Sensitivity to CT-optimal, Affective Touch Depends on Adult Attachment Style

High frequency heart rate variability is associated with sensitivity to affective touch

C-tactile afferents (CTs) are a class of unmyelinated, mechanosensitive nerve fibre that respond optimally to skin temperature, slow moving touch typical of a caress. They are hypothesised to signal the rewarding value of affiliative tactile interactions. While CT firing frequency is positively correlated with subjective ratings of touch pleasantness, trait differences in sensitivity to the specific hedonic value of CT targeted touch have been reported. Inter-individual differences in vagally mediated, high frequency heart rate variability (HF-HRV) have been linked to variation in visual social cognition. Thus, the aim of the present study was to examine the relationship between resting state HF-HRV and sensitivity to socially relevant CT targeted touch. 58 healthy participants first had a 5-minute electrocardiogram. They then rated the pleasantness of 5 randomly presented velocities of robotically delivered touch. Three velocities fell within (1, 3, 10 cm/s) and two outside (0.3, 30 cm/s) the CT optimal range. Each velocity was delivered twice. On a group level, affective touch ratings were described by a negative quadratic function, with CT optimal velocities rated as more pleasant than slower and faster speeds. Simple regression analysis confirmed participants' HF-HRV was significantly predicted by the quadratic curve fit of their touch ratings, with higher HF-HRV associated with a better quadratic fit. These findings indicate that, in line with previous observations that higher HF-HRV is associated with enhanced sensitivity to visual social cues, trait differences in autonomic control could account for previously reported individual differences in CT sensitivity.

Tactile emoticons: Conveying social emotions and intentions with manual and robotic tactile feedback during social media communications

Touch offers important non-verbal possibilities for socioaffective communication. Yet most digital communications lack capabilities regarding exchanging affective tactile messages (tactile emoticons). Additionally, previous studies on tactile emoticons have not capitalised on knowledge about the affective effects of certain mechanoreceptors in the human skin, e.g., the C-Tactile (CT) system. Here, we examined whether gentle manual stroking delivered in velocities known to optimally activate the CT system (defined as 'tactile emoticons'), during lab-simulated social media communications could convey increased feelings of social support and other prosocial intentions compared to (1) either stroking touch at CT sub-optimal velocities, or (2) standard visual emoticons. Participants (N = 36) felt more social intent with CT-optimal compared to sub-optimal velocities, or visual emoticons. In a second, preregistered study (N = 52), we investigated whether combining visual emoticons with tactile emoticons, this time delivered at CT-optimal velocities by a soft robotic device, could enhance the perception of prosocial intentions and affect participants' physiological measures (e.g., skin conductance rate) in comparison to visual emoticons alone. Visuotactile emoticons conveyed more social intent overall and in anxious participants affected physiological measures more than visual emoticons. The results suggest that emotional social media communications can be meaningfully enhanced by tactile emoticons.

Verbal Support From a Stranger Reduces the Development of Mechanical Hypersensitivity: Behavioral and Neurophysiological Evidence

Hand-holding reduces experimentally induced acute pain and buffers against the development of mechanical secondary hypersensitivity, an indirect proxy of central sensitization. Here, we tested if verbal support from a stranger, a common occurrence in clinical contexts, exerts the same effects. In this preregistered study, 44 healthy female participants were assigned to an alone or support group whereby a supportive female stranger encouraged them through the painful procedure leading to secondary mechanical hypersensitivity. Mechanical hypersensitivity was measured via self-reports and by the size of the anteroposterior and mediolateral spread of mechanical hypersensitivity. We investigated the moderating role of attachment style on self-reports and the effects of support on skin conductance level, salivary cortisol, and pinprick-evoked potentials. We also tested whether theta/beta ratio in the resting-state electroencephalogram predicted mechanical hypersensitivity. Self-reported ratings and the late part of the pinprick-evoked potentials were reduced in the support group, but the spread of mechanical hypersensitivity was not. Attachment anxiety and avoidance moderated the self-reported intensity such that individuals with higher attachment anxiety and avoidance scores reported lower intensity ratings in the support group. No significant effect of the verbal support was observed on skin conductance level and salivary cortisol. The theta/beta ratio did not predict the extent of hypersensitivity. Our data indicate that, in women, verbal support during intense pain leading to hypersensitivity is effective on some behavioral outcomes, but altogether the lack of group differences in cortisol, self-reported stress, and skin conductance does not provide strong support for the stress-buffering hypothesis. PERSPECTIVE: Verbal support by a stranger during a painful procedure leading to secondary mechanical hypersensitivity attenuated the development of some measures of mechanical hypersensitivity and associated neural responses in healthy female participants. No evidence was found for the role of stress. DATA AVAILABILITY: The authors will make all data available upon request.

Determinants for positive and negative experiences of interpersonal touch: context matters

The goal of the study was to determine which aspects of interpersonal touch interactions lead to a positive or negative experience. Previous research has focused primarily on physical characteristics. We suggest that this may not be sufficient to fully capture the complexity of the experience. Specifically, we examined how fulfilment of psychological needs influences touch experiences and how this relates to physical touch characteristics and situational factors.In two mixed-method studies, participants described their most positive and most negative interpersonal touch experience within a specific time frame. They reported fulfilment of nine needs, affect, intention, and reason for positivity/negativity, as well as the body part(s) touched, location, type of touch, interaction partner, and particular touch characteristics (e.g. humidity).Positive and negative touch experiences shared similar touch types, locations, and body parts touched, but differed in intended purpose and reasons. Overall, the valence of a touch experience could be predicted from fulfilment of relatedness, the interaction partner and initiator, and physical touch characteristics. Positive affect increased with need fulfilment, and negative affect decreased.The results highlight the importance of relatedness and reciprocity for the valence of touch, and emphasise the need to incorporate psychological needs in touch research.

Autonomic and hedonic response to affective touch in autism spectrum disorder

Interpersonal touch plays a crucial role in shaping relationships and encouraging social connections. Failure in processing tactile input or abnormal tactile sensitivity may hamper social behaviors and have severe consequences in individuals' relational lives. Autism Spectrum Disorder (ASD) is characterized by both sensory disruptions and social impairments, making affective touch an ideal meeting point for understanding these features in ASD individuals. By integrating behavioral and physiological measures, we investigated the effects of affective touch on adult individuals with ASD from both an implicit and explicit perspective. Specifically, at an implicit level, we investigated whether and how receiving an affective touch influenced participants' skin conductance tonic and phasic components. At the explicit level, we delved into the affective and unpleasant features of affective touch. Overall, we observed lower skin conductance level in ASD compared to TD subjects. Interestingly, the typically developing (TD) group showed an increased autonomic response for affective touch compared to a control touch, while ASD subjects' autonomic response did not differ between the two conditions. Furthermore, ASD participants provided higher ratings for both the affective and unpleasant components of the touch, compared to TD subjects. Our results reveal a noteworthy discrepancy in ASD population between the subjective experience, characterized by amplified hedonic but also unpleasant responses, and the physiological response, marked by a lack of autonomic activation related to affective touch. This insightful dissociation seems crucial for a deeper understanding of the distinctive challenges characterizing people with ASD and may have implications for diagnosis and therapeutic approaches.

The impact of the social context on the development of secondary hyperalgesia: an experimental study

ABSTRACT

Social support has been shown to reduce pain ratings and physiological responses to acute pain stimuli. Furthermore, this relationship is moderated by adult attachment styles. However, these effects have not been characterized in experimentally induced symptoms of chronic pain, such as secondary hyperalgesia (SH) which is characterized by an increased sensitivity of the skin surrounding an injury. We aimed to examine whether social support by handholding from a romantic partner can attenuate the development of experimentally induced SH. Thirty-seven women, along with their partners, participated in 2 experimental sessions 1 week apart. In both sessions, SH was induced using an electrical stimulation protocol. In the support condition, the partner was seated across from the participant holding the participant's hand during the electrical stimulation, whereas in the alone condition, the participant went through the stimulation alone. Heart rate variability was measured for both the participant as well as the partner before, during, and after the stimulation. We found that the width of the area of hyperalgesia was significantly smaller in the support condition. Attachment styles did not moderate this effect of social support on the area width. Increasing attachment avoidance was associated with both a smaller width of hyperalgesia and a smaller increase in the sensitivity on the stimulated arm. For the first time, we show that social support can attenuate the development of secondary hyperalgesia and that attachment avoidance may be associated with an attenuated development of secondary hyperalgesia.

The perception of pain, discriminative touch and affective touch in patients suffering from Borderline Personality Disorder

Borderline Personality Disorder (BPD) is often characterized by self-injurious behaviors, with one-half to two-third of these patients reporting hypalgesic or analgesic phenomena during self-harming. Research on pain perception in BPD suggested abnormal processing of nociception either within the sensory-discriminative and/or motivational-affective systems of pain. Nevertheless, it is still unclear whether pain insensitivity could be generalized to other somatosensory submodalities. To investigate this question, 30 BPD patients and 30 matched healthy controls were enrolled in the current study and underwent a somatosensory battery composed of well-established psychophysical test assessing all the principal submodalities of somatosensation, namely pain perception (i.e., warm, cold and mechanical), discriminative touch (i.e., tactile acuity and tactile sensitivity) as well as affective touch. Results showed abnormal warm detection threshold, warm pain threshold, mechanical pain perception, and tactile sensitivity in BPD patients, but no differences emerged neither for tactile acuity nor for cold pain thresholds, cold tolerance, or for affective touch perception. Findings point to a deficit in nociception, as well as in tactile sensitivity in BPD individuals, and were discussed in relation to BPD clinical features including self-injurious behaviors.

Touch Avoidance with Close People and Strangers: Effects of Gender, Sexual Orientation, and Relationship Status

Human contact through physical touch is a core element in social bonding, which facilitates psychosocial well-being. Touch avoidance is an individual disposition that may prevent individuals from engaging in or benefiting from physical touch. The present study recruited 450 Italian participants (51.1% female) with a mean age of 32.2 ± 13.5 to complete a battery of demographic questionnaires and the Touch Avoidance Questionnaire (TAQ). Individuals who were single and reporting same-sex attraction avoided touch with family more often than their coupled counterparts or those reporting opposite-sex attraction. Moreover, males reporting same-sex attraction avoided touch with a potential partner more frequently. When comparing sex differences, women reported greater touch avoidance with opposite-sex friends more frequently, while males avoided touch with same-sex friends more frequently. Individuals reporting opposite-sex attraction reported greater touch amongst same-sex friends. Single males avoided touch with same-sex friends more frequently than those in a relationship. Overall, this contribution reflects the individual differences related to social touch avoidance with respect to sex, relationship status, and sexual orientation in an Italian sample.

Cortical Response Variation with Social and Non-Social Affective Touch Processing in the Glabrous and Hairy Skin of the Leg: A Pilot fMRI Study

Despite the crucial role of touch in social development and its importance for social interactions, there has been very little functional magnetic resonance imaging (fMRI) research on brain mechanisms underlying social touch processing. Moreover, there has been very little research on the perception of social touch in the lower extremities in humans, even though this information could expand our understanding of the mechanisms of the c-tactile system. Here, variations in the neural response to stimulation by social and non-social affective leg touch were investigated using fMRI. Participants were subjected to slow a (at 3-5 cm/s) stroking social touch (hand, skin-to-skin) and a non-social touch (peacock feather) to the hairy skin of the shin and to the glabrous skin of the foot sole. Stimulation of the glabrous skin of the foot sole, regardless of the type of stimulus, elicited a much more widespread cortical response, including structures such as the medial segment of precentral gyri, left precentral gyrus, bilateral putamen, anterior insula, left postcentral gyrus, right thalamus, and pallidum. Stimulation of the hairy skin of the shin elicited a relatively greater response in the left middle cingulate gyrus, left angular gyrus, left frontal eye field, bilateral anterior prefrontal cortex, and left frontal pole. Activation of brain structures, some of which belong to the "social brain"-the pre- and postcentral gyri bilaterally, superior and middle occipital gyri bilaterally, left middle and superior temporal gyri, right anterior cingulate gyrus and caudate, left middle and inferior frontal gyri, and left lateral ventricle area, was associated with the perception of non-social stimuli in the leg. The left medial segment of pre- and postcentral gyri, left postcentral gyrus and precuneus, bilateral parietal operculum, right planum temporale, left central operculum, and left thalamus proper showed greater activation for social tactile touch. There are regions in the cerebral cortex that responded specifically to hand and feather touch in the foot sole region. These areas included the posterior insula, precentral gyrus; putamen, pallidum and anterior insula; superior parietal cortex; transverse temporal gyrus and parietal operculum, supramarginal gyrus and planum temporale. Subjective assessment of stimulus ticklishness was related to activation of the left cuneal region. Our results make some contribution to understanding the physiology of the perception of social and non-social tactile stimuli and the CT system, including its evolution, and they have clinical impact in terms of environmental enrichment.

Topography and relationship-specific social touching in individuals displaying body image disturbances

Interpersonal touch is intimately related to the emotional bond between the touch giver and the touch receiver. Which bodily regions we touch in those individuals in our social network is relationship specific. Perception of interpersonal touch is altered in psychiatric disorders characterised by body image disturbances (BIDs). Here, we examined whether the 'imagined' experience of social touch in individuals with BIDs is body topography- and relationship-specific. By using an interactive media mobile App, the Virtual Touch Toolkit, high versus low levels of BIDs participants completed heatmaps of full-body virtual avatars, to indicate the body regions they find soothing/unpleasant to be touched by a loved one versus an acquaintance. Self-reports of interoceptive awareness and dysmorphic concerns were also measured. Overall, imagined touch was rated as the most soothing when received from a loved one, and also when this was delivered to 'social' body regions. The importance of the social relationship for the imagined tactile interactions was particularly evident for the high levels of BIDs group, with greater problems with interoceptive awareness predicting higher soothing touch ratings when this was received by a loved one. Despite the evidence that imagined bodily contacts between meaningful people is the most pleasant for socially acceptable bodily regions, our findings may suggest a greater sensitivity to relation-specific bodily patterns of social touch particularly in the high level of BIDs group. Heightened interoceptive awareness may also play a key role in this experience of bodily affective contacts. Future research for body-oriented therapy for BIDs is encouraged to systematically probe the efficacy of imagined social touch interaction protocols which use more plausible, ecological, scenarios where touch is delivered by loved ones and to socially acceptable bodily regions.

Depression severity is associated with reduced pleasantness of observed social touch and fewer current intimate touch experiences

Depression is associated with loss of pleasure in previously enjoyed activities and withdrawal from social interactions. Depression alters the perception of social cues, but it is currently unclear whether this extends to social touch. In the current cross-sectional study, we explored the association between depression severity, perceived pleasantness of observed social touch, and general longing for touch. For observed touch, we contrasted videos of slow touch (1-10cm/s), which optimally activates C tactile afferent nerve fibres and generally feels pleasant, with 'non-CT-optimal' touch (i.e., outside the 1-10cm/s range, commonly rated more neutral). We predicted that greater depression severity would be related to lower pleasantness ratings specifically for CT-optimal touch, and less longing for touch. N = 226 adults completed self-report measures of depression severity and longing for touch, and rated touch pleasantness for six videos depicting social touch at three velocities (3cm/s in the CT-optimal range, 0.5 and 30cm/s outside this range) and at two locations varying in CT innervation (palm vs. arm). We controlled for general anhedonia and individual differences in touch experiences and attitudes. Across touch locations, greater depression severity was associated with lower perceived pleasantness of touch, especially for the fastest non-CT-optimal (rather than the CT-optimal) velocity, contrary to our prediction. However, when grouping participants into probable vs. no/minimal depression, the probable depression group rated both the fastest non-CT-optimal and the CT-optimal velocity as less pleasant than did the no/minimal depression group. Overall, while depression was associated with perceived pleasantness of observed touch, this was not specific to CT-optimal touch. Furthermore, touch longing was not associated with depression severity. Instead, variance in depression symptoms was better explained by reduced levels of current intimate touch. Though the direction of causality is unclear, greater depression severity is related to lower pleasantness of observed social touch, and lower levels of current intimate touch.

Perspectives on interpersonal touch are related to subjective sleep quality

Affective touch has been reported for its calming effects; however, it is less clear whether touch is associated with sleep. Here, the relationship between different touch variables and self-reported sleep indicators was investigated. Data were extracted from the Touch Test, a cross-sectional survey conducted in 2020. Data from a sample of 15,049 healthy adults from the UK (mean age = 56.13, SD = 13.8; 75.4% female) were analysed. Participants were asked to attribute positive, negative, or no effects on sleep to hugs, strokes, massages, intimate touch, and sleep onset with and without touch. The time since last intentional touch, touch amount satisfaction, and childhood bed routine with hugs and kisses were assessed. Sleep quality, duration, latency, wake after sleep onset and diurnal preference were measured. Data were analysed using chi-square tests and logistic regressions. Affective touch before sleep was perceived to have positive effects on sleep. Touch recency emerged as a significant predictor for some sleep variables, with a longer timespan since the last intentional touch relating to improved sleep quality, longer sleep duration, and shorter and fewer instances of waking up after sleep onset in some participants. Experiencing too much touch was related to lower sleep quality and higher instances of waking up after sleep onset. These findings highlight the importance of interpersonal touch for subjective sleep quality.

What are C-tactile afferents and how do they relate to "affective touch"?

Since their initial discovery in cats, low-threshold C-fiber mechanoreceptors have become a central interest of scientists studying the affective aspects of touch. Their pursuit in humans, here termed C-tactile (CT) afferents, has led to the establishment of a research field referred to as "affective touch", which is differentiated from "discriminative touch". Presently, we review these developments based on an automated semantic analysis of more than 1000 published abstracts as well as empirical evidence and the solicited opinions of leading experts in the field. Our review provides a historical perspective and update of CT research, it reflects on the meaning of "affective touch", and discusses how current insights challenge established views on the relation between CTs and affective touch. We conclude that CTs support gentle, affective touch, but that not every affective touch experience relies on CTs or must necessarily be pleasant. Moreover, we speculate that currently underappreciated aspects of CT signaling will prove relevant for the manner in which these unique fibers support how humans connect both physically and emotionally.

The role of early attachment experiences in modulating defensive peripersonal space

Selecting appropriate defensive behaviours for threats approaching the space surrounding the body (peripersonal space, PPS) is crucial for survival. The extent of defensive PPS is measured by recording the hand-blink reflex (HBR), a subcortical defensive response. Higher-order cortical areas involved in PPS representation exert top-down modulation on brainstem circuits subserving HBR. However, it is not yet known whether pre-existing models of social relationships (internal working models, IWM) originating from early attachment experiences influence defensive responses. We hypothesized that organized IWM ensure adequate top-down regulation of brainstem activity mediating HBR, whereas disorganized IWM are associated with altered response patterns. To investigate attachment-dependent modulation on defensive responses, we used the Adult Attachment Interview to determine IWM and recorded HBR in two sessions (with or without the neurobehavioral attachment system activated). As expected, the HBR magnitude in individuals with organized IWM was modulated by the threat proximity to the face, regardless of the session. In contrast, for individuals with disorganized IWM, attachment system activation enhances HBR regardless of the threat position, suggesting that triggering emotional attachment experiences magnifies the threatening valence of external stimuli. Our results indicate that the attachment system exerts a strong modulation on defensive responses and the magnitude of PPS.

Affective touch in anorexia nervosa: Exploring the role of social anhedonia and lifespan experiences

BACKGROUND

The pleasantness of a gentle and slow, namely affective, touch experienced in interpersonal interactions motivates social closeness. In anorexia nervosa (AN), independent evidence suggests lower pleasantness of affective touch, as well as social withdrawal. We aim to probe both the experience of affective touch and its possible association with social anhedonia and lifespan experiences of affective bodily contacts in AN.

METHODS

The pleasantness of affective and non-affective touch was compared between fourteen women with AN and fourteen healthy women. Stimuli were traditionally delivered with a brush, with the experimenter's hand, as novelty, and with a stick, as control. The pleasantness of imagined and real touch was probed. Self-report questionnaires assessed social anhedonia and lifespan experiences of affective touch.

RESULTS

A preserved pleasantness of affective touch emerged in AN in both the imagery and real task, despite higher social anhedonia and less lifespan experience of affective touch than healthy women.

LIMITATIONS

Affective touch involves loved ones; thus, the experimenter's touch may not resemble real-life interactions. Future research may take advantage of imagery procedures to solve this issue.

CONCLUSIONS

Body-oriented therapy for AN recognizes touch as a therapeutic tool: ascertaining how touch is experienced is crucial to maximize rehabilitative outcomes. Furthermore, clarifying the possible interplay between interpersonal difficulties in AN and affective touch is especially relevant considering the possible role of the attachment style, which is intensively debated in AN, on affective touch.

Thin Films on the Skin, but not Frictional Agents, Attenuate the Percept of Pleasantness to Brushed Stimuli

Brushed stimuli are perceived as pleasant when stroked lightly on the skin surface of a touch receiver at certain velocities. While the relationship between brush velocity and pleasantness has been widely replicated, we do not understand how resultant skin movements - e.g., lateral stretch, stick-slip, normal indentation - drive us to form such judgments. In a series of psychophysical experiments, this work modulates skin movements by varying stimulus stiffness and employing various treatments. The stimuli include brushes of three levels of stiffness and an ungloved human finger. The skin's friction is modulated via non-hazardous chemicals and washing protocols, and the skin's thickness and lateral movement are modulated by thin sheets of adhesive film. The stimuli are hand-brushed at controlled forces and velocities. Human participants report perceived pleasantness per trial using ratio scaling. The results indicate that a brush's stiffness influenced pleasantness more than any skin treatment. Surprisingly, varying the skin's friction did not affect pleasantness. However, the application of a thin elastic film modulated pleasantness. Such barriers, though elastic and only 40 microns thick, inhibit the skin's tangential movement and disperse normal force. The finding that thin films modulate affective interactions has implications for wearable sensors and actuation devices.

Therapeutic touch and therapeutic alliance in pediatric care and neonatology: An active inference framework

Therapeutic affective touch has been recognized as essential for survival, nurturing supportive interpersonal interactions, accelerating recovery-including reducing hospitalisations, and promoting overall health and building robust therapeutic alliances. Through the lens of active inference, we present an integrative model, combining therapeutic touch and communication, to achieve biobehavioural synchrony. This model speaks to how the brain develops a generative model required for recovery, developing successful therapeutic alliances, and regulating allostasis within paediatric manual therapy. We apply active inference to explain the neurophysiological and behavioural mechanisms that underwrite the development and maintenance of synchronous relationships through touch. This paper foregrounds the crucial role of therapeutic touch in developing a solid therapeutic alliance, the clinical effectiveness of paediatric care, and triadic synchrony between health care practitioner, caregiver, and infant in a variety of clinical situations. We start by providing a brief overview of the significance and clinical role of touch in the development of social interactions in infants; facilitating a positive therapeutic alliance and restoring homeostasis through touch to allow a more efficient process of allostatic regulation. Moreover, we explain the role of CT tactile afferents in achieving positive clinical outcomes and updating prior beliefs. We then discuss how touch is implemented in treatment sessions to promote cooperative interactions in the clinic and facilitate theory of mind. This underwrites biobehavioural synchrony, epistemic trust, empathy, and the resolution of uncertainty. The ensuing framework is underpinned by a critical application of the active inference framework to the fields of pediatrics and neonatology.

Neurobiology of Disorganized Attachment: A Review of Primary Studies on Human Beings

This article describes and analyzes various aspects related to the neurobiology of disorganized attachment (DA), which is associated with personality, eating, affective, dissociative, and addictive disorders. We included primary studies in humans, published in PubMed from 2000 to 2022. Eight genetic and one epigenetic study were considered. Three molecular studies describe possible roles of oxytocin and cortisol, seven neurophysiological studies investigated functional correlates, and five morphological studies describe anatomical changes. Findings in candidate genes involved in dopaminergic, serotonergic, and oxytonergic systems have not been able to be replicated in large-scale human studies. Alterations in the functioning of cortisol and oxytocin are preliminary. Neurophysiological studies show changes in subcortical structures (mainly in the hippocampus) and occipital, temporal, parietal, and insular cortices. Since there is a lack of robust evidence on the neurobiology of DA in humans, the possible inferences of these studies are preliminary, which restricts their translation to clinical parameters.

Atypical Response to Affective Touch in Children with Autism: Multi-Parametric Exploration of the Autonomic System

This study aimed at evaluating the autonomic response to pleasant affective touch in children with Autism Spectrum Disorders (ASD) and age-matched typically developing (TD) peers, thanks to multiple autonomic nervous system (ANS) parameters and by contrasting CT (C-tactile fibers) high- vs. low-density territory stimulations. We measured pupil diameter, skin conductance, and heart rate during gentle stroking of two skin territories (CT high- and low-density, respectively, forearm and palm of the hand) in thirty 6-12-year-old TD children and twenty ASD children. TD children showed an increase in pupil diameter and skin conductance associated with a heart rate deceleration in response to tactile stimulations at the two locations. Only the pupil was influenced by the stimulated location, with a later dilation peak following CT low-density territory stimulation. Globally, ASD children exhibited reduced autonomic responses, as well as different ANS baseline values compared to TD children. These atypical ANS responses to pleasant touch in ASD children were not specific to CT-fiber stimulation. Overall, these results point towards both basal autonomic dysregulation and lower tactile autonomic evoked responses in ASD, possibly reflecting lower arousal and related to social disengagement.

Affective Touch and Regulation of Stress Responses

Much has been documented on the association between stress and health. Both direct and indirect pathways have been identified and explored extensively, helping us understand trajectories from healthy individuals to reductions in well-being, and development of preclinical and disease states. Some of these pathways are well established within the field; physiology, affect regulation, and social relationships. The purpose of this review is to push beyond what is known separately about these pathways and provide a means to integrate them using one common mechanism. We propose that social touch, specifically affective touch, may be the missing active ingredient fundamental to our understanding of how close relationships contribute to stress and health. We provide empirical evidence detailing how affective touch is fundamental to the development of our stress systems, critical to the development of attachment bonds and subsequent social relationships across the life course. We will also explore how we can use this in applied contexts and incorporate it into existing interventions.

Hearing, touching, and multisensory integration during mate choice

Mate choice is a potent generator of diversity and a fundamental pillar for sexual selection and evolution. Mate choice is a multistage affair, where complex sensory information and elaborate actions are used to identify, scrutinize, and evaluate potential mating partners. While widely accepted that communication during mate assessment relies on multimodal cues, most studies investigating the mechanisms controlling this fundamental behavior have restricted their focus to the dominant sensory modality used by the species under examination, such as vision in humans and smell in rodents. However, despite their undeniable importance for the initial recognition, attraction, and approach towards a potential mate, other modalities gain relevance as the interaction progresses, amongst which are touch and audition. In this review, we will: (1) focus on recent findings of how touch and audition can contribute to the evaluation and choice of mating partners, and (2) outline our current knowledge regarding the neuronal circuits processing touch and audition (amongst others) in the context of mate choice and ask (3) how these neural circuits are connected to areas that have been studied in the light of multisensory integration.

Assessing individual differences in attitudes towards touch in treatment settings: Introducing the touch & health scale

Individuals commonly receive touch in treatment settings, but there is limited research on how they perceive it. The current project sought to address this gap by: 1) developing the Touch & Health Scale (THS) - a novel instrument to measure attitudes to touch in treatment settings 2) assessing inter-individual differences in THS scores, and 3) examining the association between individuals’ THS scores and wellbeing. Data of a large U.K. adults sample ( N > 12,000) were used. THS showed Cronbach’s α between 0.636 and 0.816 and significant correlations ( p < 0.001) with day-to-day attitudes to touch. THS scores differed as a function of extraversion and avoidant attachment style. Participants with more positive attitudes to touch in treatment settings showed greater wellbeing. Overall, the study highlights the importance of a personalised approach to touch in treatment settings and provides a new scale that may act as a screening tool for this purpose.

Affective touch perception and longing for touch during the COVID-19 pandemic

Interpersonal touch and affective touch play a crucial role in social interactions and have a positive influence on mental health. The social distancing regulations implemented during the COVID-19 pandemic have reduced the ability to engage in interpersonal touch. This could cause longing for touch, and it might subsequently alter the way in which affective touch is perceived. To investigate this, we conducted an online survey and included 1982 participants, which contained questions regarding the COVID-19 regulations, longing for touch, and the perceived pleasantness of affective and non-affective touch. Results showed that participants reported feelings of longing for touch. This significantly increased with the duration and severity of the COVID-19 regulations. In addition, participants who experienced more longing for touch rated videos of affective and non-affective touch as more pleasant. Current results provide insight in the impact of sudden and prolonged COVID-19 regulations and show that increasing the duration and severity of these regulations is associated with a higher desire for touch, which is associated with increased perceived pleasantness of observing touch.

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.

Acute tryptophan depletion alters affective touch perception

RATIONALE

Affiliative tactile interactions help regulate physiological arousal and confer resilience to acute and chronic stress. C-tactile afferents (CTs) are a population of unmyelinated, low threshold mechanosensitive cutaneous nerve fibres which respond optimally to a low force stimulus, moving at between 1 and 10 cm/s. As CT firing frequencies correlate positively with subjective ratings of touch pleasantness, they are hypothesised to form the first stage of encoding affiliative tactile interactions. Serotonin is a key modulator of social responses with known effects on bonding.

OBJECTIVES

The aim of the present study was to determine the effect of acutely lowering central serotonin levels on perceptions of CT-targeted affective touch.

METHODS

In a double blind, placebo-controlled design, the effect of acute tryptophan depletion (ATD) on 25 female participants' ratings of directly and vicariously experienced touch was investigated. Psychophysical techniques were used to deliver dynamic tactile stimuli; some velocities were targeted to optimally activate CTs (1-10 cm/s), whereas other, faster and slower strokes fell outside the CT optimal range. Discriminative tactile function, cold pain threshold and tolerance were also measured.

RESULTS

ATD significantly increased pleasantness ratings of both directly and vicariously experienced affective touch, increasing discrimination of the specific hedonic value of CT targeted velocities. While ATD had no effect on either tactile or cold pain thresholds, there was a trend for reduced tolerance to cold pain.

CONCLUSIONS

These findings are consistent with previous reports that depletion of central serotonin levels modulates neural and behavioural responsiveness to appetitive sensory signals.

The off-line effect of affective touch on multisensory integration and tactile perceptual accuracy during the somatic signal detection task

Affective touch refers to the emotional and motivational facets of tactile sensation and has been linked to the activation of a specialised system of mechanosensory afferents (the CT system), that respond optimally to slow caress-like touch. Affective touch has been shown to play an important role in the building of the bodily self: the multisensory integrated global awareness of one's own body. Here we investigated the effects of affective touch on subsequent tactile awareness and multisensory integration using the Somatic Signal Detection Task (SSDT). During the SSDT, participants were required to detect near-threshold tactile stimulation on their cheek, in the presence/absence of a concomitant light. Participants repeated the SSDT twice, before and after receiving a touch manipulation. Participants were divided into two groups: one received affective touch (CT optimal; n = 32), and the second received non-affective touch (non-CT optimal; n = 34). Levels of arousal (skin conductance levels, SCLs) and mood changes after the touch manipulation were also measured. Affective touch led to an increase in tactile accuracy, as indicated by less false reports of touch and a trend towards higher tactile sensitivity during the subsequent SSDT. Conversely, non-affective touch was found to induce a partial decrease in the correct detection of touch possibly due to a desensitization of skin mechanoreceptors. Both affective and non-affective touch induced a more positive mood and higher SCLs in participants. The increase in SCLs was greater after affective touch. We conclude that receiving affective touch enhances the sense of bodily self therefore increasing perceptual accuracy and awareness. Higher SCLs are suggested to be a possible mediator linking affective touch to a greater tactile accuracy. Clinical implications are discussed.

Affective regulation through touch: homeostatic and allostatic mechanisms

We focus on social touch as a paradigmatic case of the embodied, cognitive, and metacognitive processes involved in social, affective regulation. Social touch appears to contribute three interrelated but distinct functions to affective regulation. First, it regulates affects by fulfilling embodied predictions about social proximity and attachment. Second, caregiving touch, such as warming an infant, regulates affect by socially enacting homeostatic control and co-regulation of physiological states. Third, affective touch such as gentle stroking or tickling regulates affect by allostatic regulation of the salience and epistemic gain of particular experiences in given contexts and timescales. These three functions of affective touch are most likely mediated, at least partly, by different neurobiological processes, including convergent hedonic, dopaminergic and analgesic, opioidergic pathways for the attachment function, 'calming' autonomic and endocrine pathways for the homeostatic function, while the allostatic function may be mediated by oxytocin release and related 'salience' neuromodulators and circuits.

Pleasantness ratings in response to affective touch across hairy and glabrous skin: A meta-analysis

The processing of hedonic aspects of touch, namely affective touch, is associated with the activation of C-Tactile (CT) fibers. CTs were thought to be present only in hairy skin, with glabrous skin being often used as control site in affective touch studies. Nevertheless, several articles comparing pleasantness perception across hairy and glabrous skin reported no significant differences. Surprisingly, CT fibers have also been recently detected on the glabrous palm, further questioning whether affective touch perception across both hairy and glabrous skin is comparable. The present meta-analysis thus aimed to quantify pleasantness perception of affective tactile stimulations on both hairy and glabrous sites. Pooled effect sizes (Hedges' g) from 18 studies were analyzed using random effect models. No systematic preference towards affective stimulations on hairy or glabrous skin was observed. Moreover, studies were highly heterogeneous, suggesting high variance in the results of the retrieved articles. Results were not affected by publication bias nor by other moderators. Variables affecting affective touch perception on hairy and glabrous skin and methodological considerations were discussed.

Social touch deprivation during COVID-19: effects on psychological wellbeing and craving interpersonal touch

Social touch has positive effects on social affiliation and stress alleviation. However, its ubiquitous presence in human life does not allow the study of social touch deprivation 'in the wild'. Nevertheless, COVID-19-related restrictions such as social distancing allowed the systematic study of the degree to which social distancing affects tactile experiences and mental health. In this study, 1746 participants completed an online survey to examine intimate, friendly and professional touch experiences during COVID-19-related restrictions, their impact on mental health and the extent to which touch deprivation results in craving touch. We found that intimate touch deprivation during COVID-19-related restrictions is associated with higher anxiety and greater loneliness even though this type of touch is still the most experienced during the pandemic. Moreover, intimate touch is reported as the type of touch most craved during this period, thus being more prominent as the days practising social distancing increase. However, our results also show that the degree to which individuals crave touch during this period depends on individual differences in attachment style: the more anxiously attached, the more touch is craved; with the reverse pattern for avoidantly attached. These findings point to the important role of interpersonal and particularly intimate touch in times of distress and uncertainty.

Thin Films on the Skin, but not Frictional Agents, Attenuate the Percept of Pleasantness to Brushed Stimuli

Brushed stimuli are perceived as pleasant when stroked lightly on the skin surface of a touch receiver at certain velocities. While the relationship between brush velocity and pleasantness has been widely replicated, we do not understand how resultant skin movements - e.g., lateral stretch, stick-slip, normal indentation - drive us to form such judgments. In a series of psychophysical experiments, this work modulates skin movements by varying stimulus stiffness and employing various treatments. The stimuli include brushes of three levels of stiffness and an ungloved human finger. The skin's friction is modulated via non-hazardous chemicals and washing protocols, and the skin's thickness and lateral movement are modulated by thin sheets of adhesive film. The stimuli are hand-brushed at controlled forces and velocities. Human participants report perceived pleasantness per trial using ratio scaling. The results indicate that a brush's stiffness influenced pleasantness more than any skin treatment. Surprisingly, varying the skin's friction did not affect pleasantness. However, the application of a thin elastic film modulated pleasantness. Such barriers, though elastic and only 40 microns thick, inhibit the skin's tangential movement and disperse normal force. The finding that thin films modulate affective interactions has implications for wearable sensors and actuation devices.

The Challenges and Perspectives of the Integration Between Virtual and Augmented Reality and Manual Therapies

Virtual reality (VR) and augmented reality (AR) have been combined with physical rehabilitation and psychological treatments to improve patients' emotional reactions, body image, and physical function. Nonetheless, no detailed investigation assessed the relationship between VR or AR manual therapies (MTs), which are touch-based approaches that involve the manipulation of tissues for relieving pain and improving balance, postural stability and well-being in several pathological conditions. The present review attempts to explore whether and how VR and AR might be integrated with MTs to improve patient care, with particular attention to balance and to fields like chronic pain that need an approach that engages both mind and body. MTs rely essentially on touch to induce tactile, proprioceptive, and interoceptive stimulations, whereas VR and AR rely mainly on visual, auditory, and proprioceptive stimulations. MTs might increase patients' overall immersion in the virtual experience by inducing parasympathetic tone and relaxing the mind, thus enhancing VR and AR effects. VR and AR could help manual therapists overcome patients' negative beliefs about pain, address pain-related emotional issues, and educate them about functional posture and movements. VR and AR could also engage and change the sensorimotor neural maps that the brain uses to cope with environmental stressors. Hence, combining MTs with VR and AR could define a whole mind-body intervention that uses psychological, interoceptive, and exteroceptive stimulations for rebalancing sensorimotor integration, distorted perceptions, including visual, and body images. Regarding the technology needed to integrate VR and AR with MTs, head-mounted displays could be the most suitable devices due to being low-cost, also allowing patients to follow VR therapy at home. There is enough evidence to argue that integrating MTs with VR and AR could help manual therapists offer patients better and comprehensive treatments. However, therapists need valid tools to identify which patients would benefit from VR and AR to avoid potential adverse effects, and both therapists and patients have to be involved in the development of VR and AR applications to define truly patient-centered therapies. Furthermore, future studies should assess whether the integration between MTs and VR or AR is practically feasible, safe, and clinically useful.

The inside of me: interoceptive constraints on the concept of self in neuroscience and clinical psychology

Humans are unique in their ability to think about themselves and carry a more or less clear notion of who they are in their mind. Here we review recent evidence suggesting that the birth, maintenance, and loss of the abstract concept of 'self' is deeply tied to interoception, the sense of internal physiological signals. Interoception influences multiple facets of the self-concept, cutting across its material, social, moral, and agentive components. Overall, we argue that interoception contributes to the stability of the self-concept over time, unifying its layers and constraining the degree to which it is susceptible to external influences. Hence, the core features of the self-concept are those that correlate more with inner bodily states. We discuss the implications that this may have for theories of embodied cognition as well as for the understanding of psychiatric disorders in which the concept of self appears fragmented or loose. Finally, we formulate some empirical predictions that could be tested in future studies to shed further light on this emerging field.

Strengths and weaknesses of affective touch studies over the lifetime: A systematic review

C-Tactile (CT) fibers are activated by slow, caress-like stimulations, and convey a specific tactile processing of hedonic and interpersonal components, defined as affective touch. Given the beneficial effects deriving from affective tactile experiences in social interactions at all ages, a systematic review of experimental studies on affective touch perception across the lifespan was performed with the aims of 1) examining whether and how affective touch has been studied in a systematic manner throughout the lifespan; 2) verifying whether the pleasantness associated to affective stimulations is found during the entire lifespan. Empirical human studies on affective touch were searched in two databases (PubMed, PsychINFO) and 112 articles were retrieved. Results indicated that most of the studies recruited participants with a mean age ranging from 18 to 40 years, whereas other age ranges came out as under-represented or not represented at all. Despite high heterogeneity across studies, affective touch was considered as a pleasant experience across the lifetime, and it was associated to specific psychophysiological patterns in infants and adults.

Bliss in and Out of the Body: The (Extra)Corporeal Space Is Impervious to Social Pleasant Touch

Slow, gentle stimulation of hairy skin is generally accompanied by hedonic sensations. This phenomenon, also known as (positive) affective touch, is likely to be the basis of affiliative interactions with conspecifics by promoting inter-individual bindings. Previous studies on healthy humans have demonstrated that affective touch can remarkably impact behavior. For instance, by administering the Rubber Hand Illusion (RHI) paradigm, the embodiment of a fake hand enhances after a slow, affective touch compared to a fast, neutral touch. However, results coming from this area are not univocal. In addition, there are no clues in the existing literature on the relationship between affective touch and the space around our body. To overcome these lacks, we carried out two separate experiments where participants underwent a RHI paradigm (Experiment 1) and a Visuo-Tactile Interaction task (Experiment 2), designed to tap into body representation and peripersonal space processing, respectively. In both experiments, an affective touch (CT-optimal, 3 cm/s) and neutral touch (CT-suboptimal, 18 cm/s) were delivered by the experimenter on the dorsal side of participants’ hand through a “skin to skin” contact. In Experiment 1, we did not find any modulation of body representation—not at behavioral nor at a physiological level—by affective touch. In Experiment 2, no visuo-tactile spatial modulation emerged depending upon the pleasantness of the touch received. These null findings are interpreted in the light of the current scientific context where the real nature of affective touch is often misguided, and they offer the possibility to pave the way for understanding the real effects of affective touch on body/space representation.

Childhood Adversity and Affective Touch Perception: A Comparison of United Kingdom Care Leavers and Non-care Leavers

In the United Kingdom, the most common reasons for a child to come under the care of social services are neglect and abuse. Such early childhood adversity is a risk factor for social-isolation and poor mental health in adulthood. Touch is a key channel for nurturing interactions, and previous studies have shown links between early somatosensory input, experience dependent neural plasticity, and later life emotional functioning. The aim of the present study was to test the relationship between childhood neglect/abuse and later life experiences, attitudes, and hedonic ratings of affective touch. Here, affective touch is defined as low force, dynamic touch which C-Tactile afferents (CTs) respond optimally to. We hypothesized that a childhood lacking in early nurturing tactile stimulation would be associated with reduced sensitivity to socially relevant affective touch in adulthood. To test this, 19 care leavers (average 9.32 ± 3.70 years in foster care) and 32 non-care leavers were recruited through opportunity sampling (mean age = 21.25 ± 1.74 years). Participants completed a range of psychophysical somatosensory tests. First, they rated the pleasantness of CT-optimal (3 cm/s) and non-CT-optimal (0.3 and 30 cm/s) stroking touch applied to their forearm, both robotically and by an experimenter. They also made vicarious ratings of the anticipated pleasantness of social tactile interactions depicted in a series of videos. Finally, they filled in the Childhood Trauma Questionnaire (CTQ) and the Touch Experiences and Attitudes Questionnaire (TEAQ). As expected, care leavers reported significantly higher levels of childhood trauma than the control group. They also reported significantly lower levels of positive childhood touch compared to non-care leavers, but their attitudes and experiences of current intimate and affiliative touch did not differ. Across all psychophysical tests, care leavers showed specific reduction in sensitivity to the affective value of CT targeted 3 cm/s touch. The results of this study support the hypothesis that a lack of nurturing touch in early developmental periods leads to blunted sensitivity to the specific social value of affective touch. Future research should investigate the neural and physiological mechanisms underlying the observed effect.

Calming Effects of Touch in Human, Animal, and Robotic Interaction-Scientific State-of-the-Art and Technical Advances

Small everyday gestures such as a tap on the shoulder can affect the way humans feel and act. Touch can have a calming effect and alter the way stress is handled, thereby promoting mental and physical health. Due to current technical advances and the growing role of intelligent robots in households and healthcare, recent research also addressed the potential of robotic touch for stress reduction. In addition, touch by non-human agents such as animals or inanimate objects may have a calming effect. This conceptual article will review a selection of the most relevant studies reporting the physiological, hormonal, neural, and subjective effects of touch on stress, arousal, and negative affect. Robotic systems capable of non-social touch will be assessed together with control strategies and sensor technologies. Parallels and differences of human-to-human touch and human-to-non-human touch will be discussed. We propose that, under appropriate conditions, touch can act as (social) signal for safety, even when the interaction partner is an animal or a machine. We will also outline potential directions for future research and clinical relevance. Thereby, this review can provide a foundation for further investigations into the beneficial contribution of touch by different agents to regulate negative affect and arousal in humans.

Affective touch experiences across the lifespan: Development of the Tactile Biography questionnaire and the mediating role of attachment style

The sense of touch develops early in life and becomes a determinant aspect of our personal narratives, providing crucial information about the world around us and playing a prominent role in affective and social interactions. In this study we aimed to explore whether individual differences in touch experiences across the lifespan are related to adult attachment styles and to perceived touch deprivation. For this we first developed an instrument, namely the Tactile Biography, to quantify individual differences in affective touch experiences throughout life. Secondly, we performed a set of regressions models and a mediation analysis to investigate the role of attachment in relation to both the tactile history and perceived touch deprivation. We found that experiences of affective touch during childhood and adolescence seem to be closely associated with adult attachment styles and adult social touch experiences. Avoidant attachment appears to serve as a mediator in the relationship between earlier (childhood/adolescent) and later (adult) affective touch experiences, as well as between earlier affective touch experiences and perceived touch deprivation. These findings offer further support to existing literature, providing novel insights for the fields of social affective touch and attachment research.

The Anticipation and Perception of Affective Touch in Women with and Recovered from Anorexia Nervosa

Disruptions in reward processing and anhedonia have long been observed in Anorexia Nervosa (AN). Interoceptive deficits have also been observed in AN, including reduced tactile pleasure. However, the extent to which this tactile anhedonia is specifically liked to an impairment in a specialised, interoceptive C-tactile system originating at the periphery, or a more top-down mechanism in the processing of tactile pleasantness remains debated. Here, we investigated differences between patients with and recovered from AN (RAN) and healthy controls (HC) in the perception of pleasantness of touch delivered in a CT-optimal versus a CT-non-optimal manner, and in their top-down, anticipatory beliefs about the perceived pleasantness of touch. To this end, we measured the anticipated pleasantness of various materials touching the skin and the perceived pleasantness of light, dynamic touch applied to the forearm of 27 women with AN, 24 women who have recovered and 30 HCs using C Tactile (CT) afferents-optimal (slow) and non-optimal (fast) velocities. Our results showed that both clinical groups anticipated tactile experiences and rated delivered tactile stimuli as less pleasant than HCs, but the latter difference was not related to the CT optimality of the stimulation. Instead, differences in the perception of CT-optimal touch were predicted by differences in top-down beliefs, alexithymia and interoceptive sensibility. Thus, tactile anhedonia in AN might persist as a trait even after otherwise successful recovery of AN and it is not linked to a bottom-up interoceptive deficit in the CT system, but rather to a learned, defective top-down anticipation of tactile pleasantness.

Standardized massage interventions as protocols for the induction of psychophysiological relaxation in the laboratory: a block randomized, controlled trial

Health and disease are strongly linked to psychophysiological states. While stress research strongly benefits from standardized stressors, no established protocol focuses on the induction of psychophysiological relaxation. To maintain health, functioning regenerative systems are however likely as important as functioning stress systems. Thus, the identification of validated relaxation paradigms is needed. Here, we investigated whether standardized massages are capable of reliably inducing physiological and psychological states of relaxation. Relaxation was indicated by changes in high frequency heart rate variability (HF-HRV), a vagally-mediated heart rate variability component, and repeated ratings of subjective relaxation, and stress levels. Sixty healthy women were randomly assigned to a vagus nerve massage (n = 19), a soft shoulder massage (n = 22), or a resting control group (n = 19). During the intervention, HF-HRV and subjective relaxation increased, while subjective stress decreased significantly in all groups. Both massage interventions elicited significantly higher HF-HRV compared to the control group. Accordingly, both massage protocols increased psychophysiological relaxation, and may serve as useful tools in future research. However, future work will have to determine which of several protocols might be used as a gold standard to induce a psychophysiological state of relaxation in the laboratory.

Pleasantness Only?

Abstract. When gently stroked with velocities between 0.1 and 30 cm/s, participants typically rate velocities around 3 cm/s as most pleasant, and the ratings follow an inverted u-shape. This pleasantness curve correlates often, but not always, with the firing rate of unmyelinated C-tactile (CT) afferents, leading to the notion that CT afferents code for the hedonic or emotional aspect of gentle touch. However, there is also evidence that CT firing does not necessarily equal pleasantness, and the range of attributes that CT afferents code for is not known. Here, participants were stroked with different velocities assumed to activate CT afferents to a different extent while they rated the touch on several sensory and emotional attributes. We expected an inverted u-shaped rating curve for pleasantness and other emotional attributes, but not for sensory attributes. Inverted u-shaped rating patterns were found for the emotional attributes “pleasant” and “not burdensome,” but also for the sensory attribute “rough.” CT-directed stimulation is thus not only experienced as hedonic. The sensations arising from CTs together with all other types of mechanoreceptors might be centrally integrated into a percept that represents those aspects which are most salient for the stimulation at hand.

Individual Variability of Pleasantness Ratings to Stroking Touch Over Different Velocities

Many studies have investigated the perception of tactile pleasantness over a range of stroking velocities. On average, pleasantness is low at slow (e.g. 0.3 cm/s) and fast (e.g. 30 cm/s) stroking velocities, but is rated highest at velocities between 1 and 10 cm/s. On a group level, this results in an inverted-U shape pleasantness ratings curve, which is described statistically by a negative quadratic equation. We reanalyzed the data from five earlier studies to investigate whether the inverted-U shape pleasantness curve at the group level is also present at the level of the individual, - a precondition for using tactile pleasantness perception as a diagnostic marker. We pooled the data from five studies with a total of 127 participants. Each study included a 'standard condition' of stroking on the dorsal forearm over different velocities (0.3, 1, 3, 10, 30 cm/s) and participants rated the pleasantness. Factors other than stroking velocity were also varied in these studies. On the whole-group level and in each study, pleasantness ratings produced a significant negative quadratic pleasantness curve over the stroking velocities. In individual participants, ratings varied greatly and only 42% of the participants showed a significant negative quadratic curve. The steepness of the inverted-U correlated only moderately across other experimental conditions, showing that the experimental circumstances can influence pleasantness ratings. Our findings have important implications for future work, where differences in the tactile pleasantness curve should not be used to predict or diagnose issues at an individual level.

Applications, indications, and effects of passive hydrotherapy WATSU (WaterShiatsu)-A systematic review and meta-analysis

Background

WATSU (portmanteau word: water and shiatsu) is a form of passive hydrotherapy in chest-deep thermoneutral water (35°C = 95°F = 308.15 K). It combines elements of myofascial stretching, joint mobilization, massage, and shiatsu and is reported to be used to address physical and mental issues. The objective of this systematic review (PROSPERO Registration No. CRD42016029347) and the meta-analyses was to assess the applications, indications, and the effects of WATSU to form a basis for further studies.

Methods

A search for “WATSU OR watershiatsu OR (water AND shiatsu)” was conducted without any restrictions in 32 databases. Peer reviewed original articles addressing WATSU as a stand-alone hydrotherapy were assessed for risk of bias. Quantitative data of effects on pain, physical function, and mental issues were processed in random model meta-analyses with subgroup analyses by study design. Effect sizes were expressed as Hedges's g (± 95% confidence intervals).

Results

Of 1,906 unique citations, 27 articles regardless of study design were assessed for risk of bias. WATSU has been applied to individuals of all ages. Indications covered acute (e.g. pregnancy related low back pain) and chronic conditions (e.g. cerebral palsy) with beneficial effects of WATSU regarding e.g. relaxation or sleep quality. Meta-analyses suggest beneficial effect sizes of WATSU on pain (overall Hedges’s g = -0.71, 95% CI = -0.91 to -0.51), physical function (overall Hedges’s g = -0.76, 95% CI = -1.08 to -0.44), and mental issues (overall Hedges’s g = -0.68, 95% CI = -1.02 to -0.35).

Conclusion

Various applications, indications and beneficial effects of WATSU were identified. The grade of this evidence is estimated to be low to moderate at the best. To strengthen the findings of this study, high-quality RCTs are needed.

The body comes first. Embodied reparation and the co-creation of infant bodily-self

During infancy relational experiences of body-to-body exchanges (i.e., embodied interactions) contribute to the infant's bodily perception. Early embodied interactions are based on countless multimodal reciprocal exchanges, in which mother and infant contribute to interpersonal rhythmic cycles of co-regulation (i.e., attunement). However, it remains unclear how infants and their mothers actually accomplish attunement in their exchanges. Interactions between mothers and their infants typically fluctuate between attuned and misattuned states and recovery attunement states by a process called 'reparation'. Here, we discuss recent neuroscientific evidence that provides insight into the mechanisms underpinning the concepts of attunement and misattunement in early embodied interactions. We propose that a process of embodied reparation might be achieved within the dyad through tactile contact behaviors (e.g., skin-to-skin, affectionate touch) and maternal interoceptive sensitivity (i.e., ability to perceive internal input about the state of one's own body). We describe how these elements that mothers provide during embodied interactions with their infants, might contribute not only to bodily attunement, but also to co-create the infant bodily-self.