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Factors associated with the unresolved classification of the Adult Attachment Interview in women who have suffered stillbirth

Published online by Cambridge University Press:  13 April 2004

P. HUGHES ,
P. TURTON ,
E. HOPPER ,
G. A. McGAULEY  and
P. FONAGY
P. HUGHES
Affiliation:
St. George's Hospital Medical School, London
P. TURTON
Affiliation:
St. George's Hospital Medical School, London
E. HOPPER
Affiliation:
St. George's Hospital Medical School, London
G. A. McGAULEY
Affiliation:
St. George's Hospital Medical School, London
P. FONAGY
Affiliation:
University College London
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Abstract

The “unresolved” state of mind with respect to loss or trauma as assessed in the Adult Attachment Interview is common in clinical and forensic groups, as well as in mothers whose infants are classified as disorganized in their attachment relationship to them. However, questions remain about what the unresolved state represents and what factors predict the unresolved state. This case controlled study reports on 64 women who had suffered stillbirth and who were pregnant with their next child. The study explores attachment, psychiatric, and social factors associated with the unresolved state or higher unresolved scores with respect to stillbirth. Women who had experienced stillbirth were more likely to be unresolved than control women. Although a similar number of stillbirth and control women had experienced childhood trauma, only women who had experienced stillbirth were unresolved with respect to this trauma, suggesting the unresolved state may be evoked or reevoked by subsequent traumatic loss. Higher unresolved scores in relation to stillbirth were predicted by childhood trauma, poor support from family after the loss, and having a funeral for the infant. The results are discussed in terms of the woman's sense of being causal in the loss.This study was funded by South Thames West R&D, Tommy's Campaign, and the Simenauer Trust (Institute of Psycho-Analysis, London). We thank the Editor and four anonymous referees for their extremely helpful suggestions, many of which we adopted. We also thank the nursing and medical staff and the mothers who generously gave their time to the study.

Type
Research Article
Information
Development and Psychopathology , Volume 16 , Issue 1 , March 2004 , pp. 215 - 230
Copyright
© 2004 Cambridge University Press

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