Introduction. Loneliness and psychological distress are rising globally and are key contributors to poor mental health. Alcohol use has a dual role in this context, functioning both as a risk factor for, and a coping response to, psychological distress. Among some groups of women, alcohol consumption is also rising, highlighting an important public health concern. This study aimed to examine how loneliness, alcohol use, and psychological distress are related over time in a large cohort of adult women.


Method. Data were from a large Australian cohort of employed adult women, with matched data collected in 2021 and 2023 (N=4064). Structural equation modelling with autoregressive and cross-lagged paths between loneliness, alcohol use and distress was conducted. Age, parental status, country of birth, chronic health status, education and partner status were covariates.


Results. The average age was 41.88 (sd=13.85) years. Loneliness at baseline significantly predicted higher psychological distress two years later (β = .08, p = .005), and alcohol use at baseline predicted small but significant increases in later distress (β = .05, p = .04). Cross-lagged effects between loneliness and alcohol use were nonsignificant. A concurrent association remained between alcohol use and distress at follow-up (β = .04, p = .03).


Conclusion. For employed women, loneliness contributes to later psychological distress independently of alcohol use, highlighting its role as a key risk factor for poor mental health. The small but significant concurrent association between alcohol and distress at follow-up suggests that women experiencing greater distress may also drink more at the same time. This co-occurrence underscores the value of integrated approaches that reflect the unique social and emotional contexts in which women experience distress and alcohol use. Tailored strategies that address loneliness, as well as alcohol use, may be effective in improving mental health and reducing alcohol-related harm among employed women.