Investigating the Effect of Loneliness on Panic Disorder Symptoms and Frequency of Panic Attacks in Clients with Panic Disorder with the Mediating Role of Sleep Disorders and the Moderating Role of Social Support

Introduction: Loneliness is a recognized risk factor for anxiety disorders, yet its mechanisms in panic disorder remain insufficiently examined. The present study investigated the relationships between loneliness, panic disorder symptoms, and panic attack frequency, examining sleep disorders as mediators and social support as a moderator.Method: This descriptive‑correlational, cross‑sectional study was conducted among patients diagnosed with panic disorder who referred to psychological clinics in Tehran between July and October ۲۰۲۳. A convenience sample of ۱۵۸ participants completed the UCLA‑R Loneliness Scale, Mini Sleep Questionnaire, Multidimensional Scale of Perceived Social Support, and Acute Panic Inventory. Data were analyzed using Spearman correlations in SPSS‑۲۷ and structural path analysis in SmartPLS‑۴.Results: Insomnia (β = −۰.۰۲, p = ۰.۸۲۷) and hypersomnia (β = ۰.۰۲, p = ۰.۶۷۵) did not predict panic attack frequency, but both were positively associated with panic disorder symptoms (insomnia: β = ۰.۲۵, p = ۰.۰۱۰; hypersomnia: β = ۰.۱۶, p = ۰.۰۰۶). Loneliness was significantly associated with insomnia, hypersomnia, panic symptoms, and attack frequency (p < ۰.۰۱); insomnia mediated the loneliness–panic symptoms link (β = ۰.۱۵, p = ۰.۰۱۴), while social support moderated the loneliness–panic attack frequency relationship (β = −۰.۱۶, p = ۰.۰۲۱).Conclusion: Loneliness significantly exacerbates the severity of panic disorder by increasing insomnia and related panic symptoms, while both insomnia and hypersomnia contribute to greater symptom severity. Social support reduces the impact of loneliness on panic attack frequency, underscoring its protective role in clinical practice and mental health planning.

کلیدواژه ها:

Loneliness ، panic disorder ، Sleep disorders ، Social Support