First responders face elevated risks of developing mental health conditions due to frequent exposure to potentially traumatic events. However, access to appropriate care is often limited by systemic, cultural, and logistical barriers. This article presents a novel, coproduced model of mental health service delivery tailored to the unique needs of first responders, implemented through the Responder Assist program in Victoria, Australia. Responder Assist was developed using coproduction principles, integrating lived experience with clinical expertise and research evidence. The service includes centralized intake, access to specialized trauma-informed providers, and delivery of evidence-based therapies, supported by clinician supervision and continuous quality improvement processes. To provide early insights into service impact, we conducted preliminary, naturalistic analyses of 109 current and former first responders (M-age = 49.7 years, SD = 10.1; 75.2% male) enrolled between March 2021 and May 2025. Outcomes were assessed at baseline, 3 months into treatment, and discharge using repeated-measures analyses. Preliminary outcome data indicate promising reductions in symptoms of posttraumatic stress disorder, psychological distress, symptoms of major depressive disorder, and symptoms of generalized anxiety disorder, as well as modest improvements in functional disability and anger. These findings suggest that the model may effectively address barriers to care and improve mental health outcomes for first responders. This population-specific, trauma-informed service model demonstrates the value of integrating lived experience and coproduction in mental health service design. It offers a replicable framework for improving access and outcomes in trauma-exposed workforces. Future initiatives should consider similar approaches to enhance relevance, engagement, and effectiveness of care.
Childhood trauma has far-reaching effects on adult health, shaping emotional motivations for food choices and increasing the risk of maladaptive eating behaviors and related physical and psychological consequences. Objective: This study examined the effects of childhood trauma on emotional eating, focusing on the mediating roles of attachment quality and emotional distress (anxiety and depressive symptoms) in an integrative model. Method: A sample of 500 participants from the general population completed self-report measures (Childhood Trauma Questionnaire, Adult Attachment Scale, Hospital Anxiety and Depression Scale, and the Food Choice Determinants Questionnaire). Data analysis was conducted using the IBM SPSS Statistics for Windows. To evaluate the proposed model, structural equation modeling, utilizing AMOS software and using the maximum likelihood estimation method was used. Multiple-step mediation analyses with bootstrapped confidence intervals tested indirect effects. Results: Childhood trauma predicted higher attachment anxiety and lower attachment closeness, which increased anxiety distress symptoms and, in turn, higher emotional motivations for food choices. Anxious attachment also had a direct effect, whereas depressive symptoms did not mediate the relationship. Conclusions: These findings underscore the critical role of relational and affective mechanisms in the pathways linking early trauma to emotional eating. Interventions that integrate attachment-informed therapy, emotion regulation training, and nutritional guidance may more effectively address maladaptive eating behaviors and reduce related health risks. The study advances theoretical understanding and practical insights for prevention and intervention in trauma-exposed populations.
Bereavement can profoundly disrupt an individual's assumptive world and provide a context for posttraumatic growth (PTG). However, most individuals experience grief and distress alongside perceptions of PTG. The positive relationship between posttraumatic stress (PTS) symptoms and PTG has raised questions about the adaptive significance of PTG. This cross-sectional study used a sample of bereaved Icelandic adults who identified the death of a loved one as their most traumatic life event (n = 257), of which 58.8% identified as women. We aimed to (a) assess the prevalence of moderate-to-high levels of PTG, (b) examine the associations between perceived PTG and PTS symptoms, and (c) explore PTG perceptions and PTS symptoms based on the time since bereavement to better understand the potential role of PTG and its co-occurrence with distress following loss. Approximately 39% of participants reported moderate-to-high PTG. There was a small positive association between PTG and PTS scores, with intrusions and arousal/reactivity showing consistent relationships across PTG domains, supporting the importance of rumination for PTG. Individuals bereaved 5-10 years earlier showed slightly higher perceived PTG and lower PTS than those with more recent losses, although both declined when more than 10 years had passed. Time since loss did not moderate the PTG-PTS association, suggesting that growth and distress tend to co-occur. Therefore, PTG reflects ongoing cognitive engagement with the loss rather than a later resolution of distress that diminishes as adaptation progresses, a conclusion that warrants longitudinal confirmation, but is well-supported by the patterns observed here.
