant interaction and this might increase our understanding of how maternal mental health impacts on child development outcomes. However, most studies recruit from community samples and few include both a diagnostic measure of maternal depression tog...

Abstract Background: This study sought to identify depression trajectories across childhood and to model a range of child and family predictors of whether a child may be on an increasing trajectory towards depressive disorder in adolescence. Methods: Multi-group growth mixture modelling (MGMM) was used on a sample of 4983 children from the Longitu...

Understanding maternal mental health and cortisol regulation across pregnancy and the relationship to the development of the offspring’s stress regulation is critical to a range of health outcomes. The aim of this study was to investigate infant and maternal cortisol in women with depression. Data were obtained from 241 pregnant women within Mercy...

Pregnancy and the early post partum period are widely understood as a critical period for the infant’s emotional development and the earliest influence shaping social interaction. The present study aims to understand the potential influence of both antenatal and postnatal maternal anxiety and depressive symptoms on socio-emotional outcomes in offsp...

Background: Findings examining the relationship between maternal depression and parenting stress have been mixed. The complexity is likely to lie in the range of additional factors that are associated with vulnerability to depression and also to parenting stress. A women’s experience of interpersonal trauma and partner support is important in under...

Background: There is an established relationship between depression and sexual functioning in women. However, there is limited research examining the relationship between perinatal depression and sexual functioning. Methods: This study draws on the Mercy Pregnancy and Emotional Wellbeing Study and reports on 211 women recruited in early pregnancy a...

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Background: Both perinatal depression and infant sleep problems are common concerns in many communities, with these problems often coinciding. Findings in this area conflict and much of the research relies on poor measures of sleep and/or depression. Adding to this complexity is the rise in antidepressant treatment for perinatal maternal depressio...

Objective: Since the potential mental health benefits of exercise during pregnancy remain unclear, this study examined longitudinally the bidirectional relationship between exercise and maternal mental health symptoms during the perinatal period, and included adjustment for both depression and antidepressant treatment. Methods: Data were collect...

ABSTRACT Context: There is increasing use of antidepressants in pregnancy and hence children exposed in utero. Contradictory studies exist in the literature reporting on the potential impact of antidepressant exposure in utero on subsequent child motor development. Objective: The objective of this systematic review and meta-analysis was to determi...

Background: Depression is consistently shown to predict lower rates of breastfeeding. In a handful of studies, breastfeeding has predicted lower depression symptoms. However, studies demonstrating the latter are limited in their measurement of both depression and breastfeeding and have not followed participants from pregnancy across the postpartum...

Objective: The aim of this study was to use prospective data from the Avon Longitudinal Study of Parents and Children (ALSPAC) to examine association between trajectories of early childhood developmental skills and psychotic experiences (PEs) in early adolescence. Method: This study examined data from n = 6790 children from the ALSPAC cohort who pa...

The aim of this study was to investigate placental DNA methylation of the oxytocin receptor gene (OXTR) in women with depression in pregnancy. We also explored the role of antidepressant medication in pregnancy on placental OXTR methylation. Data were obtained from 237 women in the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS), a selected p...

Abstract Objective: Disorganised attachment in childhood has been considered an important early marker for the development of socio-emotional and mental health problems. This review critically examines the current evidence and methodology employed to assess the influence of perinatal maternal mental health on disorganised attachment in infancy. Me...

Background: While a meta-analysis has confirmed the association between antidepressant exposure in utero and subsequent poor neonatal adaptation, few identified studies included drug levels or standardized measures and only two studies followed up children who developed symptoms beyond infancy. Study design: The study draws on the Mercy Pregnanc...

Objectives: Many people experience irritability when manic, hypomanic, or depressed, yet its impact on illness severity and quality of life in bipolar and schizoaffective disorders is poorly understood. This study aimed to examine the relationship between irritability and symptom burden, functioning, quality of life, social support, suicidality, a...

The impact of maternal depression on parenting is well established and there is a clear interaction between maternal depression and parenting that is predictive of child outcomes. The research on paternal depression is more limited but suggests the father’s mental health may be an independent risk factor for both parenting and child outcomes. There...

Objective: This paper presents findings from a multi-centre, double-blind, randomized controlled trial that tested the hypothesis that parent and youth mental health improvements would be superior in a family-based intervention for adolescent depression (BEST MOOD) compared to a treatment-as-usual supportive parenting program (PAST). Method: Elig...

Maternal mental health represents a significant global health burden. The Mercy Pregnancy and Emotional Well-being Study (MPEWS) was established to provide a comprehensive investigation of early developmental mechanisms and modifiers for maternal, fetal and child emotional well-being. MPEWS is a prospective, longitudinal study from pregnancy to 36...

Mental illness is one of the leading complications of childbirth and a leading indirect cause of maternal mortality in both the UK and Australia (Austin et al., Med J Aust 186:364–367, 2007; Oates, Br J Psychiatry 183:279–281, 2003). As identification of mental illness in pregnancy grows, attention naturally turns to a search for effective treatmen...

Background Perinatal depression has a significant impact on both mother and child. However, the influence of hormonal changes during pregnancy and the postpartum period remains unclear. This article provides a systematic review of studies examining the effects of maternal cortisol function on perinatal depression. MethodA systematic search was cond...

A significant body of longitudinal research has followed the offspring of parents with schizophrenia. This article presents a systematic review of 46 separate papers presenting the results of 18 longitudinal studies that have followed children who are at familial high risk of developing psychotic disorders. The studies suggest that these children d...

Depression is the most common mental disorder for young people and it is associated with educational under-achievement self-harm, and suicidality. Current psychological therapies for adolescent depression are usually focused only on individual-level change and often neglect family or contextual influences. The efficacy of interventions may be enhan...

Background: This study explores the possibility that religious fundamentalism (RF) may be linked to deficits in personality structure, which is in contrast to the general assumption that religiosity and spirituality are positively related to mature personality development. Sampling andMethods: To test this hypothesis, 327 (232 female) college stud...

Abstract Objective: Given depression is a significant risk factor for suicidal behaviour, it is possible that interventions for depression may also reduce the risk of suicide in adolescents. The purpose of this literature review is to determine whether psychological interventions aimed to prevent and/or treat depression in adolescents can also redu...

Maternal mental disorders during pregnancy are associated with a range of adverse health outcomes for offspring. This systematic review examines studies reporting on the relationship between maternal depression, anxiety or stress during pregnancy and fetal growth measured using ultrasound biometry. A systematic search of PsycInfo, Medline, Scopus,...

Abstract: Maternal mental disorders over pregnancy show a clear influence on child development. This review is focused on the possible mechanisms by which maternal mental disorders influence fetal development via programming effects. Within pregnancy, the type, timing and severity of mental health symptoms requires careful consideration as does the...

Abstract: High intrauterine cortisol exposure can inhibit fetal growth and have programming effects for the child’s subsequent stress reactivity. Placental 11beta-hydroxysteroid dehydrogenase (11β-HSD2) limits the amount of maternal cortisol transferred to the fetus. However, the relationship between maternal psychopathology and 11β-HSD2 remains po...

Fetal development;fetal programming;health inequality;maternal depression;pregnancy exposures;pregnancy health;smoking;smoking policy

Background Adolescent depression is a prevalent mental health problem, which can have a major impact on family cohesion. In such circumstances, excessive use of the Internet by adolescents may exacerbate family conflict and lack of cohesion. The current study aims to explore these patterns within an intervention study for depressed adolescents. Me...

After the Multidimensional Inventory for Religious/Spiritual Well-Being (MI-RSWB) was validated as a reliable instrument for the Western European context it is primarily intended in this study to translate the measure into Spanish and adapt it for the Mexican culture. Furthermore we investigate whether spirituality/religiosity has a similar impact...

The deleterious impact of parental substance abuse on child development and family functioning is well established. However, evaluations of interventions designed to ameliorate such impacts are very limited. This paper presents the results of a service evaluation using a pre-post design of the Supporting Kids And Their Environment (SKATE) program;...

This poster introduces a new intergenerational prospective birth cohort study of attachment that is following a sub-sample of Generation 3 (G3) offspring from The Australian Temperament Project (ATP). Around 2,000 subjects (G2) and their parents (G1) have been followed for 33 years across 16 waves. This sub-study of infants 12-18 months (M=14 month...

Commentary article: Abstract: Tobacco smoking in pregnancy is arguably the most important preventable cause of adverse pregnancy outcomes and a number of childhood developmental problems. Recent findings suggest a very early effect of socio-economic disadvantage and that public health research ought to refocus on a ‘womb to tomb’ perspective.

The aim of this study was to examine possible relationships between Religious/Spiritual Well-being (RSWB), the “Big Five” personality factors and stress coping strategies among Bosnian young adults. Therefore, a first Bosnian translation of the Multidimensional Inventory of Religious/Spiritual Well-being was applied on a sample of 290 (181 females)...

In Australia, Psychology is a very popular profession and area of study. For example, figures from the Board of Psychology released in June 2014 showed that there are over 30 000 registered psychologists in Australia and this figure continues to increase year on year. In addition to obtaining registration, many psychologists also undertake several...

Background: Close family and friends who are a primary source of support for an adult with bipolar disorder commonly find it challenging to deal with the symptoms and illness consequences. Many report distress, isolation and depression, and turn to the privacy and convenience of the Internet for guidance and support. This poster reports on the deve...

Abstract Background: Children residing in families which experience intergenerational poverty are known to be a high risk group. There is minimal literature on how parents experiencing intergenerational poverty view their role as parents and the value they place on children’s play. The objective of this study was to examine how such parents view t...

Background: There is very limited research on pregnant women with Borderline Personality Disorder (BPD). However, these women can present many challenges in an obstetric setting and typically require specialized psychiatric care. This study examines pregnancy and infant outcomes of pregnant women with a clinical diagnosis of BPD presenting for obst...