Gender-informed addiction care needs evidence on whether alcohol-related aggressive behaviors, family conflict and Cluster B pathology influence treatment differently for men and women. To test gender-specific structural pathways associating years of problematic alcohol use, alcohol-related aggressive behaviors, partner conflict, child conflict and Cluster B diagnosis with appointment adherence, retention, therapeutic discharge and readmissions. Retrospective electronic health record study in Andalusia's public addiction treatment network (N=4844 entrants, 2015-2021; 25.5% women). Multigroup structural modelling tested within-gender associations and gender differences in pathways to outcomes. Child conflict was more prevalent in women than men (31.7% vs 15.9%; V=0.17; p<0.001) and was associated with higher readmissions in women (β=0.101; p=0.001) but not men (β=-0.029; p=0.126); partner conflict was associated with fewer readmissions in men (β=-0.041; p=0.019). In men, alcohol-related aggressive behaviors were associated with lower appointment adherence (β=-0.059; p=0.001). Cluster B diagnosis was associated with lower therapeutic discharge (men: β=-0.063; p=0.017; women: β=-0.138; p=0.005) and higher readmissions (men: β=0.062; women: β=0.095; both p<0.001). Retention was associated with higher discharge and fewer readmissions in both genders (all p<0.001). Meaningful gender-specific structural differences emerged only in the pathway associating child conflict to readmissions. These pathways highlight child conflict as a gender-specific readmission risk marker for women and support family-focused, gender-informed interventions that strengthen adherence and retention.

Pornography use is common in the United States, and a subset of individuals develop problematic pornography use (PPU). Previous research often excluded abstainers, leading to potentially biased conclusions on the overall role of religion and moral beliefs in pornography research. This study tested whether religious identification and moral disapproval of pornography function as risk factors for PPU or resources for well-being when the full population is considered. We analyzed data from a census-matched sample of U.S. adults (n=2,806), using correlations, group comparisons, and hierarchical regressions to examine associations of religious identification and moral disapproval of pornography with sexual, romantic, and general life satisfaction, and suicidality. When including pornography-abstainers in analyses, moral disapproval and Judeo-Christian religious identification were unassociated with PPU, but linked to higher sexual, romantic, and general life satisfaction, and less suicidality. In contrast, PPU and pornography frequency were linked to lower satisfaction and more suicidality. Expanding analyses on the general population reframes the role of religion and morality in pornography research. Findings suggest that religion and moral disapproval may serve as protective resources for well-being and mental health. Further studies are needed to clarify the underlying mechanisms.

Alcohol consumption patterns have been associated with long-term anxiety, but evidence on how these associations vary across population subgroups remains limited. This study examines longitudinal associations between alcohol consumption frequency and quantity and subsequent anxiety, and tests whether these relationships were moderated by sex, age, and income level. Participants were from a nationally representative sample of Australian adults (N = 21,405) from the Household, Income, and Labour Dynamics in Australia (HILDA) survey between 2006 and 2021. Linear mixed-effects models predicted anxiety based on alcohol consumption one-year prior up to eight times per participant. Moderation by sex (male, female), age-group (18-25, 26-37, 38-50, 51+years), and income quartile were examined. Anxiety was measured using the Kessler-10 anxiety subscale and alcohol consumption was measured using self-reported alcohol consumption frequency (alcohol consumption occasions per week) and alcohol consumption quantity (standard drinks consumed on alcohol consumption occasions). An adjusted model demonstrated a small effect of frequency (IRR[95% CI]=0.98[0.98, 0.99]) and quantity (IRR[95% CI]=1.02[1.01, 1.03]) on anxiety one-year later. Age, but not sex nor income, moderated the relationship between alcohol consumption and anxiety. Specifically, frequency was associated with slightly lower longitudinal anxiety for 51+year-olds (β[95% CI]=-0.04[-0.05, -0.03]), but showed no association for 18-50-year-olds. Conversely, quantity was associated with slightly greater longitudinal anxiety for 51+year-olds (β[95% CI]=0.03[.02, 0.05]) and 26-50-year-olds (β[95% CI]=0.02[.01, 0.03]), but not 18-25-year-olds. While the impact of alcohol consumption on anxiety appears very small, divergent relationships of drinking frequency versus quantity on long-term anxiety seem to emerge across the lifespan. Drinking larger amounts per occasion appears associated with slight increases in anxiety from early adulthood, while drinking more frequently but in smaller amounts appears associated with slight decreases in anxiety in older adulthood.