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.