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.

A randomized clinical trial was conducted to evaluate the efficacy of interpersonal psychotherapy (IPT) for ethnically and racially diverse, economically disadvantaged women with Major Depressive Disorder (MDD). Non-treatment seeking urban women (N=128; M age=25.40; SD=4.98) with infants were recruited from the community. Participants were at or below the poverty level: 59.4% identified as Black and 21.1% were Hispanic. Women were screened for depressive symptoms using the Center for Epidemiologic Studies-Depression Scale; the Diagnostic Interview Schedule was used to confirm MDD diagnosis. Participants were randomized to individual IPT or Enhanced Community Standard (ECS). Depressive symptoms were assessed before, after, and eight months post treatment with the Beck Depression Inventory-II (BDI-II) and Revised Hamilton Rating Scale for Depression (HRSD-R). The Social Support Behaviors Scale (SBS), Social Adjustment Scale-Self Report (SAS-SR) and Perceived Stress Scale (PSS) were administered to examine mediators of outcome at follow-up. Treatment effects were evaluated with a growth mixture model for randomized trials using Complier-Average Causal Effect (CACE) estimation. Depressive symptoms trajectories from baseline through post-intervention to follow-up showed significant decreases among the IPT group compared to the ECS group. Changes on PSS and SBS mediated sustained treatment outcome.

We utilize a perspective derived from developmental psychopathology to guide our discussion of advances that have been made in the field of prevention science over the last decade. After addressing definitional perspectives on prevention, we review programmatic preventive initiatives that are consistent with the goals of a developmental psychopathology perspective. We then direct our attention to conceptual and methodological considerations in the field of prevention science, paying particular attention to the incorporation of multilevel investigations into randomized controlled trials. In the penultimate section of this chapter, we discuss the importance of translational research and of dissemination efforts. We conclude by preferring recommendations for future directions for prevention science in the decades ahead.

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