Unresolved loss due to miscarriage: an addition to the Adult Attachment Interview

Parental unresolved loss as assessed in the Adult Attachment Interview (AAI; George, Kaplan, & Main, 1985) is significantly associated with infant disorganized attachment. Lapses in the monitoring of both reasoning and discourse and reports of extreme behavioural reactions are evidence of the continuing presence of unresolved responses to loss. (Main, DeMoss, & Hesse, 1994). The original format of the AAI does not include a separate question concerning the experience of miscarriage. We added questions on this subject because, for many parents, miscarriage represents a significant loss. The questions and follow-up probes closely followed the format of the questions in the AAI about loss and were asked immediately after these questions. Answers to the questions about miscarriage were rated with the current classification system for unresolved loss. In a sample of 85 middle-class, non-clinical mothers of 1-year-old infants, thirty mothers (35%) reported that they had experienced a miscarriage. Scores on the 9-point rating scale for unresolved loss due to miscarriage were related to infant disorganized attachment behaviour, r(30) = .30, p = .05. Mothers' unresolved loss was not related to the amount of time that had passed since they had a miscarriage. Unresolved loss due to miscarriage was, however, related to the duration of the pregnancy before miscarriage, r(30) = .56, p = .004. Thus, including a question on miscarriage in the AAI may yield theoretically and clinically important information.