Document Type : Original Article
Authors
1
Department of psychology, Science and Research Branch, Islamic Azad University, Tehran, Iran
2
Department of Clinical Psychology, Kermanshah Branch, Islamic Azad University, Kermanshah, Iran
3
Department of Psychology, Marvdasht Branch, Islamic Azad University, Marvdasht, Fars, Iran
4
Department of Psychology, Shahre Ghods Branch, Islamic Azad University, Shahrak Ghods, Iran
5
Department of Psychology, Science and Research Branch, Islamic Azad University, Isfahan, Iran
Abstract
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 2023. A convenience sample of 158 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‑27 and structural path analysis in SmartPLS‑4.
Results: Insomnia (β = −0.02, p = 0.827) and hypersomnia (β = 0.02, p = 0.675) did not predict panic attack frequency, but both were positively associated with panic disorder symptoms (insomnia: β = 0.25, p = 0.010; hypersomnia: β = 0.16, p = 0.006). Loneliness was significantly associated with insomnia, hypersomnia, panic symptoms, and attack frequency (p < 0.01); insomnia mediated the loneliness–panic symptoms link (β = 0.15, p = 0.014), while social support moderated the loneliness–panic attack frequency relationship (β = −0.16, p = 0.021).
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.
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