The lived experience of social anxiety disorder: A conceptual model based on published literature and social media listening

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Abstract
Social anxiety disorder (SAD) affects up to 1 in 8 individuals over their lifetime and is characterized by an intense fear of social situations where there may be exposure to unfamiliar people or possible scrutiny. The analysis of social media data rather than traditional methods (interviews or focus groups) can provide a unique opportunity to understand the lived experience of individuals with SAD, for whom interacting with strangers is challenging. This retrospective observational study reviewed published literature from PubMed and data from Reddit using social media listening (SML). A stepwise analysis in line with US Food and Drug Administration Patient-Focused Drug Development guidelines was performed to develop a conceptual model for SAD. Natural language processing techniques and machine learning approaches were employed to extract symptoms and impacts described by individuals with SAD. Eleven publications from the literature and 535,544 posts from 118,040 Reddit users were included. Clinical and patient experts then refined the conceptual model covering three key symptom domains (physical, negative automatic thoughts, and emotions) and two impact domains (social functioning and occupational/educational functioning). This study provides insights into the lived experience of individuals with SAD and confirms the value of SML when traditional methods are inappropriate.

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