Social Touch, Social Isolation, and Loneliness in Borderline Personality Disorder During the COVID-19 Pandemic

BACKGROUND

Interpersonal impairments in borderline personality disorder (BPD) are characterised by a lack in the sense of belonging and the fear of being excluded. One feature of interactions that can promote a sense of social belonging is interpersonal touch. While some studies suggest that individuals with BPD experience social touch as less pleasurable than healthy individuals (HCs), there are no studies that investigated whether this difference is associated with feeling less socially connected. This question is particularly important during the COVID-19 pandemic, since one central behavioural recommendation is "social distancing". An increase in loneliness has been discussed as a consequence and it has been suggested that individuals with BPD may be particularly burdened. However, the primary goal of "social distancing" is not preventing social contacts, but physical proximity. In our study we investigated the interplay between feeling close to others, contact frequency and the appraisal of social touch in BPD. We were additionally interested in whether these factors contribute to the burden through "physical distancing".

METHODS

We assessed subjective and objective social isolation, the need, importance, and liking of social touch, as well as the burden through "physical distancing" policies in 130 women (61 BPD and 69 HCs).

RESULTS

Participants of the BPD group reported higher loneliness, less social contacts and a lower need for, importance and liking of social touch compared to HCs. Larger social networks, higher frequency of in-person contacts and higher liking and importance of social touch were associated with lower levels of loneliness. Both groups did not differ regarding their burden through "physical distancing". A higher need for and lower importance of social touch predicted a higher burden through "physical distancing".

CONCLUSIONS

A positive appraisal of social touch was associated with less loneliness, independently of an individual's objective social isolation. In BPD, impairments of this fundamental facet of social interaction might hamper forming and strengthening of social bonds and contribute to the patients' interpersonal dysfunction. Changing the attitude towards social touch and in consequence its liking and importance in social interaction might provide one avenue to improve the sense of social connectedness in these patients.

The persuasive power of robot touch. Behavioral and evaluative consequences of non-functional touch from a robot

The unique physical embodiment of robots enables physical contact between machines and humans. Since interpersonal touch research has demonstrated that touch has several positive behavioral (e.g., reduced stress, better immune functioning) as well as evaluative consequences (e.g., better evaluation of the initiator of touch), the question arises whether touch from a humanoid robot, the body of which is somewhat similar to that of a human, can evoke similar effects. To answer this question, we conducted a between-subjects experiment in the laboratory with n = 48 students who encountered a humanoid robot (Softbank Robotics' NAO) that either did or did not touch their hand in a non-functional manner during a counseling conversation. The analyses of participants' behavior revealed that they mostly reacted by smiling and laughing. Furthermore, participants who were touched by the robot complied significantly more frequently with a request posed by the robot during conversation, and reported better feelings compared to those who were not touched. However, there were no effects of robot touch on subjective evaluations of the robot or on the interaction experience.

Psychology of the Embrace: How Body Rhythms Communicate the Need to Indulge or Separate

In the context of embodiment research, there has been a growing interest in phenomena of interpersonal resonance. Given that haptic communication is particularly under-researched, we focused on the phenomenon of embracing. When we embrace a dear friend to say good-bye at the end of a great evening, we typically first employ smooth and yielding movements with round transitions between muscular tensing and relaxing (smooth, indulging rhythms), and when the embrace is getting too long, we start to use slight patting (sharp, fighting rhythms with sharp transitions) on the back or the shoulders of the partner in order to indicate that we now want to end the embrace. On the ground of interpersonal resonance, most persons (per-sonare, latin = to sound through) understand these implicit nonverbal signals, expressed in haptic tension-flow changes, and will react accordingly. To experimentally test the hypothesis that smooth, indulgent rhythms signal the wish to continue, and sharp, fighting rhythms signal the wish to separate from an embrace, we randomly assigned 64 participants, all students at the University of Heidelberg, to two differently sequenced embrace conditions: (a) with the fighting rhythm at the end of the sequence of two indulgent rhythms (Sequence A: smooth-smooth-sharp); and (b) with the fighting rhythm between two indulgent rhythms (Sequence B: smooth-sharp-smooth). Participants were embraced for 30 s by a female confe-derate with their eyes blindfolded to focus on haptic and kinesthetic cues without being distracted by visual cues. They were instructed to let go of a handkerchief that they held between the fingers of their dominant hand during the embrace, when they felt that the embracer signaled the wish to finish the embrace. Participants significantly more often dropped the handkerchief in the phase of the fighting rhythm, no matter in which location it occurred in the embrace sequence. We assume that we learn such rhythmic behaviors and their meaning from the beginning of life in the communication with caregivers and meaningful others. Some are universal and some are quite idiosyncratic. Infants seem to be highly sensitive to the dynamic nuances presented to them, demonstrating a high capacity for embodied resonance and a high behavioral plasticity. Such adaptive mechanisms are assumed to lay the foundations of family culture (including the degree to which nonverbal cues are attended to, the communication of taboos, etc.) and larger culture, and may also play an important role in interpersonal attraction and aesthetic experience.

Reliability and Validity of the European Portuguese Version of the Social Touch Questionnaire

Social touch is essential for physical and emotional well-being. However, different meanings can be attributed to physical contact during social interactions and may generate bonding or avoidant behaviors. This personal and unique experience is not usually taken into account in health and social care services. The aim of this study is to produce a valid and reliable European Portuguese version of the Social Touch Questionnaire (STQ, Wilhelm et al. in Biol Psychol 58:181–202, 2001. doi:10.1016/S0301-0511(01)00113-2). The STQ is a self-report questionnaire for adolescents and adults measuring behaviors and attitudes towards social touch. The original version was translated into European Portuguese using a forward-back translation process and its feasibility was examined. To evaluate the psychometric properties, a total of 242 Portuguese university students participated in the study (21.3 ± 3.8 years). The STQ was considered feasible, showed adequate internal consistency (Cronbach’s α = .734), and the test–retest correlation with the STQ items demonstrated a high concordance between the tests over a two-week interval (ICC = .990; n = 50). Validity tests were performed, comparing the total score of the STQ with that of the anxiety and avoidance subscales of the Social Interaction and Performance Anxiety and Avoidance Scale (SIPAAS). A very significant conceptual convergence was confirmed between the STQ and with the SIPAAS-Anxiety (r = .64; p < .0001) and with the SIPAAS-Avoidance (r = .59; p < .0001). The exploratory factor analysis, with Promax rotation, revealed 3 factors: dislike of physical touch, liking of familiar physical touch and liking of public physical touch (Cronbach’s alphas ranged from .68 to .75). Psychometric properties confirmed the adaptation of the STQ to the Portuguese culture. It is a reliable and valid self-report questionnaire and it appears to be a useful tool to assess behaviors and attitudes towards social touch.