Love and loss : attachment and the prediction of prolonged grief

As part of attachment theory, Bowlby (1980) proposed an individual difference model of coping with bereavement and described how insecure attachment orientations would be linked to two disordered variants of grieving: chronic mourning and the prolonged absence of conscious grieving (also called absent, delayed, inhibited, or suppressed grief). While empirical research has supported the association between an anxious attachment orientation and grief symptoms, studies have failed to support an association between avoidant attachment and symptoms. In fact, some studies on loss have found a negative association between avoidant attachment and symptoms. In a series of three studies the current research sought to further investigate Bowlby's individual difference model by examining insecure attachment patterns and responses to loss. The first study examined attachment and responses to death and non-death loss and included 57 people who reported a death loss and 119 people who reported a non-death loss. Contrary to previous research, avoidant attachment was a significant predictor of grief and trauma symptoms for death loss, while attachment anxiety was a significant predictor of symptoms for non-death loss. This study was the first published study to show a positive association between avoidant attachment and grief symptoms. It was unclear, however, which aspects of avoidant attachment were contributing to the positive association with symptoms, as avoidant and anxious attachment were highly correlated in the regression model (r = .634). The second study sought to clarify these findings using a different measure of attachment and improve upon the research by separately assessing general and relationship-specific attachment patterns (with the deceased) and measuring complicated or prolonged grief symptoms rather than only normative grief responses. In the second study 368 people reported a significant death loss, with most losses being the loss of a grandparent or parent. General avoidant attachment was positively associated with prolonged grief symptoms, while relationship-specific avoidant attachment was negatively associated with symptoms. The negative association between specific avoidant attachment and symptoms was explained by the strength of the attachment relationship with the deceased, or lack thereof. General and relationship-specific attachment anxiety were associated with prolonged grief symptoms, with a stronger association for relationship-specific attachment anxiety. The third study extended the research further by specifically examining adjustment to parental loss, or loss of a primary attachment figure. The death loss of a mother or father during childhood or young adulthood was reported by 71 people. General avoidant attachment was positively associated with prolonged grief symptoms while relationship-specific avoidant attachment was negatively associated with symptoms. Relationship-specific attachment anxiety was also associated with prolonged grief symptoms in this study, but no association was found for general attachment anxiety. Normative grief symptoms were also assessed in the second and third studies and interestingly, general avoidant attachment was not associated with these more typical symptoms. The results from these studies support the distinction between general and relationship-specific attachment insecurities and between normative and prolonged grief responses. The theoretical and clinical implications of this research are presented in the final chapter, as well as recommendations for future research