title: Factors associated with the unresolved classification of the Adult Attachment Interview in women who have suffered stillbirth.
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.
authors.affiliation: Department of Psychiatry, St. George's Hospital Medical School, London, UK. p.hughes@sghms.ac.uk
authors.forename: P
authors.initials: P
authors.lastname: Hughes
authors.forename: P
authors.initials: P
authors.lastname: Turton
authors.forename: E
authors.initials: E
authors.lastname: Hopper
authors.forename: G A
authors.initials: GA
authors.lastname: McGauley
authors.forename: P
authors.initials: P
authors.lastname: Fonagy
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D009769:Object Attachment; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000523:psychology*; D011584:Psychology; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology*; D011795:Surveys and Questionnaires