土耳其寄养家庭研究：养母依恋风格与9至12岁儿童依恋安全感的混合方法研究

摘要

依恋理论预测，照护者自身的依恋组织会塑造其所照护儿童的安全感，但相关证据几乎全部来自亲生父母—婴儿二元组。这一预测是否适用于没有共同遗传史、没有共同婴儿期、且仍存在一个竞争性依恋对象的照护关系，在很大程度上尚未得到检验，尤其是在童年中期——此时儿童能够自己报告这段关系。本研究考察了寄养中9–12岁儿童的依恋安全感是否与其寄养母亲的依恋风格、其进入保护系统的年龄以及与其原生家庭的接触频率相关，并探讨了寄养母亲与儿童如何描述这些关系。在这项解释性序贯混合方法研究中，来自土耳其八个省份的314对寄养母亲—儿童二元组（占符合条件全国人口的13.2%）完成了关系量表问卷和Kerns安全感量表。对按全部四种依恋分类抽样的10位寄养母亲及其10名儿童进行了深度访谈，并进行了主题分析。儿童的安全感因寄养母亲的依恋风格而不同，F(3, 310) = 13.16，p < 0.001，η² = 0.113，90% CI [0.058, 0.164]；安全型依恋寄养母亲的儿童得分高于恐惧型（d = 0.83）、 preoccupied（d = 0.76）和 dismissing（d = 0.78）寄养母亲的儿童。在三岁或三岁前被安置的儿童中，安全感也更高，F(2, 311) = 4.34，p = 0.014，η² = 0.027，并且因接触频率而不同，F(4, 309) = 2.56，p = 0.039，η² = 0.032，尽管这一效应未通过Bonferroni校正，且模式是非单调的而非线性的：无接触的儿童得分与每月接触的儿童一样高。没有任何探索性比较通过校正。四个寄养母亲主题和三个儿童主题与这一模式相吻合，儿童的隐喻——安全港湾、向导与光、保护盾、发自内心的爱——描述了一个运作良好的安全基地。照护者自身的依恋组织与儿童安全感差异的关联，比安置史或接触频率高出数倍，这支持对照护者进行依恋知情的评估和支持。

1 引言

依恋理论认为，反复经历在压力情境下可提供并回应照料的照顾者，会固化为一种内部工作模型，即一套关于亲密关系是否值得寻求、痛苦是否会得到回应的预期（Bowlby, 1958；Ainsworth, 1979）。这种表征对儿童为何重要，已有充分确立。元分析证据将童年期依恋安全性与更高的同伴社交能力联系起来（Groh et al., 2014），并将依恋不安全性分别与整个童年期和青春期的内化症状（Brumariu and Kerns, 2010）以及焦虑的发展（Kerns and Brumariu, 2014）联系起来。童年中期是这种表征变得可报告的发展阶段：儿童对照顾者是否可及、痛苦是否会得到回应持有一套明确表述的预期，而这些预期组织着儿童如何寻求帮助、调节痛苦以及接近同伴。因此，这一阶段依恋表征的安全性不仅是对某一段关系的描述，更是儿童更广泛社会情绪功能的标志，这正是它如何形成这一问题具有重要后果的原因。

发展心理学中最富有成果的主张之一是，这些模型会被传递：照顾者自身在依恋方面的心理状态预测其所照料儿童的安全性。van IJzendoorn（1995）确立了成人依恋表征与婴儿依恋分类之间的强关联，同时表明照顾者敏感性只能解释其中一部分，这一残差后来被称为传递缺口；Verhage et al.（2016）综合了95个样本，确认这一关联成立，尽管比曾经假设的更为温和。

几乎所有这类证据都来自亲生父母与婴儿的二元组合，在这种组合中，传递主张与共享基因、共享产前环境以及自出生起持续的照料相混淆。寄养去除了其中的每一项：寄养母亲与儿童没有共同的遗传历史，关系在大多数安置中始于婴儿期之后，儿童到来时带着在别处形成的工作模型，而且在许多情况下，亲生父母仍是活跃的人物。如果传递反映的是照顾者自身的表征如何组织其照料行为，而非生物学或连续性，那么在这里应当可以观察到。如果在这里没有出现，那么这一现象就比该领域所认为的更为狭窄。

现有证据表明，这种情况确实存在，但基础薄弱且集中于婴儿期。Dozier et al. (2001) 发现寄养母亲的依恋心理状态与安置在其身边的婴儿的依恋质量之间存在一致性，其程度接近生物学二元关系中观察到的水平，而 Stovall-McClough and Dozier (2004) 表明，寄养婴儿的依恋行为在安置后两个月内围绕新的照料者组织起来，其轨迹取决于她的心理状态。Bernard et al. (2012) 通过实验证明，对照料者进行基于依恋的干预减少了受虐待儿童中的混乱型依恋，从而确立二元关系中的照料者一方具有因果作用，而不仅仅是相关，并且 Dozier and Lindhiem (2006) 表明寄养父母对孩子的承诺存在显著差异，这一构念不同于敏感性，且为非生物学照料所特有。Schofield and Beek (2005，2009) 将这些材料纳入长期寄养的安全基地模型，其中可得性、敏感性、接纳、合作和家庭归属感是寄养照料者建立安全感的维度。

进入这一关系的儿童并非以白纸一张的状态到来。家庭外照料的儿童表现出更高比例的不安全型依恋，尤其是混乱型依恋：最近的一项系统综述发现，机构照料中的儿童以不安全型和混乱型模式为主（Martínez-Usarralde et al., 2025），Jorjadze et al. (2023) 发现德国寄养儿童的行为安全性低于对照组，而表征混乱程度高于对照组，Dalgaard et al. (2025) 发现丹麦寄养儿童在混乱型上尤其升高，而 McWey (2004) 在最直接地建模寄养儿童依恋风格的研究中，将问题定位于儿童的历史而非安置本身。与此相对，Kliewer-Neumann et al. (2023) 追踪了新安置的寄养儿童第一年的情况，发现安全性在六个月内上升至常模水平。寄养是一段可能发生重组的时期，问题在于什么决定了它的方向。

安置本身通常有两个特征被提及。第一个是儿童进入照护的年龄：Smyke 等（2010）在布加勒斯特早期干预项目中发现，较早安置到寄养家庭能在机构化儿童中产生更好的依恋结果，Bernier 等（2004）和 Spieker 等（2014）报告了趋同的证据，表明早期窗口很重要。第二个是与原生家庭的接触，在这一问题上，文献的结论远不如政策话语所假设的那样确定。系统综述和范围综述的结论是，探视对儿童适应的影响并不一致，且接触质量和父母敏感性比接触频率更能预测适应（Poitras 等，2022a；Ruiz-Romero 等，2022）；更频繁的接触与较低的父母敏感性相结合，会预测更多的外化行为（Poitras 等，2022b）。马拉加团队的研究使这一机制变得具体：寄养家庭、社会工作者和原生家庭都将探视后的痛苦归因于规划不当、场所不合适和监督不足，而非接触本身（García-Martín 等，2018；Fuentes 等，2018）。探视质量可以通过观察进行测量（García-Martín 等，2024），并且可以通过对原生父母的结构化支持加以改善（González-Pasarín 等，2023；Bernedo 和 González-Pasarín，2025a，2025b）。儿童、寄养父母和社会工作者对同一次探视的评价差异很大（Salas Martínez 等，2016），亲属寄养则表现出独特的接触模式（León 等，2017）。趋同的启示是，频率并不能很好地代表真正重要的东西。

还有两个空白塑造了本研究。第一，这些文献绝大多数是关于婴幼儿和学龄前儿童的。童年中期是一个依恋围绕可得性和开放沟通而非身体接近进行重组的时期，也是儿童能够用自己的话描述这种关系的时期（Kerns 等，1996；Kerns 和 Brumariu，2014）。Kerns 安全量表正是为这一发展窗口开发的，并具有效度的元分析证据（Brumariu 等，2018）。然而，它很少与照护者自身依恋的测量一起用于寄养儿童。第二，证据基础几乎完全来自西欧和北美。土耳其提供了一个有信息价值的案例：寄养家庭服务模式（koruyucu aile）作为一项有意的去机构化政策的一部分，在2012年后迅速扩展，以至于到2024年，约有10,084名儿童生活在寄养家庭中，而14,509名儿童仍留在机构照护中（家庭和社会服务部，2024）。它运作于一种强调大家庭义务和以宗教框架看待孤儿照护的背景中，并通过一个负责筛选、批准和监测寄养家庭并规范与原生父母接触的国家机构来实施（Akan Ellis，2021；Karaveli 和 Erükçü Akbaş，2026；Kelebek 和 Kucur，2025）。

因此，这一空白是明确的。依恋传递在生物学二元关系中已得到充分证实，在寄养婴儿中部分得到证实，而在寄养儿童中基本未经检验——尤其是处于童年中期的寄养儿童，此时儿童自身的报告可供获取，且安置史与持续的生家庭接触同时发挥作用。关于寄养儿童安全依恋的研究通常只测量儿童或照料者中的一方，很少在同一二元关系中同时测量两者，也很少与双方的质性叙述相结合；即便有所结合，这些线索通常也只是并列呈现而非整合，从而丧失了该设计的主要优势。

本研究以一项全国样本中的二元、多信息源、解释性序列混合方法设计来填补这一空白。其贡献有两点。在实证层面，它表明，在一种不存在生物学或婴儿期连续性的关系中，寄养母亲的依恋风格与学龄寄养儿童依恋安全性方差的关联，是安置年龄或接触频率所关联方差的数倍；并且接触频率与安全性之间的关联是非单调的，而非线性的。在理论层面，它将依恋传递框架扩展至生物学二元关系之外，也扩展至婴儿期之外。它运用寄养母亲和儿童自身的叙述，展示传递从关系内部来看是什么样子。

从这一框架引出四个研究问题。前三个是方向性的、验证性的，源自传递模型和安全基地模型；第四个是探索性的。

RQ1：在寄养家庭服务模式中，9–12岁儿童的安全依恋是否因其被纳入保护时的年龄而有所不同？

RQ2：他们的安全依恋是否因与生家庭的接触频率而有所不同？

RQ3：他们的安全依恋是否因寄养母亲的依恋风格而有所不同？

RQ4：寄养家庭服务模式中的寄养母亲和儿童如何描述他们的依恋经历，这些叙述与定量模式有何关联？

2 材料与方法

2.1 设计

采用了解释性序列混合方法设计（Creswell and Plano Clark, 2011；Fetters et al., 2013）。横断面定量阶段（Karasar, 2011）确立了寄养母亲的依恋风格、安置变量与儿童安全依恋之间的关联模式。随后基于这些结果设计了质性阶段：有目的地选取寄养母亲，使四种依恋分类均得到体现，并对其照护的儿童也进行了访谈，采用现象学方法，聚焦于个体如何描述他们所经历的事件（Creswell, 2002；Patton, 2014）。两条线索在解释阶段通过联合展示进行整合（Guetterman et al., 2015；Bazeley, 2024）。质性线索按照COREQ报告（Tong et al., 2007）；清单见补充材料。

2.2 背景：土耳其寄养家庭服务模式

由于许多读者对相关背景并不熟悉，这里作简要说明。在土耳其，无法继续留在原生家庭的儿童会依据法院命令被纳入保护范围，并由家庭与社会服务部负责安置；该部负责运营机构照护、收养以及寄养家庭服务模式。寄养家庭向省级主管机构提出申请，由专业社会工作者通过家访和社会调查进行评估，并由专门的寄养部门批准、培训和监督。获批家庭每月可领取抚养费并接受持续监督。每个安置个案都会分配一名个案工作者：即由该部聘用、派驻省级主管机构寄养部门的专业社会工作者，负责开展家访、监督安置情况并保管儿童的管理档案。个案工作者是儿童保护机构的工作人员，不属于研究团队成员。

该模式有三种形式：临时照护（geçici koruyucu aile），用于短期危机安置；亲属或近环境照护（akraba veya yakın çevre koruyucu aile），由儿童的亲属或原本就认识的成年人提供；以及长期照护（süreli koruyucu aile），这是最主要的形式，适用于预计持续到成年的安置。法定监护权仍归国家所有，安置不会切断儿童与原生家庭的法律关系，与亲生父母的接触由省级主管机构安排、排期，且在大多数情况下受到监督，而不是由两个家庭私下协商。

2.3 参与者与抽样

2.3.1 定量部分

根据该部统计数据，全国寄养家庭服务模式中共有2379名9至12岁儿童和2085名寄养母亲，构成目标人群。在根据地理多样性和该模式下儿童数量选出的八个省份中，确定了682名可接触儿童：İstanbul（192）、İzmir（107）、Ankara（86）、Konya（73）、Gaziantep（64）、Samsun（65）、Kahramanmaraş（61）和Malatya（34）。

所需样本量采用有限总体公式计算：n = (N × t² × p × q) ÷ (d²(N − 1) + t² × p × q)，其中N = 682，t = 1.96，p = q = 0.50，d = 0.05，得出最低需要246对。配额抽样按各省人口占比将这一最低样本量分配到八个省份，配额由省级寄养部门的个案工作者通过便利抽样完成，因为只有这些人员能够合法获取家庭联系方式。最终实现的314对样本超过了各省配额（补充表S1），占该年龄段全国符合条件人群的13.2%。敏感性分析表明，在四组、α = 0.05的情况下，有80%的把握度检测到η² ≥ 0.034（f = 0.19）；实际达到的把握度为：RQ3为1.00，RQ1为0.75，RQ2为0.73。

纳入标准为：数据收集时年龄9–12岁；与寄养家庭共同居住至少12个月；能够无障碍地读、写、理解和说土耳其语。排除标准为：年龄不在9–12岁范围内；在当前安置中不足12个月；读、写、理解或说土耳其语的困难足以妨碍其独立完成儿童版工具；以及在匹配阶段，任何一对中三种工具中一种或多种缺失或不完整的二元组。

按设计，仅对寄养母亲进行了调查。在土耳其模式中，寄养母亲在实践中是绝大多数安置中登记的主要照顾者；Kerns安全量表是针对母亲形象施测的，因此母子二元组是可比较的单位；而纳入父亲则需要以父亲为参照的施测，这是实地调查方案所不允许的。排除寄养父亲限制了研究结果的范围，这一点在局限性部分予以讨论。

共有314名9–12岁儿童参与（M = 10.61，SD = 1.13），其中57.3%为女孩。五分之二（40.1%）在三岁或更小时进入保护系统，五分之一（20.7%）在七岁或更大时进入；最常见的进入原因是忽视和/或虐待（43.6%）。略低于一半（49.7%）与原生家庭没有接触，12.4%每月接触一次，17.5%每三个月接触一次。大多数（72.6%）有亲生兄弟姐妹，大多数（72.6%）处于长期寄养中，17.5%处于亲属或近环境照护中，9.9%处于临时照护中。

314名寄养母亲年龄为26至65岁（M = 49.68，SD = 7.62）。大多数已婚（92.4%），有自己的亲生子女（58.9%），没有从事有偿工作（67.8%），受教育程度为小学或初中（60.8%）。两组的完整社会人口学详情见表1。

表1

定量样本的社会人口学特征（N = 314对二元组）。

儿童年龄 M = 10.61，SD = 1.13（范围9–12）。寄养母亲年龄 M = 49.68，SD = 7.62（范围26–65）。

2.3.2 定性部分

通过省级理事会的个案工作者招募了十位养母及其照护的十名儿童。选样为立意抽样：在定量分析之后，识别出《关系量表问卷》剖面将其归入四种依恋分类中每一类的养母，并从各组中寻找志愿者。最终实现的定性样本包括四位被归类为安全型的养母、三位专注型、两位恐惧型和一位冷漠型。所有十名儿童均被安置在这十位养母家中，因此每一对访谈对象代表一个二元组。

样本量由信息效力而非数据饱和决定（Malterud et al., 2016）：研究目标狭窄，样本对现象高度特异，分析有理论支持，对话质量通过预试得到加强，策略为跨个案。十位养母年龄在39至64岁之间，养育年限为三至十一年；六位为长期安置，四位为亲属安置。十名儿童年龄在9至12岁之间，进入保护系统的年龄在一至十岁之间。每个二元组的完整特征见表2。

表2

定性研究部分中十个养母–儿童二元组的特征。

RSQ，关系量表问卷。养母在文中称为FM1–FM10，儿童称为C1–C10，与上表中的二元组编号相对应。

2.4 测量工具

2.4.1 个人信息表

由第一作者编制的一份表格记录了养母的年龄、婚姻状况、教育程度、就业状况、收入及亲生子女数量，以及儿童的年龄、性别、进入保护系统时的年龄和原因、安置时长、寄养服务类型、亲生兄弟姐妹、其照护状况及与他们的接触频率、与原生家庭的接触频率以及原生家庭的居住地。该表由负责该儿童和家庭的个案工作者填写，从而减少了对行政变量依赖照护者回忆的程度。

2.4.2 关系量表问卷（RSQ）

养母的依恋风格采用关系量表问卷（Relationship Scales Questionnaire）进行测量，该问卷由Griffin和Bartholomew根据成人依恋四类别模型编制（Bartholomew and Horowitz, 1991；Griffin and Bartholomew, 1994），并由Sümer和Güngör（1999）改编为土耳其语版本。该工具包含30个条目，采用7点Likert量表作答（1 = 完全不像我；7 = 非常像我）。17个条目的指数包含四种风格：安全型（5个条目）、回避型（5个条目）、专注型（4个条目）和恐惧型（4个条目）；其中一个条目（“没有亲密情感关系我也感到舒适”）为反向计分，并同时计入专注型和回避型得分。每个分量表以其条目的算术平均数计分，得出四个1至7分的连续得分，每位参与者被归入其得分最高的类别（Sümer and Güngör, 1999）。在土耳其语改编研究中，内部一致性范围为α = 0.41至α = 0.71；在本样本中，范围为α = 0.59至α = 0.82。该范围的低端低于常规阈值，这是该工具的一个已知特性（Kurdek, 2002；Ravitz et al., 2010）；这一点在局限性部分予以讨论，结果部分同时报告了连续变量和分类变量的处理方式。

2.4.3 Kerns安全感量表

儿童依恋安全感采用由Kerns等人（1996）为童年中期和青少年期编制的安全感量表（Security Scale）进行测量，由Sümer和Anafarta Şendağ（2009）改编为土耳其语版本。该工具包含15个条目，采用4点强迫选择格式，分别针对母亲和父亲形象施测；此处使用以母亲为参照的版本，以养母为参照对象。七个条目（1、3、4、9、10、13、15）为反向计分，得分越高表示安全感越强。元分析证据支持该量表在该年龄段的构念效度（Brumariu et al., 2018）。在原始编制研究中内部一致性为α = 0.84，在土耳其语改编中为α = 0.84（母亲）和α = 0.88（父亲）；在本样本中，养母版为α = 0.85。

2.4.4 半结构化访谈提纲

两份半结构化提纲，分别针对养母和儿童，由九位学术专家审阅（四位心理学家和一位具有依恋专业知识的咨询专家、一位儿童发展专家，以及三位从事寄养工作研究的社会工作学者），并在未纳入主研究的养母和儿童中进行了预试，据此进行了相应修改。在儿童访谈中，研究者首先询问每个儿童如何称呼其养母，并在整个过程中使用儿童自己的称呼。两份提纲均作为补充材料提供。

2.5 伦理

伦理批准由Selçuk大学健康科学学院非干预性临床研究伦理委员会授予（决定号2023/467，2023年4月26日），研究许可由家庭和社会服务部授予（部级批准号73595336-605.01(605.01)-241，2023年6月1日）。所有程序均遵循《赫尔辛基宣言》。

使用了三份独立的知情同意文件。寄养母亲在完成任何工具之前收到一份书面信息说明并签署知情同意书。个案工作者在为所照护的儿童填写个人信息表之前签署了一份同等表格。儿童收到一份适合其年龄、以通俗语言写成的同意书，其中说明参与是自愿的，如果他们拒绝，没有人会感到不快，他们的姓名不会被分享；该同意书由儿童签署，并由法定监护人副签。参与在每个阶段都是自愿且无报酬的，参与者被告知他们可以在任何时候退出而无需给出理由，并提供了一个联系地址以供提问。

数据在录入时即进行假名化处理：各工具通过匿名代码而非姓名进行关联，寄养母亲被标识为FM1–FM10，儿童被标识为C1–C10，所有引文中可识别身份的信息均已删除。由于参与者是受国家保护的儿童，因此不报告任何个体层面的数据。

2.6 程序

定量数据于2023年6月至10月期间收集。第一作者走访了各省，会见了省级主管和个案工作者，并通过他们向自愿参与的寄养母亲和儿童分发工具。个案工作者填写个人信息表，寄养母亲填写关系量表问卷，儿童填写安全量表；三者通过匿名代码进行关联。三种工具分别回收了337份、353份和354份；经代码匹配后，保留了314对完整配对（伊斯坦布尔79、伊兹密尔45、卡赫拉曼马拉什38、安卡拉36、科尼亚36、加济安泰普35、萨姆松29、马拉蒂亚16）。

定性数据在此之后收集。全部20次访谈，包括对10位寄养母亲和10名儿童的访谈，均由第一作者——一位男性社会工作学者——进行。个案工作者安排了与家庭的接触，但未出席任何访谈，也未参与定性数据的收集。七对配对进行了面对面访谈，三对在线进行；对寄养母亲的访谈持续约40分钟，对儿童的访谈约25分钟。寄养母亲和儿童分别在不同地点接受访谈；没有儿童在其寄养母亲在场的情况下接受访谈。面对面访谈在寄养照料单位进行，因为寄养母亲拒绝在家中接受访谈。第一作者作了自我介绍，解释了研究目的，并向参与者保证信息不会在研究之外使用。

有一项实地条件需要明确披露。根据该部所要求的承诺，不允许进行音频和视频录制。第一作者进行了同步书面记录，并在每次访谈结束时，在参与者离开之前，对任何不完整或不清晰的段落重新提问并加以澄清。因此，下文报告的引文是接近逐字记录的同步记录，而非转录稿；其影响在局限性部分予以考虑。

2.7 数据分析

2.7.1 定量分析

分析在SPSS 25.0中进行。正态性通过偏度和峰度进行评估；所有量表及分量表均落在±1.5范围内（Tabachnick and Fidell, 2013；Supplementary Table S2），因此采用参数检验。组间差异采用独立样本t检验和单因素方差分析进行检验。由于各组样本量明显不等，事后比较采用Scheffé检验，因其是最保守的标准程序，且不假定各单元格样本量相等（Scheffé, 1959）。所有检验均为双尾，α = 0.05。对于每一项推断性检验，均报告精确p值，并附上方差分析的η²（基于非中心F分布的90%置信区间）和ω²，以及t检验和事后对比的Cohen's d及其95%置信区间；这些均在Python 3中使用SciPy 1.17计算。为控制多重检验，检验被分为两个家族：对应预先设定的研究问题RQ1–RQ3的三项验证性检验，以及关于儿童和照护者特征的十项探索性比较。在每个家族内，p值采用Benjamini–Hochberg错误发现率程序进行调整；对于验证性家族，还报告了更为保守的Bonferroni标准（α = 0.05/3 = 0.017）。

2.7.2 定性分析

访谈笔记在MAXQDA 2024中采用主题分析进行分析（Braun and Clarke, 2006，2021；Patton, 2014），遵循数据缩减、数据展示以及得出结论并验证结论的序列（Berg and Lune, 2019）。首先生成编码，将其归入类别，再根据这些类别界定主题和子主题。作为一个示例，能够不带血缘关系地去爱是类别关于寄养母亲身份的感受和想法下的一个编码，而该类别又属于主题成为寄养母亲之前的过程。

编码由第一作者完成。这是一个局限，此处明确说明补偿性程序，而非隐而不提。编码框架和编码材料样本由第二作者（一位社会工作教授）以及一位专门研究儿童保护、未以其他方式参与本研究的学者独立审查。审查者检查了编码摘录与类别定义之间的契合度；类别边界上的分歧通过讨论解决，直至达成一致，框架因此修订了两次。编码、类别和分析备忘录的审计轨迹保存在MAXQDA中，可向通讯作者索取。参与者的原话以归属于参与者标识符的扩展直接引文形式呈现，以便读者评估数据与解释之间的契合度。未计算也未报告正式的编码者间信度系数；读者应据此权衡定性研究结果。

可信度依据 Lincoln 和 Guba（1985）提出的四项标准进行考察，并由 Shenton（2004）加以操作化。可信性通过预试、访谈结束时的澄清以及上文所述编码框架的独立审查得到支持。可迁移性通过第 2.2 节和第 2.3 节以及 表 2中对研究情境、服务模式和参与者的描述得到支持。可靠性依赖于审计轨迹，以及对编码序列足够详细、可供重复的报道。可确认性依赖于将每一项解释性主张都建立在引用的材料之上，以及下文的反身性陈述。

2.7.2.1 反身性

第一作者是一名男性社会工作学者，曾在儿童服务总局担任社会工作专家七年。这带来了接触机会和机构内部知识，同时也带来一种风险：参与者可能将他视为负责监督其安置情况的机构的代理人，从而正面地呈现其经历。因此，他自我介绍为一名大学研究者，目前不在该部担任任何职务，对安置决定没有影响力；他将访谈围绕经历而非对服务的评价展开；并在分析中特别关注困难、冲突和遗憾的叙述，这些叙述与正面叙述一并报告。

2.8 整合

各研究脉络在三个层面进行整合（Fetters 等，2013；Bazeley，2024）：在设计层面，定性样本建立在定量结果之上；在方法层面，每位受访寄养母亲的依恋分类作为一项属性被带入定性分析；在解释层面，研究结果被汇总为一个联合展示（表 3），将每一项定量结果与证实、否定或扩展该结果的定性证据相对照，讨论部分即围绕此展开。

表 3

联合展示：定量与定性发现的整合。

3 结果

3.1 研究变量的描述性统计

儿童的安全量表平均得分为M = 3.28（SD = 0.54），采用1–4分制。在关系量表问卷上，养母各分量表的平均得分为：安全型4.38（SD = 1.09），轻视型4.05（SD = 1.04），恐惧型4.03（SD = 1.02），专注型依恋3.96（SD = 0.82）（表4）。分类归属将130名养母（41.4%）归入安全型类别，85名（27.1%）归入轻视型类别，52名（16.6%）归入恐惧型类别，47名（15.0%）归入专注型类别（表5）。

表4

研究变量的描述性统计（N = 314）。

RSQ，关系量表问卷。本样本中四个RSQ分量表的Cronbach's α范围。

表5

养母的依恋分类（N = 314）。

参与者被归入其得分最高的关系量表问卷分量表。

没有可用的常模对照组，因此报告描述性均值时不对其相对于与出生家庭同住的儿童的水平作出断言。

3.2 RQ1：进入保护系统的年龄

儿童依恋安全性因进入保护系统的年龄不同而存在显著差异，F(2, 311) = 4.34，p = 0.014，η² = 0.027，90% CI [0.003, 0.060]，ω² = 0.021。该效应在多重检验校正后依然显著（Benjamini–Hochberg q = 0.021；满足 Bonferroni 标准）。Scheffé 事后比较显示，三岁或更小时进入保护系统的儿童（M = 3.39，SD = 0.49）得分高于四至六岁进入者（M = 3.22，SD = 0.53；d = 0.33，95% CI [0.08, 0.58]）以及七岁或更大时进入者（M = 3.19，SD = 0.63；d = 0.37，95% CI [0.07, 0.67]）。后两组之间无差异（d = 0.05，95% CI [−0.25, 0.35]）。按常规基准衡量，该效应较小，且置信区间下限接近零（表6）。

表6

儿童进入保护系统时年龄与依恋安全性（RQ1）。

d 值为 Cohen's d，附95%置信区间。b 与 c 无差异（d = 0.05 [−0.25, 0.35]）。

3.3 RQ2：与原生家庭的接触频率

依恋安全性因接触频率不同而存在显著差异，F(4, 309) = 2.56，p = 0.039，η² = 0.032，90% CI [0.001, 0.060]，ω² = 0.020。该效应在错误发现率校正后依然显著（q = 0.039），但未满足 Bonferroni 标准，应相应谨慎解读。Scheffé 比较发现，每三个月接触一次的儿童（M = 3.11，SD = 0.54）与另外两组存在差异：无接触儿童（M = 3.35，SD = 0.56；d = 0.43，95% CI [0.12, 0.74]）和每月接触儿童（M = 3.34，SD = 0.51；d = 0.44，95% CI [0.02, 0.85]）。

该模式并非单调。无接触儿童与每月接触儿童得分几乎相同（d = 0.02，95% CI [−0.33, 0.37]），每年接触一次的儿童得分相近（M = 3.33，SD = 0.53），而两个中间类别——每三个月和每六个月（M = 3.17，SD = 0.47）——得分最低。因此，安全性并不随接触频率呈现任何一致方向的变化。该效应较小，其置信区间几乎包含零，且各组样本量不等（n = 31 至 156），提示应谨慎解读（表7；第4.4节）。

表7

儿童与原生家庭接触频率与依恋安全性（RQ2）。

各组模式呈非单调：a、b 和 e 之间无差异（a 与 b，d = 0.02 [−0.33, 0.37]），而 c 和 d 较低（见第4.4节）。

3.4 RQ3：养母的依恋风格

依恋安全性因养母的依恋风格而存在显著差异，F(3, 310) = 13.16，p < 0.001，η² = 0.113，90% CI [0.058, 0.164]，ω² = 0.104。该效应在两种校正后均依然存在（q < 0.001）。Scheffé 比较显示，被归类为安全型的养母所抚养的儿童（M = 3.50，SD = 0.42）得分高于被归类为恐惧型的养母所抚养的儿童（M = 3.07，SD = 0.71；d = 0.83，95% CI [0.50, 1.16]）、专注型（M = 3.15，SD = 0.56；d = 0.76，95% CI [0.42, 1.10]）和冷漠型（M = 3.16，SD = 0.46；d = 0.78，95% CI [0.50, 1.06]）。三种不安全类别之间彼此没有差异（表 8）。

表 8

按养母依恋分类划分的儿童依恋安全性（RQ3）。

b、c 和 d 组之间彼此没有差异。

这是本研究中幅度明显最大的关联：其方差约为进入保护系统时年龄所对应方差的三倍，约为接触频率所对应方差的三倍半，并且是这三个效应中唯一一个置信区间明显远离零的效应。

由于基于最高分量表均值进行的分类赋值会丢弃信息，因此将四个连续分量表得分同时纳入多元回归重新估计该关联（表 9；补充表 S4）。四个分量表共同解释了儿童依恋安全性方差的 14.4%，R² = 0.144，调整后 R² = 0.133，F(4, 309) = 12.97，p < 0.001，比分类分析所恢复的比例更大。只有两个分量表独立贡献：安全型依恋，β = 0.271，t = 4.87，p < 0.001，sr² = 0.066；以及专注型依恋，β = −0.150，t = −2.78，p = 0.006，sr² = 0.021。恐惧型（β = −0.094，p = 0.083）和冷漠型依恋（β = −0.051，p = 0.358）在其他变量保持不变时没有贡献。方差膨胀因子范围为 1.05 至 1.11，因此估计值不受分量表之间共线性的影响。

表 9

儿童依恋安全性对养母连续依恋分量表得分的多元回归（N = 314）。

R² = 0.144，调整后 R² = 0.133，F(4, 309) = 12.97，p < 0.001。RSQ，关系量表问卷；β，标准化回归系数；sr²，半偏相关平方；VIF，方差膨胀因子。

与结果相关的两个安置变量无法纳入同一个模型，因此它们可能造成的混杂强度只能被限定范围。进入保护系统的年龄和接触频率分别与儿童的安全感相关，η = 0.16 和 η = 0.18。即使假设该协变量与寄养母亲的安全依恋相关高达 0.50，从寄养母亲安全依恋与儿童安全感之间观察到的关联（r = 0.325）中偏出这一强度的协变量后，偏相关仍为 0.28 至 0.30，且没有任何低于 0.99 的协变量相关能将这一关联降至 r = 0.10 以下。因此，这一关联的强度并非这两个安置变量所能解释，尽管直接估计的联合模型仍然更可取，并被确定为未来分析的首要任务。

由于关系量表问卷各分量表的内部一致性范围为 α = 0.59 至 α = 0.82，因此还对两个工具中的测量误差进行了校正。由于最低值可能适用于任何分量表，校正后的估计值按全范围报告。寄养母亲安全依恋与儿童安全感之间的相关从 r = 0.325 上升至 r = 0.389（α = 0.82）至 r = 0.459（α = 0.59）之间；相应的校正后相关为：恐惧型 −0.199 至 −0.234，专注型 −0.259 至 −0.305， dismissing 型 −0.186 至 −0.219。因此，照料者测量中的不可靠性减弱而非夸大了这一关联，观察到的估计值，包括分类分析，都是保守的。

3.5 未达到显著性的分析

为避免选择性报告，所有进行的分析均已披露（补充表 S3）。另外测试了十项比较。儿童的安全感不因性别、进入保护系统的原因、安置时长、亲生兄弟姐妹数量、寄养服务类型、寄养母亲的教育程度、就业状况或年龄而存在差异（所有 p ≥ 0.064，所有 η² ≤ 0.015，所有 |d| ≤ 0.21）。两项涉及兄弟姐妹的探索性比较达到显著。没有亲生兄弟姐妹的儿童得分高于有兄弟姐妹的儿童，t(312) = 2.46，p = 0.015，d = 0.30，95% CI [0.55, 0.05]；而兄弟姐妹本身也在儿童保护系统中的儿童得分低于兄弟姐妹不在其中的儿童，t(312) = −2.02，p = 0.044，d = −0.24，95% CI [−0.47, −0.02]。这两项均为非计划性分析，且均未能在探索性家族内通过多重检验校正（Benjamini–Hochberg q 分别为 0.146 和 0.214）；它们作为假设而非发现报告。26–49 岁的寄养母亲在安全依恋上得分高于 50 岁及以上者，在恐惧型和专注型依恋上得分低于后者（d 分别为 0.31、−0.32 和 −0.40，所有 p ≤ 0.007），在 dismissing 型依恋或教育程度上无差异。由于八个候选混杂因素中有六个与结果无关联，它们无法实质性解释 RQ3 的结果；有相关的那两个，即进入保护系统的年龄和接触频率，未与寄养母亲的依恋风格联合建模；它们可能的影响在第 3.4 节中进行了限定。

3.6 定性发现：寄养母亲

识别出四个主题和十一个子主题（表10）。引文归属于FM1–FM10，并附有每位参与者的定量依恋分类（表2）；每个子主题给出两段摘录，更完整的引文见补充文件S4。

表10

寄养母亲访谈的主题结构。

3.6.1 主题1：成为寄养母亲之前的过程

3.6.1.1 对寄养母亲身份的感受和想法

没有血缘关系的爱、牵起有需要的孩子的手，以及进入一个未知的过程，是反复出现的想法。

母性不仅仅是生育。母性不是一个头衔；它是一种能够为一个孩子的生命承担责任的感觉。当我们出发去触动他们的生活时，他们也触动了我们的生活。（FM5，安全型）

成为寄养家庭让我更敏感，也更胆怯。由于服务模式的性质，其中也包含恐惧，因为孩子随时可能离开的担忧占据主导。（FM7，恐惧型）

3.6.1.2 成为寄养母亲的动机

内在来源（母性情感、对孩子的渴望、精神信念）和外在来源（社会环境、鼓励、与社会服务的接触、经济期望）都被提及。

因为我们没有孩子，我一直渴望有一个。我想收养一个孩子，给他们爱，用深情抚养他们，让他们把我当作母亲。我想给他们一个美好的未来。（FM7，恐惧型）

It began with my neighbour taking in a child. It saddened me that children stayed within four walls in an institution… Everyone around me also gave me courage that I could do it. (FM9, preoccupied)

3.6.1.3 The first encounter with the child

Emotional intensity at the first meeting tracked the foster mother’s classification.

In the first meeting I made eye contact rather than physical contact… I asked permission and hugged her. When I hugged her she put her head on my chest. That was the day I felt I had become a mother. (FM5, secure)

We first met at the foster care unit. The staff introduced us. Since it was an institutional setting and crowded, we could not sit for very long. I cannot remember any more than that. (FM3, preoccupied)

3.6.2 Theme 2: The foster motherhood process

3.6.2.1 Building the relationship with the child

Accounts divided sharply, and the division corresponded to the quantitative classification.

We had no difficulty at all in the adjustment period. I sat and played with the children, we went shopping together, and in this way they adjusted quickly. I felt as though they had always been living with me. (FM10, secure)

My fear was, can I love him as much as his biological mother, can I close that gap. He was a traumatised child. Whenever he saw a knife in my hand while I was cooking he would flinch. He resisted staying in a home environment. (FM7, fearful)

3.6.2.2 Situations of interaction with the child

The texture of daily interaction also differed by classification.

Every morning while I prepare breakfast we spend time together in the kitchen. After school I am beside him while he does his homework. In the evenings we read a book together or watch a film he likes. (FM4, secure)

During the week they go to school, come back, do their homework. Sometimes he talks with me and sometimes he does not. He sees his friends more often. (FM9, preoccupied)

3.6.2.3 Foster and biological motherhood from the foster mother’s perspective

Accounts of greater effort came only from foster mothers classified as preoccupied or dismissing.

You look after your biological children anyway. But here, in a situation where you are not obliged, you love from the heart, you become attached afterwards. (FM4, secure)

Compared with my own biological motherhood, my experiences with my foster child have been more demanding. Complaints come right up to the door. We change classes, we change schools. (FM3, preoccupied)

3.6.2.4 The child’s feelings in the relationship, as the foster mother perceives them

Emotional closeness and feelings that impede attachment were both described.

They have a heartfelt way of calling out, "My dear mother!" They look at me without taking their eyes off me. I ask, do you need something, and they say no, I just love you very much. (FM9, preoccupied)

My daughter has an intense fear of losing me. As soon as she witnesses a separation scene on television her eyes fill. She seems not to have got over her separation anxiety. (FM8, secure)

3.6.3 Theme 3: Meanings attributed to the concept of the child

3.6.3.1 The child as a deep emotional bond

Affective meanings appeared across all classifications.

For me the word child means the love of a son or daughter. It means sweetness, warmth, goodness, love, compassion. (FM9, preoccupied)

The word child expresses innocence and purity to me. (FM3, preoccupied)

3.6.3.2 The child as the meaning of life

Meanings of renewal were used almost only by foster mothers classified as secure.

When the children were not here the walls always closed in on me. The hours stopped, time did not pass. Now I do not know how time passes. (FM10, secure)

The word child, I think, is the code of life. A person can learn a great deal from a child. (FM5, secure)

3.6.4 Theme 4: The process after becoming a foster mother

3.6.4.1 Reorganisation of environmental subsystems

Extended family, neighbourhood, school and service systems were described as changing.

Our kinship relations are intertwined. They all welcomed it very warmly. My older sister gave a large dinner for the children. After the children came, happiness and liveliness increased in our family system. (FM10, secure)

My husband changed a great deal. Before, he did not want me to go out, to go to my mother's. After we took the children, he himself says go, go out, so that I would not feel oppressed. (FM9, preoccupied)

3.6.4.2 Making room for the child within the family

Acceptance by family members and changes in spousal and sibling roles were described.

When we had our biological child we called him our second child, because our first child was our foster child. The siblings were also very respectful to each other. (FM5, secure)

We became a big family. Sitting down at a crowded table, going on outings as a crowd, turned out to be a very beautiful feeling. (FM8, secure)

3.7 Qualitative findings: children

Three themes and eleven subthemes were identified (Table 11). Quotations are attributed to C1–C10; two excerpts are given per subtheme where two children spoke to it.

Table 11

Theme structure for the child interviews.

3.7.1 Theme 1: The child’s relationship with the foster mother

3.7.1.1 Strong bonds and belonging

My foster mother and father are like my real family; they never made me feel like a stranger. I do not see my mother as a foster mother. My communication with my mother especially is very good. (C2)

Actually I feel as though my mother gave birth to me. When I close my eyes and think of the word mother, it is her I see. (C5)

3.7.1.2 Functionality of the relationship

Every child made at least one statement here

I never suffered the lack of a mother while I was beside her. When I am upset she supports me. When I do something wrong she tries to support me. (C1)

She listens to me constantly. When I have any trouble I can share it with my mother without hesitation; in fact my mother mostly understands me from my facial expression. (C2)

3.7.1.3 Non-dynamic relationships

In each case the corresponding foster mother independently described difficulty.

With my grandmother, our relationship is neither very attached nor very separate. Recently I can say there has been a decrease in the things she does for me. (C1)

With my mother we are sometimes good and sometimes bad. I am watching television and she says do not watch… when I say why should I not, our relationship breaks down. (C3)

3.7.2 Theme 2: The process before placement with the foster mother

3.7.2.1 A sense of family

Because I was three I do not really remember, but I felt as though I had always been together with them. When I first saw my foster mother and my unease went away, my insides fluttered, I was so very glad. (C2)

A welcome surprise was made at home. Before I came, food had been cooked, my room had been prepared, clothes had been bought. (C8)

3.7.2.2 Uncertainty and anxiety

I hoped a good family would come out of it. But I also thought: will a good family or a bad family come out of it. When I first saw my foster mother, at first I was afraid. (C7)

I was a little worried about where we were going. When we came home I looked at my mother, I looked at my father, I was a bit shy, I could not speak very much. (C10)

3.7.2.3 Feeling safe

One child, in a kinship placement, spoke to this subtheme.

We already knew my mother from before. When I learned I would go to her I was happier. I was going to a home for the first time; I was very happy, I was very excited. (C5)

3.7.2.4 Abandonment and loneliness

One child described the placement as a loss; this is the clearest counter-case in the data.

At first I was very upset because my own family left me and went. I did not want to come here at all, but they left me here by force. And I tried to get myself used to living in this family. (C10)

3.7.3 Theme 3: The perceived metaphor of foster motherhood

3.7.3.1 Safe harbour

A mother, for me, is the person you share your troubles with, the person you pour out your heart to. It means sacrifice, being solution-focused, trust. (C2)

When I think of my foster mother, love and a great happiness come to mind. I compare my foster mother to family, and family is a beautiful thing. (C10)

3.7.3.2 Guide and light

One child spoke to this subtheme.

My mother is more like a nursery teacher to me. She helps me with things I do not know; she is both my mother and my teacher. She is like a light that illuminates me. (C4)

3.7.3.3 Protective shield

I compare my mother to an angel, because she is like an angel. She holds my hands, she hugs me, she really loves me. (C3)

My foster mother always seems to me like a guardian angel. When she is beside me, I feel safe. Her love and support make me feel as though I am spreading wings. (C4)

3.7.3.4 Loving from the heart

One child spoke to this subtheme; the image echoes the foster mothers’ language in theme 2.

At seven, I questioned this a great deal: is a child born from the heart or from the belly? My mother said from the heart. I did not understand it then. Now I understand. (C3)

3.8 Integration of the quantitative and qualitative findings

Table 3 presents a joint display setting each quantitative finding against the qualitative evidence that confirms, disconfirms, or expands it. Three patterns emerge. The association between foster mother attachment style and child security is confirmed and explained: securely classified foster mothers described the caregiving the secure base model specifies (attunement at first contact, dense accounts of shared time, no differentiation between foster and biological children, the child as a source of meaning), insecurely classified foster mothers described fear of loss and inadequacy and interaction accounts from which they were absent, and the three children who described flat or avoidant relationships (C1, C3, C9) were the children of fearful and preoccupied foster mothers whose own interviews independently described struggling. The finding on age at entry is confirmed and expanded: C2, placed at three, could not recall an arrival, while C10, placed at four, described being left by force; thus, the small statistical effect corresponds to a large difference in whether the child possesses a narrative of loss. The finding on contact frequency is disconfirmed as a linear relationship and reframed: no child mentioned frequency; instead, they described the emotional character of what they knew about their birth families, which concerns the meaning and quality of the connection rather than its schedule.

4 Discussion

This study asked whether the intergenerational transmission of attachment, established in biological parent–infant dyads, is observable in a caregiving relationship that shares neither genes nor infancy, and whether it can be detected in middle childhood using the child’s own report. The answer is that it is, that the association is of a magnitude comparable to what the transmission literature reports for biological dyads, and that it is substantially larger than the association with either of the two placement variables that dominate practice and policy discussion.

4.1 The foster mother’s attachment organization

Children whose foster mothers were classified as securely attached reported markedly higher attachment security than children whose foster mothers were classified as fearful, preoccupied, or dismissing, with standardized differences between 0.76 and 0.83 and 11.3% of the variance in children’s security associated with the classification. For comparison, Verhage et al. (2016) report a corrected r ≈ 0.31 between parental attachment representation and child attachment in biological dyads, accounting for roughly 10% of the variance. The association found here in non-biological dyads, in middle childhood, years after placement, is of a similar order. Because the caregiver measure has modest reliability, this is a lower bound: corrected for measurement error, the association between foster mothers’ secure attachment and children’s security lies between r = 0.39 and r = 0.46 (Section 3.4). It is consistent with the concordance Dozier et al. (2001) found among foster infants and with Stovall-McClough and Dozier's (2004) demonstration that foster infants’ attachment organized around the new caregiver’s state of mind within two months.

The finding constrains what the transmission phenomenon can be. In biological dyads, transmission is confounded with shared genes, prenatal environment, and continuous caregiving from birth; here, none of those applies, and the association persists. This is consistent with the interpretation that what is transmitted is not a trait but a pattern of caregiving conduct organized by the caregiver’s own representation of attachment, the mechanism the secure base model specifies (Schofield and Beek, 2005, 2009) and which the experimental evidence supports: Bernard et al. (2012) reduced disorganized attachment among maltreated children by intervening on the caregiver rather than the child.

The qualitative data give that mechanism concrete form, as summarised in Table 3, and the correspondence between the three children who described flat or avoidant relationships and their foster mothers’ independent accounts of struggling is the study’s most direct evidence that the association reflects something happening inside the relationship rather than a shared response tendency. That said, this is a cross-sectional association and must be read as one. In particular, the direction of influence cannot be established: an easier, more responsive child may elicit more sensitive caregiving and may also lead a foster mother to report a more secure attachment style, so that part of what appears here as transmission from carer to child may instead reflect the child’s influence on the carer. Only a longitudinal design with caregiver attachment measured at placement can separate the two (Section 4.10); this and the remaining alternatives are discussed in Section 4.9.

The recruitment route deserves particular attention because it bears directly on this finding. Both samples were reached through caseworkers, who approached families known to them, and well-functioning placements are therefore likely to be over-represented. The direction in which this biases the estimate is not self-evident. If selection favoured placements going well on both sides, carer security and child security would be jointly inflated and the association overstated; if it mainly truncated the lower end of either distribution, the restricted range would attenuate the association and the estimate would be conservative. Two features of the data suggest that the range was not seriously collapsed: a majority of foster mothers (58.6%) were classified as insecure, and children’s security scores spanned the full scale from 1.00 to 4.00. The qualitative sample was drawn from the same channel but deliberately included foster mothers from all four classifications and retained accounts of conflict, distress and self-reliance that a sample confined to well-functioning placements would not be expected to produce. A cross-province sensitivity analysis, testing whether the association holds in each recruitment site, could not be carried out with the data available to us and is identified as a priority for future analysis.

4.2 Age at entry into protection

Children who entered protection at three or younger reported higher attachment security than children who entered later, an effect that is statistically significant but small (η² = 0.027), with a confidence interval that nearly reaches zero. The direction is consistent with Smyke et al. (2010), Bernier et al. (2004), Spieker et al. (2014), and Dozier et al. (2001), all of which found that earlier placement or stable early care produced better attachment outcomes.

The magnitude, however, deserves more caution than this literature usually receives in policy translation. The interview data suggest why the effect might be real but modest. What distinguishes early from late placement in the children’s accounts is not the quality of current caregiving but the presence or absence of a remembered narrative of separation. The difference lies in what the child carries, not in what the foster family provides, which is consistent with a small effect persisting for years in a stable placement, rather than the large effect expected if early placement determined outcomes.

4.3 An exploratory finding: siblings in the care system

Children with biological siblings reported lower attachment security than children without them, and security was also lower among children whose siblings were themselves in the child protection system. Neither comparison was planned and neither survives correction for multiple testing, so the pattern is offered as a hypothesis. It is nevertheless interpretable. A sibling who remains in care keeps the birth family psychologically present in a way that a sibling living with the birth family, or no sibling at all, does not, and sibling separation is itself a continuing loss that the placement does not resolve. This reading is consistent with evidence that sibling relationship quality buffers depressive symptoms among youth in foster care (McWey et al., 2023), and it suggests that the relevant variable is not the existence of siblings but where they are and whether the relationship is maintained. The study recorded the frequency of contact between children and their siblings but did not analyse it; that is the first test of this hypothesis, and it can be carried out within these data.

4.4 Contact with the birth family

This finding requires the most careful statement. Attachment security did differ by contact frequency, but the effect does not survive Bonferroni correction across the three confirmatory tests, and the pattern is not monotonic. Children with no contact, monthly contact, and annual contact scored at essentially the same level, while children with contact every three or six months scored lower. No linear relationship between contact frequency and attachment security exists in these data, and no policy recommendation about increasing or decreasing frequency can be derived from them.

Read against the contact literature, this is not an anomaly but a confirmation. Poitras et al. (2022a) concluded from a systematic review that visitation effects on child adjustment are inconsistent and that contact quality and parental sensitivity predict adjustment better than frequency; Ruiz-Romero et al. (2022) reached the same conclusion across 21 studies, adding that contact supports well-being when it is adequately supervised and emotionally safe and not otherwise; and Poitras et al. (2022b) found that more frequent contact with a less sensitive parent predicted more externalizing behaviour. The Málaga programme has made the point most concretely: foster families, social workers, and birth families all attribute post-visit disturbance to poor planning, unsuitable venues, and inadequate supervision rather than to contact as such (García-Martín et al., 2018; Fuentes et al., 2018), visit quality is measurable independently of frequency (García-Martín et al., 2024), and it is modifiable through structured support of birth parents (González-Pasarín et al., 2023; Bernedo and González-Pasarín, 2025a, 2025b).

If frequency is a poor proxy for quality, a frequency variable should not exhibit an orderly relationship with a child outcome, as these data show. The most defensible interpretation of the dip in the intermediate categories is that quarterly and half-yearly schedules in this system are disproportionately associated with placements in which contact is contested, irregular, or emotionally difficult, whereas both no contact and regular monthly contact reflect settled arrangements. This interpretation is post hoc and offered as a hypothesis for future work. What can be said with confidence is that contact frequency is not, on this evidence, a lever for improving attachment security. The interview data support this indirectly: no child raised frequency, and what children raised was the emotional content of what they knew of their birth families, consistent with Salas Martínez et al.'s (2016) finding that children, foster parents, and social workers evaluate the same visits very differently.

Contact must also be framed as a right, not only as a variable. Under the Convention on the Rights of the Child (United Nations, 1989), a child separated from their parents is entitled to maintain personal relations and direct contact with them regularly unless this is contrary to the child’s best interests. A measured association between contact frequency and an attachment score does not, on its own, license restricting a right. The implication of these findings is therefore about how contact is planned, prepared, and supported, not about whether it should occur.

4.5 What the children’s accounts add

The metaphors children used for foster motherhood, safe harbour, guide and light, protective shield, and loving from the heart, name the functions of an attachment figure with unusual precision: haven, secure base, protection, and a bond understood as chosen rather than given. These children were describing an internal working model of a caregiver who is available, who can be returned to under stress, and whose commitment is not contingent on biology, at the developmental stage when attachment reorganizes around availability and open communication rather than proximity (Kerns et al., 1996; Kerns and Brumariu, 2014).

The loving-from-the-heart metaphor is the most theoretically interesting because children and foster mothers arrived at the same image independently: FM4 spoke of loving from the heart even when she was not obliged to, and C3 asked whether a child is born from the heart or from the belly. This shared vocabulary appears to be how both parties resolve the absence of a biological tie into a legitimate claim of kinship, echoing Diogo and Branco's (2017) finding among Portuguese foster mothers. The negative cases are equally informative: C1, C3, C9, and C10 described diminishing care, an oscillating relationship, self-reliance in place of help-seeking, and placement experienced as abandonment. These are the qualitative counterparts of the insecure groups in Table 8, and a study drawn from all four attachment classifications that reported only warm accounts would have failed its own design.

4.6 The foster mothers’ route into the role

Two foster mother themes concern the periods before and after placement. The motivations described divided into intrinsic sources (maternal feeling, a longing for a child, spiritual conviction) and extrinsic ones (encouragement from family and neighbours, contact with the social services, in one case financial expectation), which maps onto the child-centred and self-focused distinction of Rhodes et al. (2006) and Cole (2005) found that reasons for fostering predict the quality of the relationship subsequently formed. Because the Turkish model pays approved families a monthly maintenance allowance, the question of whether payment functions as a motive rather than a support is a live one, and it has been raised for alternative care systems generally (Engle et al., 2011). These data cannot answer it: motivation was explored only in the interviews and was not measured in the survey, so the prevalence of financially driven fostering in this population is unknown. What can be said is that the one account in which payment figured was not otherwise distinctive, and that the qualitative material as a whole is dominated by child-centred and spiritual motives rather than material ones. The theme of entering an unknown process is where the service model enters the psychology of the relationship: the two foster mothers who described fearing the child’s removal (FM7, FM3) were both classified as insecure, and both described building the relationship as frightening. Dozier and Lindhiem (2006) identified commitment as a construct specific to non-biological caregiving, and Turner et al. (2023) found that foster carers sustain investment despite considerable difficulty; these accounts suggest that the structural impermanence of the placement, a feature of the model rather than the carer, is one condition under which commitment becomes hard to sustain, and one that is modifiable through how placements are communicated and supported. The fourth theme, the reorganization of the household and its wider systems, points towards assessment and support that address the household and its network rather than the carer alone.

4.7 Findings in the Turkish cultural context

Two features of the setting shape how these results should be read. First, care of children without parents is framed in Türkiye through religious obligation as much as through welfare policy, and this was audible in the interviews: spiritual conviction was among the most frequently named intrinsic motives, and foster mothers described the child as entrusted to them rather than given to them. That framing supports commitment without requiring the fiction of biological kinship, which may be why the loving from the heart metaphor was produced independently by foster mothers and children as a way of establishing a legitimate claim to one another. Second, the extended family is an active party to the placement rather than a background condition. Foster mothers described relatives organising welcomes, spouses changing their conduct, and kinship networks absorbing the child, and kinship or close-environment placements accounted for 17.5% of the sample. Where the caregiving unit is the household and its network rather than the dyad, an attachment measured only at the level of the foster mother may understate the resources available to the child (Akan Ellis, 2021). Both features caution against transferring these estimates directly to systems in which fostering is organised as a contractual service between the state and an individual carer.

4.8 Implications for policy and practice

Three implications follow, each calibrated to the magnitude of the corresponding finding.

4.8.1 Attachment-informed assessment and support of foster carers

This rests on the strongest finding. Foster carer assessment in Türkiye currently examines material circumstances, household composition, motivation, and social investigation; these findings suggest that the caregiver’s own attachment organization is associated with several times as much variance in child outcomes as either placement timing or contact arrangements. That does not warrant screening out prospective carers based on an attachment measure, which would be psychometrically indefensible with instruments of this reliability and ethically dubious. It warrants using attachment as a support variable: identifying carers likely to need more intensive help with the relationship, and giving it to them. Attachment-based caregiver interventions, as evaluated by Bernard et al. (2012), have demonstrated effects on children’s attachment organization and are a far more specific proposal than generic parenting training.

4.8.2 Support at the point of placement, especially for later-placed children

Children placed after infancy carry a narrative of separation into the placement, and their foster mothers described precisely this as the source of their own sense of inadequacy. Preparing both parties for the first encounter and supporting them through the first months is where the earlier-placement advantage might be partly compensated.

4.8.3 Contact quality rather than contact frequency

These data provide no basis for changing the frequency of contact. They provide a basis for attending to how contact is planned, prepared, located, and supervised, and for supporting birth parents before and after visits, which the Spanish intervention studies show is feasible; the observational quality index of García-Martín et al. (2024) offers a practicable instrument for directorates that currently record only frequency.

4.9 Limitations

The design is cross-sectional, and the associations are not causal. Reverse causation (an affectionate, easy child raising a caregiver’s self-reported security) and selection (Ministry screening favouring both secure carers and the placement of less disturbed children with them) cannot be excluded, and placement stability, the strongest known predictor in this literature, was not recorded. The foster mother’s four attachment subscales are now modelled jointly (Section 3.4), but age at entry into protection and contact frequency could not be entered into the same model, so the caregiver’s incremental contribution is bounded by sensitivity analysis rather than estimated directly. A jointly specified model remains the preferable analysis and is the first item under Future research. Both instruments are self-report, and although they were completed by different informants with administrative data recorded by the caseworker, common method variance remains a residual threat.

The Relationship Scales Questionnaire showed internal consistency as low as α = 0.59 on one subscale, a documented weakness of the instrument (Kurdek, 2002; Ravitz et al., 2010); this attenuates rather than inflates the observed associations (Section 3.4), but categorical assignment by highest subscale mean also discards information and produced unequal groups. No factor structure or measurement invariance was tested, and the Security Scale captures the child’s perception of the relationship rather than attachment organization assessed observationally. Recruitment through caseworkers probably over-represents well-functioning placements (see Section 4.1), no comparison group of children living with birth families was available, and the sample is confined to eight provinces, to children aged 9–12 in placement for at least a year, and to foster mothers. The foster mother’s length of experience in the role was recorded for the interview sample but was not asked in the survey form, so it could not be examined quantitatively. Since experience plausibly shapes both caregiving behaviour and the carer’s own account of it, this is a substantive omission and a variable that any replication should collect. The design had 80% power to detect η² ≥ 0.034, so the effects for RQ1 and RQ2 sit at the edge of reliable detection, cell sizes were unequal, and non-independence among children sharing a foster mother was not modelled.

In the qualitative strand, coding was performed by a single researcher without an intercoder reliability coefficient, the Ministry’s prohibition on recording means quotations are contemporaneous notes rather than transcripts, and the first author’s former Ministry employment and the directorate interview setting may have inclined participants towards favourable accounts.

4.10 Future research

Five lines of work follow directly. The first is a reanalysis of these data in a single multivariable model entering age at entry into protection and contact frequency alongside the foster mother’s continuous attachment scores, to estimate the caregiver’s incremental contribution, together with a cross-province sensitivity analysis testing whether the association holds in each recruitment site. Beyond that, a longitudinal design following newly placed children over two years with caregiver attachment measured at baseline would separate transmission from reverse causation; Kliewer-Neumann et al. (2023) show this is feasible and that the relevant change occurs within months. An observational measure of foster carer sensitivity alongside the self-report measures would test whether sensitivity mediates the association as it partially does in biological dyads (Verhage et al., 2016) and would break the common-method dependence. Contact should be measured by quality rather than frequency, using an instrument such as the observational checklist of García-Martín et al. (2024), which would test the interpretation offered in Section 4.4 directly. Finally, including foster fathers and the father-referenced form of the Security Scale would establish whether the association is specific to the maternal relationship or a property of the household.

5 Conclusion

In a national sample of 314 foster mother–child dyads in Türkiye, foster mothers’ attachment styles were associated with several times more variance in the attachment security of children aged 9–12 than either age at entry into protection or frequency of contact with the birth family, at a magnitude comparable to the meta-analytic benchmark for biological dyads. This suggests that the intergenerational transmission of attachment is not contingent on shared biology or shared infancy and remains detectable in middle childhood. Foster mothers’ and children’s accounts describe the mechanism in convergent terms: securely attached foster mothers described attuned, undifferentiated caregiving, and their children described a safe harbour, a guide, a shield, and someone who loves from the heart. The association between contact frequency and security was not linear, and no recommendation about frequency follows; what follows is that contact quality is where attention belongs. For practice, the attachment organization of the person who will do the caregiving is the most consequential variable identified here, and supporting it is a more promising target than adjusting the parameters of the placement.

Statements

Data availability statement

The datasets generated and analysed for this study are not publicly available because the participants are children in state protection and the research permission granted by the Ministry of Family and Social Services does not permit open deposition of individual-level data. De-identified data and the analysis syntax are available from the corresponding author on reasonable request, subject to approval by the Ministry. Requests to access the datasets should be directed to Cezmi Ervüz, cervuz013@gmail.com. The interview schedules and the COREQ checklist are provided as Supplementary Material.

Ethics statement

The study was approved by the Non-Interventional Clinical Research Ethics Committee, Faculty of Health Sciences, Selçuk University (no. 2023/467, April 26, 2023), and research permission was granted by the Ministry of Family and Social Services of the Republic of Türkiye (No. 73595336-605.01(605.01)-241, June 1, 2023). It was conducted in accordance with local legislation, institutional requirements and the Declaration of Helsinki. Written informed consent was provided by the foster mothers and by the legal guardians of the child participants, and assent was obtained from each child prior to participation.

Author contributions

CE: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Writing – original draft, Writing – review & editing. ÖK: Conceptualization, Formal analysis, Methodology, Supervision, Validation, Writing – review & editing.

Funding

The author(s) declared that financial support was not received for this work and/or its publication.

Acknowledgments

The authors thank the provincial directorates of the Ministry of Family and Social Services in İstanbul, Ankara, İzmir, Konya, Kahramanmaraş, Gaziantep, Malatya and Samsun, and the social workers of their foster care units, without whose cooperation the fieldwork would not have been possible. Above all the authors thank the foster mothers and children who gave their time and their accounts. This study was derived from the doctoral thesis completed by Cezmi Ervüz under the supervision of Özlem Karakuş in the Department of Social Work, Institute of Health Sciences, Selçuk University, Konya, Türkiye.

Conflict of interest

The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Generative AI statement

The author(s) declared that Generative AI was used in the creation of this manuscript. Claude (Anthropic; Opus 5) was used at the manuscript-preparation stage only, after the study had been designed, conducted, analysed and coded by the authors. It was used for four tasks. First, language editing and restructuring: the manuscript was rewritten in English from the authors' earlier draft and from the first author's doctoral thesis, including reorganisation into the Frontiers Original Research structure. Second, translation: participant quotations, originally recorded in Turkish, were translated into English with AI assistance and were then checked against the Turkish source records by the first author, who is a native speaker and conducted the interviews. Third, computation of effect sizes: eta squared with 90% confidence intervals, omega squared, Cohen's d with 95% confidence intervals, exact p values and achieved power were calculated in Python (SciPy) from the test statistics produced by the authors' SPSS analyses. Fourth, reference checking: every reference was verified against Crossref and OpenAlex records. No part of the study design, data collection, statistical analysis in SPSS, qualitative coding, or interpretation was performed by generative AI. No text, data, statistic, participant quotation or bibliographic reference was accepted without author verification. The authors take full responsibility for the content of this article.

Any alternative text (alt text) provided alongside figures in this article has been generated by Frontiers with the support of artificial intelligence and reasonable efforts have been made to ensure accuracy, including review by the authors wherever possible. If you identify any issues, please contact us.

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Supplementary material

The Supplementary material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpsyg.2026.1986177/full#supplementary-material

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Keywords

attachment security, birth family contact, child welfare, foster care, intergenerational transmission of attachment, middle childhood, mixed methods, Türkiye

Citation

Ervüz C and Karakuş Ö (2026) Foster mothers’ attachment styles and children’s attachment security in middle childhood: a mixed-methods study of the Turkish foster family service model. Front. Psychol. 17:1986177. doi: 10.3389/fpsyg.2026.1986177

Received

02 September 2026

Revised

21 September 2026

Accepted

23 September 2026

Published

12 October 2026

Volume

17 - 2026

Updates

Copyright

© 2026 Ervüz and Karakuş.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Cezmi Ervüz, cervuz013@gmail.com

Disclaimer

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.