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

Psychometric evaluation of the Social Touch Questionnaire in Chinese adolescents

Social touch promotes psychological well-being through inducing positive effects on social affiliation and stress alleviation, especially in adolescence. However, there is a scarcity of instruments available for evaluating adolescents' attitude toward social touch in China. The present study aimed to investigate the validity and reliability of the Social Touch Questionnaire (STQ) in Chinese adolescents. A total of 2839 high school students were enrolled, ranging in age from 11 to 19 years. The dimensions of the scale were conducted by exploratory factor analysis, and validated by confirmatory factor analysis. A three-factor model showed the best fit and consisted of the following subgroups: liking of informal social touch, liking of general social touch, and dislike of social touch. Furthermore, positive associations were found between social touch and interaction anxiety, fear of negative evaluation, depressive and anxiety symptoms, and sleep quality. Short-term prediction of dislike of social touch in anxiety symptoms was determined, while no significant predictor of depressive symptoms was found. The STQ demonstrates reliability and validity as a self-report questionnaire designed to assess behaviors and attitudes toward social touch. It effectively adapts to the nuances of the Chinese context among adolescents.

Development and validation of the Social Touch Experiences and Attitudes Questionnaire-Chinese version (STEAQ-C): How interpersonal touch relates to subclinical traits and symptoms

Social touch has a vital role in human development and psychological well-being. However, there is a lack of measures assessing individual differences in social touch experiences and attitudes, especially under Eastern cultures. This study developed the Social Touch Experiences and Attitudes Questionnaire - Chinese version (STEAQ-C) and examined its psychometric properties with healthy young Chinese adults. In Study 1, an item pool was generated and principal component analysis (PCA) was used to identify the factor structure of the STEAQ. Study 2 recruited an independent sample and examined its reliability and validity. Network analysis further explored the interrelations between social touch and a variety of subclinical traits and symptoms. PCA identified four factors of the STEAQ-C, relating to childhood touch experiences, current touch with intimate partners, with family and friends, and with unfamiliar people. Study 2 confirmed the four-factor structure and upheld its internal consistency and stability. Positive attitudes towards and greater experiences of social touch were negatively correlated with sensory over-responsiveness and sensory hyposensitivity, as well as childhood trauma particularly emotional neglect, supporting the convergent validity. Evidence of criterion-related validity was accrued via its concurrent and predictive associations with secure attachment style, higher levels of social competence, and lower levels of social anxiety. Network analysis highlighted altered perception of social touch may be a shared feature for psychiatric conditions with social dysfunctions (e.g., autism, social anxiety and negative schizotypy). The newly-developed STEAQ-C may be a timely tool in assessing social touch experiences and attitudes under Eastern cultures.

The Hedonic Experience Associated with a Gentle Touch Is Preserved in Women with Fibromyalgia

Background/Objectives: Although manual therapies can be used for pain alleviation in fibromyalgia, there is no clear evidence about the processing of gentle, affective touch in this clinical condition. In fact, persistent painful sensations and psychological factors may impact the hedonic experience of touch. Methods: This observational cross-sectional study compared the subjective experience of affective touch between 14 women with fibromyalgia (age range: 35-70; range of years of education: 5-13) and 14 pain-free women (age range: 18-30; range of years of education: 13-19). The participants rated the pleasantness of slow and fast touches delivered by a brush, the experimenter's hand, and a plastic stick. Tactile stimuli were either imagined or real to disentangle the contribution of top-down and bottom-up sensory components. Additionally, a self-report questionnaire explored the lifetime experiences of affective touch. Results: Akin to healthy counterparts, individuals with fibromyalgia rated slow touches delivered by the experimenter's hand or a brush as more pleasant than fast touches, regardless of whether they were imagined or real. However, the intensity of pain affects only the imagined pleasantness in our participants with fibromyalgia. Furthermore, despite the fibromyalgia patients reporting fewer experiences of affective touch in childhood and adolescence, this evidence was not associated with the experimental outcomes. Conclusions: The hedonic experience of affective touch seems preserved in fibromyalgia despite poor intimate bodily contact in youth. We confirmed that bottom-up and top-down factors contribute to the affective touch perception in fibromyalgia: bodily pain may impact even more the expected pleasure than the actual experience. Future investigations may introduce neurophysiological measures of the implicit autonomic responses to affective touch in fibromyalgia. To conclude, although preliminary, our evidence may be in favor of manual therapies for pain relief in fibromyalgia.

The meaning of touch: Relational and individual variables shape emotions and intentions associated with imagined social touch

Touch is a key channel for conveying meaning in social interactions. The affective quality of touch and its effects on well-being are shaped by relational context (relationship between touch giver vs. recipient) and person variables (e.g. adult attachment style). Yet, such effects have not been explored in relation to the meaning ascribed to touch. We used data from the Touch Test, the world's largest touch survey, which included questions on the degree to which people felt and related specific emotions and intentions to imagined gentle stroking touch and hugs. In N = 23,428, we examined how relational context (imagined source of touch) and person variables (gender, recalled positive childhood touch and adult attachment style) were associated with positive (e.g. love, desire, support) and negative (e.g. fear, anger, warning) emotions and intentions related to imagined touch. Love, desire and support were endorsed more when participants had had their partner (vs. someone else) in mind, and women (vs. men) gave lower ratings for desire overall. Gentle stroking touch was most linked with arousal when participants had had their partner in mind. Further, more positive childhood touch and secure and anxious attachment scores were associated with more positive emotions and intentions, while the opposite was found for avoidant attachment scores. Lastly, positive childhood touch and higher anxious attachment scores were related to greater discrimination between distinct emotion and intention categories, while higher attachment avoidance was associated with reduced discriminability. Thus, contextual and person variables matter in shaping the meaning of social touch.

Stroking in early mother-infant exchanges: The role of maternal tactile biography and interoceptive sensibility

Caress-like is a crucial component of caregiving and a key factor in mother-infant interactions. Mother's experience of touch during her own childhood (i.e., tactile biography) has been found to be related to maternal actual use of caress-like touch (i.e., stroking) during mother-infant exchanges. Evidence also suggests that maternal interoceptive sensibility (i.e., self-perceived sensitivity to inner-body sensations) might be related to sensitive caregiving abilities. However, further empirical investigation is needed to understand to what extent tactile biography and interoceptive sensibility have an impact on mothers' stroking when interacting with their infants. Using an online survey, this cross-sectional study explored the potential association between maternal tactile biography, interoceptive sensibility and use of touch for interaction with their own infants in a group of 377 Italian mothers (mean age = 33.29; SD = 4.79). We tested and compared a series of multivariate linear mediation models using maternal tactile biography as predictor, maternal use of affective touch as outcome variable and Multidimensional Assessment of Interoceptive Awareness (MAIA) subscale scores as mediators. We found that, if a mother had positive touch experiences in her own childhood, she may be more likely to use touch in a positive and nurturing way with her own infant (i.e., stroking). Furthermore, mothers' interoceptive sensibility in the form of attention regulation, self-regulation and body listening mediates the association between their past experiences of positive touch and their use of caress-like touch in mother-infant exchanges. This study highlights that maternal tactile biography is directly associated with mothers' use of caress-like touch and indirectly linked to it through the mediating role of interoceptive sensibility.

Reliability and validity of a simplified touch experiences and attitudes questionnaire for Chinese college students

Touch cultures have both differences and commonalities in different regions. The Touch Experiences and Attitudes Questionnaire (TEAQ) is a widely applicable self-report tool. The purpose of our research was to examine the validity and reliability of the Chinese version of TEAQ for Chinese college students. We translated the 57 items of the original TEAQ into Chinese and assessed its cultural and linguistic adaptation in Chinese context. Two samples were recruited for the assessment of validity and reliability. The Social Support Rating Scale, Index of Well-being Scale and Security Questionnaire were chosen as criterion-related validity indicators. Item analysis, principal component analysis and confirmatory factor analysis indicated that the simplified Chinese version of TEAQ contained 18 items in three factors: Attitude to Intimate Touch, Childhood Touch and Current Positive Touch, with a cumulative variance contribution rate of 57.12%. The 3-factor model had good validity and reliability. The TEAQ was positively correlated with social support, sense of security and well-being. There were demographic differences in sex and left-behind experience. We anticipate the simplified TEAQ will be a valuable tool for the research of touch among Chinese college students.

Autistic Traits Related to the Importance of Interpersonal Touch and Appreciation of Observed Touch during COVID-19 Social Distancing

Studies have confirmed the significance of touch for psychological wellbeing. Social distancing regulations during the COVID-19 pandemic reduced people's ability to engage in interpersonal touch and caused increased an appreciation for observed touch, as well as a longing for touch within the neurotypical population. Yet, while the impact of social distancing and the importance of touch are evident in neurotypical individuals, it remains unclear how these factors manifest in autistic individuals. Previous research has related high levels of autistic traits to reduced levels of perceived pleasantness of touch and a reduced interest in interpersonal touch. Our study aimed to examine the differences in the appreciation of observed touch and longing for touch during social distancing between individuals with low and high levels of autistic traits. We conducted an online survey on autistic traits, the appreciation of observed CT-optimal touch and longing for touch. Consistent with our predictions, our results confirmed that individuals with high levels of autistic traits evaluated videos depicting CT-optimal touch less favorably compared to those with lower scores on autistic traits. Additionally, only the group with low levels of autistic traits exhibited a longing for touch during social distancing, whereas the group with high levels of autistic traits did not. The results provide insights in the appreciation of touch in relation to autistic traits during the unique circumstances of the COVID-19 pandemic.

The perception of affective touch in women affected by obesity

Introduction

Pleasant and comforting bodily contacts characterized intimate and affective interactions. Affective touch informs us about others' emotions and intentions, sustains intimacy and closeness, protecting from loneliness and psychological distress. Previous evidence points to an altered experience of affective touch in clinical populations reporting interpersonal difficulties. However, there is no investigation of affective touch in obesity, which is often associated with negative affective-relational experiences since childhood.

Methods

This study aimed to provide the first evidence about the experience of affective touch in obesity by comparing 14 women with obesity with 14 women with healthy weight. Participants rated the pleasantness of both imagined and actual tactile stimuli, which consisted of (i) soft-brush strokes, (ii) touches of the experimenter's hand, and (iii) of a plastic stick (as control, non-affective, stimulation). Participants should report the pleasantness of each kind of touch. Moreover, we explored lifespan experiences of affective touch and interpersonal pleasure in social contexts through self-report questionnaires.

Results

No differences emerged for the pleasantness of affective touch (in both the real and imagery task) between the two groups. However, participants with obesity reported less frequent and less satisfying early experiences of affective touch when compared with the controls.

Discussion

Our results spoke in favor of a preserved experience of affective touch when experimentally probed in obesity, despite a limited early exposure to bodily affective contacts. We interpreted our results in the light of the social reconnection hypothesis. Nevertheless, we provided crucial methodological considerations for future research, considering that both the experimenter's and the brush touch may not resemble adequately real-life experiences, in which affective touch involves intimate people.

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.

Exploring maternal touch in the infant's first 18 months of Life: A study on an Italian sample

Affective touch is a crucial component of caregiving in early life and constitutes a key factor with a significant impact on infant later-life outcomes. The Parent-Infant Caregiving Touch Scale (PICTS) allows to quantify and qualify the caregiver's self-perception of touch in the first months of an infant's life. In the current study, we contributed to validation of the PICTS in the Italian language in order to explore whether early maternal touch would be associated with maternal emotional state, maternal history of affective touch experiences throughout the lifespan, and infants' sex and age. Data analyses were run on a sample of 377 Italian mothers (mean age = 33.29; SD = 4.79) participating in an online survey. Confirmatory factor analysis was applied. A three-dimensional structure of PICTS (i.e., stroking, affective communication, and holding) after removing one item out resulted in the best model in our sample. Maternal emotional state did not affect PICTS factor scores while maternal comfort and amount of affective touch experienced during adulthood was significantly associated with the stroking, affective communication, and holding factors. Regarding infants' dimensions, infants' sex and age were not associated with PICTS factor scores. Findings suggest that the PICTS Italian version is a good measurement of caregiver's self-perception of touch in early infancy and that maternal history of touch is associated with a mother's current use of touch.

The perception of affective and discriminative touch in blind individuals

Enhanced tactile acuity in blindness is among the most widely reported results of neuroplasticity following prolonged visual deprivation. However, tactile submodalities other than discriminative touch are profoundly understudied in blind individuals. Here, we examined the influence of blindness on two tactile submodalities, affective and discriminative touch, the former being vital for social functioning and emotional processing. We tested 36 blind individuals and 36 age- and sex-matched sighted volunteers. In Experiment 1, we measured the perception of affective tactile signals by asking participants to rate the pleasantness of touch delivered on the palm (nonhairy skin, sparsely innervated with C tactile [CT] fibers) or the forearm (hairy skin, densely innervated with CT fibers) in a CT-optimal versus a CT-nonoptimal manner using a paradigm grounded in studies on tactile sensory neurophysiology. In Experiment 2, we implemented a classic task assessing discriminative touch abilities, the grating orientation task. We found that blind individuals rated the touch as more pleasant when delivered on the palm than on the forearm, while the opposite pattern was observed for sighted participants, who rated stimulation on the forearm as more pleasant than stimulation on the palm. We also replicated the previous findings showing enhanced discriminative tactile acuity in blind individuals. Altogether, our results suggest that blind individuals might experience affective touch differently than sighted individuals, with relatively greater pleasantness perceived on the palm. These results provide a broader insight into somatosensory perception in blind individuals, for the first time taking into consideration the socioemotional aspect of touch.

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.

Velocity-tuning of somatosensory EEG predicts the pleasantness of gentle caress

Numerous studies have established an inverted u-shaped effect between the velocity of a caress and its pleasantness and linked this effect to the C-tactile (CT) system considered central for physical and mental health. This study probed whether cortical somatosensory representations predict and explain the inverted u-shaped effect and addressed associated individual differences. Study participants (N = 90) rated the pleasantness of stroking at varying velocities while their electroencephalogram was being recorded. An analysis across all participants replicated a preference for intermediate velocities, while a cluster analysis discriminated individuals who preferred slow (N = 43) from those who preferred fast stroking (N = 47). In both groups, intermediate velocities maximized amplitudes of a somatosensory event-related potential referred to as sN400, in line with the average rating effect. By contrast, group differences emerged in how velocity modulated a late positive potential (LPP) and Rolandic power. Notably, both the sN400 and the velocity-tuning of LPP and Rolandic power predicted the participants' pleasantness ratings. Participants were more likely to prefer slow over fast stroking the better their LPP and Rolandic power differentiated between different velocities. Together, these results shed light on the complexity of tactile affect. They corroborate an average preference for intermediate velocities that relates to largely shared effects of CT-targeted touch on the activity of somatosensory cortex. Additionally, they identify individual differences as a function of how accurately somatosensory cortex represents the velocity of peripheral input and suggest these differences are relevant for the extent to which individuals pursue beneficial, CT-targeted touch.

Modeling affective touch pleasantness across skin types at the individual level reveals a reliable and stable basic function

Touch is perceived most pleasant when delivered at velocities known to optimally activate the C-tactile afferent system. At the group level, pleasantness ratings of touch delivered at velocities in the range between 0.3 and 30 cm/s follow an inverted-U shape curve, with maximum pleasantness between 1 and 10 cm/s. However, the prevalence, reliability, and stability of this function at the individual level and across skin types based on hair density remains unknown. Here, we tested a range of seven velocities (0.3, 1, 3, 6, 9, 18, and 27 cm/s) delivered with a soft brush, on both hairy (forearm and dorsal hand) and nonhairy skin (palm) in 123 participants. Our results suggest that the relationship between pleasantness and velocity of touch is significantly best described by a negative quadratic model at the individual level in the majority of participants both on hairy (67.1%) and nonhairy (62.6%) skin, a larger extent than previously reported. Higher interoceptive accuracy and self-reported depression were related to a better fit of the quadratic model and the steepness of the curve, respectively. The prevalence of the quadratic model at the individual level was stable across body sites (62.6%, experiment 1), across two experimental sessions (73%-78%, experiment 2), and regardless of the number of repetitions of each velocity (experiment 3). Thus, the individual perception of tactile pleasantness follows a characteristic velocity-dependent function across skin types and shows trait characteristics. Future studies can investigate further the possibility to use affective touch as a behavioral biomarker for mental health disorders.NEW & NOTEWORTHY Touch is perceived as most pleasant when delivered at slow, caress-like velocities, known to activate C-tactile afferents. At the group level, tactile pleasantness and velocity of touch show a reliable pattern of relationship on hairy skin. Here, we found that the perception of tactile pleasantness follows a consistent pattern also at the individual level, across skin types and testing sessions. However, individual differences in interoceptive abilities and self-reported depression do play a role.

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.

Tactile Biography Questionnaire: A contribution to its validation in an Italian sample

As the interest in the beneficial effects of positive touch experiences is rapidly growing, having reliable and valid tools to its assessment is essential. The Tactile Biography Questionnaire (TBQ) allows to quantify individual differences in affective touch experiences throughout life. The aim of this article is to present a contribution to its validation in the Italian population. Data analysis were run on a sample of 2040 Italian individuals (Females = 1342, 64%) participating in an on-line survey. Confirmatory Factor Analysis and invariance analyses for gender were applied. Concurrent validity was checked using two specific subscales of the Touch Avoidance Questionnaire (TAQ—i.e., Family and Stranger). The four-dimensional structure of the TBQ was confirmed in the overall sample and by gender. Also, the TBQ showed an excellent internal consistency and a good concurrent validity with TAQ. The present study suggests that the TBQ can be used to support healthcare professionals and researchers to assess experiences of affective touch in different settings.

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.

Application areas and effects of aquatic therapy WATSU - A survey among practitioners

INTRODUCTION

WATSU (WaterShiatsu) is a treatment administered in warm water. The present study investigated if and how frequently scientifically studied application areas and effects of WATSU occur in practice, whether similar effectiveness of WATSU is observed in trials and practice, and whether practitioners can contribute additional application areas and effects of WATSU.

METHODS

Application areas and effects of WATSU reported in a recent systematic review were extracted verbatim to be assessed in a worldwide multilingual cross section online survey, generating quantitative and qualitative data. A pre-test and retest were conducted to ensure quality and evaluate the questionnaire's psychometric properties.

RESULTS

Answers of 191 respondents were processed. All proposed 26 application areas and 20 effects were confirmed, each with relatively high ratings of observed effectiveness of WATSU. WATSU was frequently applied in healthy individuals (including during pregnancy), and individuals in various pain- (e.g., low back pain, neck pain, myofascial pain, fibromyalgia) and stress-related (e.g., stress, depression, sleep disorders, fatigue, anxiety disorders) conditions. Frequently confirmed effects were physical relaxation, relief of physical tension, pain relief, increased mobility and flexibility, improved quality of life, spiritual experiences, and increased psychological health. Respondents contributed 73 additional application areas and effects (both, mental and physical) of WATSU.

CONCLUSIONS

Application areas and effects of WATSU are consistently employed practically and scientifically. Respondents' ratings of effectiveness of WATSU match tentative research efforts. WATSU is cautiously recommended for the use in pain- and stress-related conditions. Short- and long-term effectiveness of WATSU need to be evaluated in high level intervention studies.