Epilepsy-related romantic and sexual relationship problems and concerns: Indications from Internet message boards ☆ Wendy R. Miller a, ⁎, Amanda N. Gesselman b , Justin R. Garcia b,c , Doyle Groves a , Janice M. Buelow a a Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, USA b The Kinsey Institute, Indiana University Bloomington, Morrison Hall, 1165 East Third Street, Bloomington, IN 47405, USA c Department of Gender Studies, Indiana University Bloomington, Ballantine Hall, 1020 East Kirkwood Avenue, Bloomington, IN 47405, USA abstract article info Article history: Received 21 May 2017 Accepted 18 June 2017 Available online xxxx The objective of this study was to, utilizing a Big Data set and innovative methods, explore romantic and sexual relationship-related concerns among people with epilepsy and their partners. We applied Word Adjacency Graph modeling to more than 2000 message board posts, and five distinct categories of romantic and sexual re- lationship-related concerns emerged. We conclude that persons with epilepsy are at particular risk for the expe- rience of decrements in their romantic and sexual relationships, which can negatively impact their self- management and overall health. © 2017 Published by Elsevier Inc. Keywords: Epilepsy Adults Big Data Relationships Sex 1. Introduction The Internet has become a major source of information and sharing among people of all demographics. In the United States, nearly 87% of adults use the Internet [1], and 72% of Internet users report searching for health information online or discussing health-related problems on social media platforms [2,3]. Advances in mobile phone accessibility and technology have further facilitated the public's use of the Internet, social media, and mobile apps to gather and discuss health-related in- formation, with smartphones increasingly accessible to people across socioeconomic statuses, levels of education, and ethnic groups, and with 62% of smart phone users reporting that they use phones to seek health information [4]. Use of the Internet for health information has be- come a prevalent practice, both for patients and among family and friends seeking to better understand health issues [5,6]. The pervasiveness of Internet use, including social media and mobile apps, for health-related searches and discussions has resulted in large repositories of information about people's health interests, concerns, and experiences. This, in turn, has led to the creation of large and com- plex datasets, termed Big Data, which reflect the public's organic questions and concerns about health [7]. Big Data sets are highly reflec- tive of a wide range of populations and demographics, providing a na- tional or international snapshot of issues that often are not openly discussed nor captured with traditional research methods. For this rea- son, Big Data sets tend to provide pools of data that are more generaliz- able than that generated by standard research methods, which utilize a limited sample. Thus, Big Data is increasingly used to study a wide vari- ety of health-related issues, including uncovering various aspects of health phenomena. In this paper, we use a Big Data set to explore the understudied topic of romantic and sexual relationships in people with epilepsy (PWE). In particular, we explore romantic and sexual relationship-related problems and concerns among PWE and their partners. 1.1. Epilepsy and romantic relationships Epilepsy is the fourth most common neurological disorder in the United States, with as many as 3 million people affected. It is a chronic neurological condition consisting of recurrent and unprovoked seizures that can be associated with a wide range of seizure types and vary in se- verity from person to person. Epilepsy is also associated with multiple comorbid conditions affecting mental and physical health. For example, PWE are more likely to suffer from depression and anxiety, and are also more likely to be socially isolated, less likely to maintain long-term rela- tionships or be employed, less likely to be married, and generally have a lower quality of life when compared with those without epilepsy [8,9]. Seizure control is the best defense against additional health problems Epilepsy & Behavior 74 (2017) 149–153 ☆ This work was supported by funding from the Indiana University School of Nursing Center for Enhancing Quality of Life. ⁎ Corresponding author. E-mail addresses: wrtruebl@iu.edu (W.R. Miller), agesselm@indiana.edu (A.N. Gesselman), jusrgarc@indiana.edu (J.R. Garcia), doygrove@iupui.edu (D. Groves), jbuelow@iu.edu (J.M. Buelow). http://dx.doi.org/10.1016/j.yebeh.2017.06.023 1525-5050/© 2017 Published by Elsevier Inc. Contents lists available at ScienceDirect Epilepsy & Behavior journal homepage: www.elsevier.com/locate/yebeh