Conditions leading to unresolved attachment status for loss and the role of complicated grief

A central goal of this study is to better understand why some mothers become unresolved with respect to experiences of loss whereas others do not. Adults are considered to be unresolved with respect to loss if they display signs of mental disorganization while discussing an attachment-related loss due to death – for example, talking in the present tense about a deceased person as if the person is still alive (Main, Goldwyn, & Hesse, 2002). Studies have accumulated documenting the negative consequences of being unresolved. Researchers have linked unresolved attachment to frightened/frightening maternal behavior (Jacobvitz, Leon, & Hazen, 2006), drug/alcohol abuse (Riggs & Jacobvitz, 2002), and other Axis I and II disorders (Ward, Lee, & Polan, 2006; Fonagy et al., 1996); as well as anxiety, anger, (Busch, Cowan, & Cowan, 2008) and controlling behavior (Creasey, 2002) in romantic relationships. Less is known about the conditions under which a person becomes unresolved. This study will be one of the first to examine the comprehensive effects of several risk factors known to influence a person’s ability to resolve a loss including kinship, cause of death, and suddenness as well as primary attachment pattern. Other factors included in this study are social support and lifestyle changes.

Although attachment theory provides a thorough explanation for an individual’s inability to resolve a loss, it is only one of many theoretical explanations of this phenomenon (Rando, 1993). One theory that is conceptually similar to unresolved loss is the theory of complicated grief, the process of painful searching and yearning for a deceased person (Prigerson et al., 1995b). Like those who study unresolved loss, complicated grief researchers are still seeking to understand what factors can predict whether an individual will experience prolonged symptoms of grief (van der Houwen et al., 2010). Also similar to unresolved loss, complicated grief involves irregular patterns of mental processes following a loss; however, complicated grief seems to be a conscious process, whereas unresolved loss has non-conscious components. Hence, this dissertation also examined whether complicated grief was related to unresolved loss and, if so, whether the origins for complicated grief were similar to unresolved loss.