It is well established that child maltreatment has significant deleterious effects for the individual as well as for society. We briefly review research regarding the impact of child maltreatment on the attachment relationship, highlighting the need for relational interventions for maltreated children and their families to effectively thwart negative developmental cascades that are so often observed in the context of child maltreatment. Next, historical and contemporaneous perspectives on relational interventions for individuals with histories of child maltreatment are discussed with attention to the empirical evidence for and the current evidence-based status of several relationally based interventions for child maltreatment. Differential sensitivity to the environment is then discussed as a theoretical framework with important implications for interventions for individuals who have been reared in maltreating environments. Current research on neurobiology and maltreatment is then reviewed, with an emphasis on the need for future investigations on genetic variants, epigenetics, and the efficacy of relational interventions for maltreated children. We conclude with a discussion of the tenets of developmental psychopathology, their implications for relational interventions for child maltreatment, and recommendations for advancing the development, provision, and evaluation of relational interventions for individuals with histories of child maltreatment.

There is a bidirectional relationship between attention-deficit/hyperactivity disorder (ADHD) and epilepsy. ADHD increases seizure risk, while patients with epilepsy have an increased prevalence of ADHD. The reasons explaining this association are not fully understood. Proposed mechanisms include effects of antiepileptic medications, underlying neurodevelopmental vulnerability, the effects of chronic seizures and subclinical epileptiform activity on cognitive functions and adrenergic dysfunction. There may also be a common genetic defect underlying both disorders in some families. Antiepileptics associated with ADHD-like side effects include phenobarbital, gabapentin, vigabatrin and topiramate. Methylphenidate has been studied in a double-blind setting against placebo for treatment of ADHD comorbid with epilepsy, and has a good risk-benefit ratio. Amphetamine, atomoxetine, clonidine and guanfacine only have case series to support their use and bupropion should be avoided.

Numerous investigations have demonstrated that Child-Parent Psychotherapy (CPP) promotes secure attachment between mothers and offspring. However, the role of post-intervention attachment security as it relates to long-term child outcomes has never been evaluated. The present study therefore examined post-intervention attachment status as a mediator of the association between CPP for depressed mothers and their offspring and subsequent peer relations among offspring. Depressed mothers and their toddlers were randomized to receive CPP (n = 45) or to a control group (DC; n = 55). A prior investigation with this sample indicated that offpring who received CPP attained significantly higher rates of secure attachment post-intervention, wheras insecure attachment continued to predominate for offspring in the DC group. The present study examined follow-up data of teachers’ reports on participants’ competence with classroom peers when they were approximately 9 years old. Findings indicated that children who received CPP were more likely to evidence secure attachments at post-intervention, which in turn was associated with more positive peer relationships at age 9.

The ecological-transactional model proposes that nested contexts interact to influence development. From this perspective, child maltreatment represents an individual-level risk factor posited to interact with numerous other nested contextual levels, such as the neighborhood environment, to affect development. The aim of this study was to investigate whether adolescents with maltreatment histories represent a vulnerable group for whom disadvantaged neighborhoods confer risk for substance use disorders. Participants were 411 adolescents (ages 15–18; mean age=16.24) from an investigation of the developmental sequelae of childhood maltreatment. Multiple-group structural equation models, controlling for family-level SES, indicated that neighborhood disadvantage was associated with more marijuana dependence symptoms among maltreated, but not non-maltreated adolescents. Moreover, among maltreated adolescents, those who experienced multiple subtypes of maltreatment were at greatest risk for problematic marijuana use in the context of neighborhood disadvantage. Interestingly, the direct effect of neighborhood disadvantage, but not the interaction with maltreatment, was related to adolescent alcohol dependence symptoms. Results highlight the importance of considering multiple levels of influence when examining risk associated with child maltreatment.