Psychophysiological responses underlying unresolved loss and trauma in the Adult Attachment Interview.

Lianne Bakkum,Marije L Verhage,Mirjam Oosterman,Robbie Duschinsky,Carlo Schuengel,R M Pasco Fearon,Florentina C Kunseler

doi:10.1017/s0954579420001492

Abstract

Unresolved loss/trauma in the context of the Adult Attachment Interview (AAI) has been theorised to result from dissociative processing of fear-related memories and ideas. To examine the plausibility of this model, this study tested hypothesised associations between unresolved loss/trauma and indicators of autonomic nervous system (ANS) reactivity. First-time pregnant women (N = 235) participated in the AAI while heart rate (interbeat interval; IBI) and indicators of parasympathetic reactivity (respiratory sinus arrhythmia; RSA) and sympathetic reactivity (pre-ejection period; PEP, skin conductance level; SCL) were recorded. Using multilevel modelling, ANS reactivity was examined in relation to topic (loss/trauma versus other questions); discussion of actual loss/trauma; classification of unresolved/disorganised; and unresolved responses during the interview. Responses to loss/trauma questions and discussion of loss were associated with respectively larger and smaller IBIs. There was no moderation by unresolved/disorganised status. Unresolved responses about loss were associated with smaller IBIs. Participants classified as unresolved/disorganised showed decreasing PEP and blunted SCL throughout the whole interview. The findings suggest that unresolved speech about loss co-occurs with physiological arousal, although the inconclusive findings regarding parasympathetic and sympathetic nervous system responses fail to clearly support the role of fear.

Highlights

Since its introduction by Bowlby (1969), attachment theory has given insight into how early social experiences, including loss and trauma, may affect human behavior and mental processes
Beijersbergen et al (2008) did not find that responses to the loss and trauma questions in the Attachment Interview (AAI) were associated with the interview being classified as U/d
We examined associations between autonomic nervous system (ANS) reactivity and (a) responding to questions about loss, abuse, and other trauma; (b) discussion of experiences of loss/trauma anywhere in the interview; (c) the interview being classified as U/d; and (d) instances of unresolved discourse about loss/trauma

Summary

Introduction

Since its introduction by Bowlby (1969), attachment theory has given insight into how early social experiences, including loss and trauma, may affect human behavior and mental processes. According to Bowlby (1973), children form expectations of the world, themselves, and their attachment figures. Attachment figures are preferred persons, such as parents, to whom children turn when anxious or alarmed. Children’s expectations of their attachment figures, developing throughout childhood and adolescence, help them to be effective in eliciting support and protection when needed. Loss and other events that disrupt the accessibility of attachment figures as sources of comfort may be cause for alarm. After the loss of an attachment figure, attached persons usually go through a process of mourning. Bowlby (1980) proposed several components of mourning.

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Conclusion