The impact of daily affective touch on cortisol levels in institutionalized & fostered children

Institutionalized children are often deprived of affective touch. Such tactile deprivation often leads to constant stress, as measured by the levels of salivary cortisol. We report here the impact of an affective touch program, optimized to activate a specific population of unmyelinated mechanosensitive nerves in the skin called c-tactile afferents (CT) on stress resistance. Two populations of children (age 4-10) were recruited: (i) a cohort living in an orphanage and (ii) a fostered cohort. Both groups received the affective touch program daily for 10-15 min for 5-6 weeks. A cohort of age-matched children living in a family environment acted as a control group and did not receive any instructions for tactile stimulation. Salivary cortisol was collected at the beginning (T1) and at the end (T2) of the study in all three groups. For institutionalized and fostered children there was a significant improvement in the level of cortisol (p < 0.0001) between T1 and T2, which is manifested in the balancing cortisol levels: a decrease where it was elevated and an increase, where the critically low level testified to the distress of the child. Balancing cortisol levels is a process of recovery to normal values, which indicates the restoration of neurohumoral mechanisms of stress regulation. The effect of balancing cortisol levels was more pronounced in the group of fostered children compared to the group of orphanage children (p = 0.0326). The children in the control group had no significant differences.

Construction of the Views oN Infant Sleep (VNIS) Questionnaire

Parents' beliefs about infant sleep behaviour vary over time and across cultures. No validated instrument exists to understand parents' pre- and postnatal views on infant sleep behaviours, which may influence their caregiving decisions. The Views oN Infant Sleep Questionnaire (VNIS) will be a tool to assess parents' beliefs in order to facilitate tailored perinatal care, increase the reliability of postnatal self-report measures, allow for cross-cultural comparisons, and provide a baseline for researchers to use in longitudinal studies. We recruited an online sample of 971 female participants who were resident in the United Kingdom, at least 28 weeks pregnant, and at least 18 years of age. The initial questionnaire consisted of 31 questions about infant independence, night-waking, infant feeding, touch, and safety, and items were rated on a 5-point Likert scale. The item pool was reduced to 12 using principal component analysis and a structure was found for the three components "Closeness", "Independence", and "Night-waking". Overall, these results suggest that the VNIS can provide a brief scale to measure different aspects of individuals' beliefs about infant sleep. In further research the VNIS needs to be validated with a confirmatory factor analysis in another sample, and to be tested as a cross-cultural instrument.

Maternal prenatal depressive symptoms and child brain responses to affective touch at two years of age

BACKGROUND

Touch is an essential form of mother-child interaction, instigating better social bonding and emotional stability.

METHODS

We used diffuse optical tomography to explore the relationship between total haemoglobin (HbT) responses to affective touch in the child's brain at two years of age and maternal self-reported prenatal depressive symptoms (EPDS). Affective touch was implemented via slow brushing of the child's right forearm at 3 cm/s and non-affective touch via fast brushing at 30 cm/s and HbT responses were recorded on the left hemisphere.

RESULTS

We discovered a cluster in the postcentral gyrus exhibiting a negative correlation (Pearson's r = -0.84, p = 0.015 corrected for multiple comparisons) between child HbT response to affective touch and EPDS at gestational week 34. Based on region of interest (ROI) analysis, we found negative correlations between child responses to affective touch and maternal prenatal EPDS at gestational week 14 in the precentral gyrus, Rolandic operculum and secondary somatosensory cortex. The responses to non-affective touch did not correlate with EPDS in these regions.

LIMITATIONS

The number of mother-child dyads was 16. However, by utilising high-density optode arrangements, individualised anatomical models, and video and accelerometry to monitor movement, we were able to minimize methodological sources of variability in the data.

CONCLUSIONS

The results show that maternal depressive symptoms during pregnancy may be associated with reduced child responses to affective touch in the temporoparietal cortex. Responses to affective touch may be considered as potential biomarkers for psychosocial development in children. Early identification of and intervention in maternal depression may be important already during early pregnancy.

Brain mechanisms for processing caress-like touch in skin-picking disorder

Skin-picking disorder (SPD) is characterized by repetitive touching and picking of one's skin. The picking is typically experienced as pleasant although this behavior leads to tissue damage. The present functional magnetic resonance imaging (fMRI) study investigated how individuals with SPD react to caress-like touch, which stimulates C-tactile afferents. A standardized touch procedure was used. Seventy females with a primary diagnosis of SPD and 62 healthy females received CT-optimal brushing of their forearms (3 cm/s) and non-optimal brushing (30 cm/s) during an fMRI session. The two types of tactile stimulation were rated according to pleasure, arousal, and urge to pick one's skin. Relative to healthy controls, patients with SPD showed greater activation in parietal regions (supramarginal/angular gyrus) during CT-optimal touch. Moreover, the deactivation of the middle/ inferior frontal cortex displayed by control participants was absent in the SPD group. Being touched was rated as less pleasant, more arousing, and elicited a greater urge to perform skin-picking in participants with SPD. The mentioned frontal and parietal brain regions are sources of attentional control. They are involved in integrating somatosensory information and switching attention between external/internal stimuli. The present study adds to the limited database on the dysfunctional processing of touch in SPD. This study was preregistered on the German Clinical Trials Register (DRKS00022123, June 8th, 2020).

Atypical cerebellar activity and connectivity during affective touch in adults with skin-picking disorder

Excessive touching and picking of one's skin are core symptoms of skin-picking disorder (SPD). Previous research has shown that patients with SPD display difficulties in motor control and show altered reward responsivity. Considering the limited knowledge about neuronal mechanisms in SPD, particularly concerning the cerebellum, the analysis focused on this brain region due to its involvement in sensorimotor and affective functions. The participants of the present study received affective (caress-like), which is typically perceived as pleasant and can be passively enjoyed. A total of 132 female participants (70 patients with SPD, 62 healthy controls) received affective and nonaffective touch to their forearms (slow vs. fast brushing) during functional magnetic resonance imaging. This tactile stimulation was rated according to pleasure, arousal, and the urge to pick one's skin. Being touched was perceived as more negative and arousing by the SPD group, and elicited a greater urge to perform skin-picking. During affective touch, those participants with SPD were characterized by reduced activity in lobule VIII, reduced functional connectivity of lobule VIII with the hippocampus, and increased connectivity with the superior parietal lobule. Since VIII is involved in the inhibition of movement, the present findings point to deficient motor control in SPD in the context of affective-sensory processing.

Differences in temporal profile of brain responses by pleasantness of somatosensory stimulation in autistic individuals

Purpose/Aim. Autistic individuals may show either hyper- or hypo- responsiveness to touch compared to non-autistic individuals. These behavioural responses depend on perceptual and evaluative mechanisms, which unfold sequentially and thus can be distinguished by exploring the timing of neural responses. In this study, we examined neural response timing to pleasant, unpleasant, and affectively neutral textures, to determine whether these perceptual versus evaluative subprocesses differ in autism and how each subprocess contributes to behavioural responses.Materials and Methods. Our sample included n = 13 autistic and n = 14 non-autistic adults who completed functional magnetic resonance imaging. We analysed early, intermediate, and late phases of the tactile response, derived from studies of noxious tactile stimulation, to three different textures.Results. The autistic group showed distinct differences from the non-autistic group to each of the textures, showing earlier, somatosensory differences in response to the pleasantly and unpleasantly rated textures and later, frontomotor differences in response to the neutrally rated texture. Further, reduced early phase response to the pleasant texture correlated with increased sensory seeking behaviour.Conclusions. While preliminary, these results suggest distinct patterns between autistic and non-autistic individuals in how the neural response to touch unfolds and its correspondence with the perceived pleasantness of tactile experience. The findings suggest perceptual differences in response to affectively charged textures and evaluative differences in response to neutral, ambiguous textures. These temporal properties may inform future studies of tactile processing in autism, lending a better understanding of how individuals differ in their sensory experiences across contexts.

The role of affective touch in modulating emotion processing among preschool children

Recognizing emotional expressions is a prerequisite for understanding others' feelings and intentions, a key component of social interactions that develops throughout childhood. In multisensory social environments, touch may be crucial for emotion processing, linking external sensory information with internal affective states. The current study investigated whether affective touch facilitates recognition of emotional expressions throughout childhood. Preschool children (N = 121 3- to 6-year-olds) were presented with different tactile stimulations followed by an emotion-matching task. Results revealed that affective touch fosters the recognition of negative emotions and increases the speed of association of positive emotions, highlighting the centrality of tactile experiences for socioemotional understanding. The current research opens new perspectives on how to support emotional recognition with potential consequences for the development of social functioning.

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.

You can touch this! Brain correlates of aesthetic processing of active fingertip exploration of material surfaces

The haptic exploration and aesthetic processing of all kinds of materials' surfaces are part of everyday life. In the present study, functional near-infrared spectroscopy (fNIRS) was used to investigate the brain correlates of active fingertip exploration of material surfaces and subsequent aesthetic judgments of their pleasantness (feels good or bad?). In absence of other sensory modalities, individuals (n = 21) performed lateral movements on a total of 48 textile and wood surfaces varying in terms of their roughness. Behavioral results confirmed the influence of the stimuli's roughness on aesthetic judgments, with smoother textures being rated as feeling better than rough textures. At the neural level, fNIRS activation results revealed an overall increased engagement of the contralateral sensorimotor areas as well as left prefrontal areas. Moreover, the perceived pleasantness modulated specific activations of left prefrontal areas with increasing pleasantness showing greater activations of these regions. Interestingly, this positive relationship between the individual aesthetic judgments and brain activity was most pronounced for smooth woods. These results demonstrate that positively valenced touch by actively exploring material surfaces is linked to left prefrontal activity and extend previous findings of affective touch underlying passive movements on hairy skin. We suggest that fNIRS can be a valuable tool to provide new insights in the field of experimental aesthetics.

Changes in food cue reactivity through affective and nonaffective touch: An event-related potential study

Affective touch (gentle/slow brushing of the skin) can facilitate the allocation of processing resources to simultaneously present stimuli from different modalities. The present event-related potential (ERP) study investigated whether affective touch can enhance attention to visual cues of healthy food. Female participants (n = 117) were randomly assigned to three different groups that either received affective touch, nonaffective touch (fast brushing of the skin), or no touch during the presentation of pictures of healthy food (fruits and vegetables) and non-food. Electrocortical markers of motivated attention (frontal/parietal P300, late positive potential: LPP) and reported appetite for the depicted food items were compared between the three groups. Nonaffective touch was associated with reduced amplitudes of the frontal P300/LPP (300-1000 ms) for food pictures indexing reduced motivated attention. Affective touch did not influence food cue reactivity (P300/LPP, appetite). Effects of affective touch may be restricted to specific stimuli, e.g. those with social relevance.

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.

Dynamic touch induces autonomic changes in preterm infants as measured by changes in heart rate variability

Preterm birth significantly increases the risk of developing various long-term health problems and developmental disabilities. While touch is a crucial component of many perinatal care strategies, the neurobiological underpinnings are rarely considered. C-tactile fibers (CTs) are unmyelinated nerve fibers that are activated by low-force, dynamic touch. Touch directed specifically at CTs activates the posterior insular cortex, consistent with an interoceptive function, and has been shown to reduce heart rate and increase oxygen saturation. The current research compared the effect of five minutes of CT optimal velocity stroking touch versus five minutes of static touch on autonomic markers of preterm infants between 28 and 37 weeks gestational age. CT touch induces a higher increase in heart rate variability metrics related to the parasympathetic system, which persisted for a 5-minute post-touch period. Conversely, there was no such increase in infants receiving static touch. The present findings confirmed that CTs signal the affective quality of nurturing touch, thereby arguing an additional neurobiological substrate for the evident valuable impacts of neonatal tactile interventions and improving the effectiveness of such interventions.

An integrative perspective on the role of touch in the development of intersubjectivity

Touch concerns a fundamental component of sociality. In this review, we examine the hypothesis that somatomotor development constitutes a crucial psychophysiological element in the ontogeny of intersubjectivity. An interdisciplinary perspective is provided on how the communication channel of touch contributes to the sense of self and extends to the social self. During gestation, the transformation of random movements into organized sequences of actions with sensory consequences parallels the development of the brain's functional architecture. Brain subsystems shaped by the coordinated activity of somatomotor circuits to support these first body-environment interactions are the first brain functional arrangements to develop. We propose that tactile self-referring behaviour during gestation constitutes a prototypic mode of interpersonal exchange that supports the subsequent development of intersubjective exchange. The reviewed research suggests that touch constitutes a pivotal bodily experience that in early stages builds and later filters self-other interactions. This view is corroborated by the fact that aberrant social-affective touch experiences appear fundamentally associated with attachment anomalies, interpersonal trauma, and personality disorders. Given the centrality of touch for the development of intersubjectivity and for psychopathological conditions in the social domain, dedicated research is urged to elucidate the role of touch in the evolution of subjective self-other coding.

Imaging affective and non-affective touch processing in two-year-old children

Touch is an important component of early parent-child interaction and plays a critical role in the socio-emotional development of children. However, there are limited studies on touch processing amongst children in the age range from one to three years. The present study used frequency-domain diffuse optical tomography (DOT) to investigate the processing of affective and non-affective touch over left frontotemporal brain areas contralateral to the stimulated forearm in two-year-old children. Affective touch was administered by a single stroke with a soft brush over the child's right dorsal forearm at 3 cm/s, while non-affective touch was provided by multiple brush strokes at 30 cm/s. We found that in the insula, the total haemoglobin (HbT) response to slow brushing was significantly greater than the response to fast brushing (slow > fast). Additionally, a region in the postcentral gyrus, Rolandic operculum and superior temporal gyrus exhibited greater response to fast brushing than slow brushing (fast > slow). These findings confirm that an adult-like pattern of haemodynamic responses to affective and non-affective touch can be recorded in two-year-old subjects using DOT. To improve the accuracy of modelling light transport in the two-year-old subjects, we used a published age-appropriate atlas and deformed it to match the exterior shape of each subject's head. We estimated the combined scalp and skull, and grey matter (GM) optical properties by fitting simulated data to calibrated and coupling error corrected phase and amplitude measurements. By utilizing a two-compartment cerebrospinal fluid (CSF) model, the accuracy of estimation of GM optical properties and the localization of activation in the insula was improved. The techniques presented in this paper can be used to study neural development of children at different ages and illustrate that the technology is well-tolerated by most two-year-old children and not excessively sensitive to subject movement. The study points the way towards exciting possibilities in functional imaging of deeper functional areas near sulci in small children.

The influence of duration, arm crossing style, gender, and emotional closeness on hugging behaviour

Hugging is one of the most common types of affective touch encountered in everyday life. However, little is known about the factors that influence hugging evaluation and behaviour. Here, we aimed to assess how different hugs would be evaluated and whether they can affect mood. Furthermore, we aimed to investigate what kind of arm crossing is common in a naturalistic setting and whether arm crossing style could be predicted from gender, emotional closeness, and the height difference of huggers. We conducted two studies addressing these questions. In study 1, participants hugged a confederate for 1 second (s), 5 s or 10 s with two different arm crossing styles and reported how pleasant, arousing and under control the touch felt. Additionally, participants were asked about their mood ("self-ratings") immediately after, 3 minutes (min) after and 6 min after each hug. In study 2, participants were approached on campus and asked to share a hug, with arm crossing style being the dependent variable. The height difference, gender and self-rated emotional closeness to the hug partner were recorded as possible predictors for arm crossing style. Results from study 1 indicate that duration matters more than arm crossing style for hug pleasure, arousal, and control, with 1 s hugs being rated as least pleasant and under control than 5 s and 10 s hugs. Accordingly, 1 s hugs also resulted in lower pleasure self-ratings immediately post hug than 5 s and 10 s hugs. Arousal self-ratings were higher immediately post hug than several minutes after a hug. In study 2, gender was linked to arm crossing style, with male-male hug dyads exhibiting a different hugging style from female-female dyads. These findings are discussed in relation to previous hug research and gender differences in touch behaviour.

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 experience in different contexts: A review

Social touch is increasingly utilized in a variety of psychological interventions, ranging from parent-child interventions to psychotherapeutic treatments. Less attention has been paid, however, to findings that exposure to social touch may not necessarily evoke positive or pleasant responses. Social touch can convey different emotions from love and gratitude to harassment and envy, and persons' preferences to touch and be touched do not necessarily match with each other. This review of altogether 99 original studies focuses on how contextual factors modify target person's behavioral and brain responses to social touch. The review shows that experience of social touch is strongly modified by a variety of toucher-related and situational factors: for example, toucher's facial expressions, physical attractiveness, relationship status, group membership, and touched person's psychological distress. At the neural level, contextual factors modify processing of social touch from early perceptual processing to reflective cognitive evaluation. Based on the review, we present implications for using social touch in behavioral and neuroscientific research designs.

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.

Past and present experiences with maternal touch affect infants' attention toward emotional faces

Maternal touch is considered crucial in regulating infants' internal states when facing unknown or distressing situations. Here, we explored the effects of maternal touch on 7-month-old infants' preferences towards emotions. Infants' looking times were measured through a two-trial preferential looking paradigm, while infants observed dynamic videos of happy and angry facial expressions. During the observation, half of the infants received an affective touch (i.e., stroke), while the other half received a non-affective stimulation (i.e., fingertip squeeze) from their mother. Further, we assessed the frequency of maternal touch in the mother-infant dyad through The Parent-Infant Caregiving Touch Scale (PICTS). Our results have shown that infants' attention to angry and happy facial expressions varied as a function of both present and past experiences with maternal touch. Specifically, in the affective touch condition, as the frequency of previous maternal affective tactile care increased (PICTS), the avoidance of angry faces decreased. Conversely, in the non-affective touch condition, as the frequency of previous maternal affective tactile care increased (PICTS), the avoidance of angry faces increased as well. Thus, past experience with maternal affective touch is a crucial predictor of the regulatory effects that actual maternal touch exerts on infants' visual exploration of emotional stimuli.

Haptotherapy for patients with cancer; experience of haptotherapists and reasons for consultation: A survey among haptotherapists

BACKGROUND AND PURPOSE

Haptotherapy is a type of mind-body therapy that makes use of affective touch. This study aims to provide insights in reasons for haptotherapy for patients with cancer, and in experiences of haptotherapists with these patients.

MATERIALS AND METHODS

In a cross-sectional study, a survey was conducted among 536 Dutch haptotherapists. Multiple-choice and open-ended questions were analyzed both quantitatively and qualitatively.

RESULTS

Of 272 (50.7%) responding haptotherapists, 167 (61.5%) had experience with treating people with cancer. Most frequently, combinations of emotional problems and a disturbed body experience were reported as reasons for haptotherapy. Haptotherapists emphasized the need for affective touch to restore patients' body connection.

CONCLUSION

Two-thirds of the respondents treat patients with cancer, addressing the interaction of body and mind. Reasons for consultation cover a wide range of problems in multiple dimensions, in which a disturbed body experience in combination with emotional problems is mentioned most often.

A Better Touch: C-tactile Fibers Related Activity is Associated to Pain Reduction During Temporal Summation of Second Pain

C-tactile (CT) fibers, responsible for the so-called "affective" touch (AT), have drawn a fair amount of attention within the scientific community for their marked social dimension. However, while the pain-relieving potential of discriminative touch (DT) has been documented, proofs of the analgesic properties of AT are still scarce. Additionally, no study has so far tested its possible pain-relieving effects on a clinically-relevant model. Temporal summation of second pain (TSSP), otherwise referred to as "wind-up," relies on repetitive stimulation of C-nociceptors and it is thought to reflect central sensitization, a process linked to many chronic pain conditions. In the present experimental, within participants, design we induced TSSP through trains of ascending and descending repetitive heat stimulation. Forty-two healthy participants' pain was measured during 2 different tactile stimulations (stroking velocities AT: 10 cm/s; DT: 0.3 cm/s) or without concomitant tactile input. Since measures of pleasantness of the tactile stimulation have been found to strongly correlate with C-tactile fibers' firing rate, these, together with participants' body awareness, were also taken into account. Our results show that AT brought about a decrease of our participants' pain as opposed to both DT and no touch, while DT did not produce any significant pain reduction. Thus, only AT successfully modulated wind-up. As expected, AT was perceived as more pleasant than DT, while a clear relationship between body awareness and pain was found only during DT. Targeting CT fibers could pave the way to new treatments for chronic pain conditions whose aetiology depend on abnormal C-nociceptors' physiology. PERSPECTIVE: This study extends previous findings on the analgesic potential of affective touch, documenting a clear pain reduction during temporal summation of second pain (TSSP). Since TSSP is thought to reflect central sensitization, the psychophysiological mechanisms of affective touch could be exploited for new chronic pain treatments.

The role of affective touch in whole-body embodiment remains equivocal

Previous studies have highlighted that affective touch delivered at slow velocities (1-10 cm/s) enhances body-part embodiment during multisensory illusions, yet its role towards whole-body embodiment is less established. Across two experiments, we investigated the role of affective touch towards subjective embodiment of a whole mannequin body within the full body illusion, amongst healthy females. Participants perceived affective touch to be more pleasant than non-affective touch, but this did not enhance subjective embodiment within the illusion and no interaction between synchrony (Experiment 1), or congruency (Experiment 2), and the velocity of touch was observed. Finally, the perceived pleasantness of touch was not modulated by subthreshold eating disorder psychopathology, as measured by means of a self-report questionnaire. Therefore, the present findings suggest that enhancement of embodiment due to affective touch may be body-part specific, and not generalise to greater ownership towards a whole body.

Perceived pleasantness of gentle touch in healthy individuals is related to salivary oxytocin response and EEG markers of arousal

Affective touch plays an important role in human social bonding, affiliative behavior, and in general emotional well-being. A system of unmyelinated low-threshold mechanosensitive C-type afferents innervating hairy skin (C-tactile or CT system) is postulated to provide the neurophysiological background of affective touch perception. C-tactile afferents respond optimally to soft and slow strokes, and this response correlates positively with pleasure ratings of tactile stimuli. As gentle touch is consistently associated with oxytocin release further promoting prosocial behavior, it has been suggested that this effect is mediated by the response of C-tactile afferents. This study assesses a possible link between CT-optimal touch, its subjective pleasantness, EEG indices of cortical arousal, and peripheral oxytocin response. EEG was recorded in 28 healthy volunteers during resting state and tactile stimulation[gentle slow brush strokes on forearm (CT-targeted touch) and palm (non-CT-targeted touch)]. Saliva samples were collected before and after the touch stimulation. Oxytocin concentration increase was significantly associated with greater subjective ratings of CT-targeted touch but not of non-CT-targeted touch, and with lower peak alpha frequency values indicating decreased cortical arousal. The findings suggest that CT-targeted stimulation triggers oxytocin release but only when the touch is perceived at an individual level as having clearly positive affective salience. This corresponds to previous studies reporting that oxytocin response to touch can be related to different personality factors, and bears important implications for planning touch-based interventions in social and medical care.

Oxytocin increases the pleasantness of affective touch and orbitofrontal cortex activity independent of valence

Touch plays a crucial role in affiliative behavior and social communication. The neuropeptide oxytocin is released in response to touch and may act to facilitate the rewarding effects of social touch. However, no studies to date have determined whether oxytocin facilitates behavioral or neural responses to non-socially administered affective touch and possible differential effects of touch valence. In a functional MRI experiment using a randomized placebo-controlled, within-subject design in 40 male subjects we investigated the effects of intranasal oxytocin (24IU) on behavioral and neural responses to positive, neutral and negative valence touch administered to the arm via different types of materials at a frequency aimed to optimally stimulate C-fibers. Results showed that oxytocin significantly increased both the perceived pleasantness of touch and activation of the orbitofrontal cortex independent of touch valence. The effects of OT on touch-evoked orbitofrontal activation were also positively associated with basal oxytocin concentrations in blood. Additionally, anterior insula activity and the functional connectivity between the amygdala and right anterior insula were enhanced only in response to negative valence touch. Overall, the present study provides the first evidence that oxytocin may facilitate the rewarding effects of all types of touch, irrespective of valence.

Reduced task-dependent modulation of functional network architecture for positive versus negative affective touch processing in autism spectrum disorders

Individuals with autism spectrum disorders (ASD) experience impairments in social communication and interaction, and often show difficulties with receiving and offering touch. Despite the high prevalence of abnormal reactions to touch in ASD, and the importance of touch communication in human relationships, the neural mechanisms underlying atypical touch processing in ASD remain largely unknown. To answer this question, we provided both pleasant and unpleasant touch stimulation to male adults with and without ASD during functional neuroimaging. By employing generalized psychophysiological interaction analysis combined with an independent component analysis approach, we characterize stimulus-dependent changes in functional connectivity patterns for processing two tactile stimuli that evoke different emotions (i.e., pleasant vs. unpleasant touch). Results reveal that neurotypical male adults showed extensive stimulus-sensitive modulations of the functional network architecture in response to the different types of touch, both at the level of brain regions and large-scale networks. Conversely, far fewer stimulus-sensitive modulations were observed in the ASD group. These aberrant functional connectivity profiles in the ASD group were marked by hypo-connectivity of the parietal operculum and major pain networks and hyper-connectivity between the semantic and limbic networks. Lastly, individuals presenting more social deficits and a more negative attitude towards social touch showed greater hyper-connectivity between the limbic and semantic networks. These findings suggest that reduced stimulus-related modulation of this functional network architecture is associated with abnormal processing of touch in ASD.

Controlled emotional tactile stimulation during functional magnetic resonance imaging and electroencephalography

BACKGROUND

Tactile stimulation used to induce emotional responses is often not well-controlled. Replicating the same tactile stimulations across studies is difficult, compared to replicating visual and auditory modalities, which have standardized stimulus sets. Standardizing a stimulation method by replicating stimuli across studies is necessary to further elucidate emotional responses in neuroscience research using tactile stimulation.

THE NEW METHOD

We developed a tactile stimulation device. The device's ultrasonic motor and optical force sensor have the following criteria: (1) controls the physical property of stimuli, pressure, and stroking speed; (2) measures actual touch timing; (3) is safe to use in a magnetic resonance imaging (MRI) scanner; and (4) produces low noise in electroencephalography (EEG) and MRI.

RESULTS

The noise level of the device's drive was sufficiently low. For the EEG experiment, we successfully used signal processing to diminish the commercial power supply noise. For functional MRI (fMRI) scans, we found <5% signal loss occurred during device rotation.

COMPARISON WITH EXISTING METHOD(S)

We found no previous report about the noise level of a tactile stimulation device used to induce emotional responses during EEG and fMRI recordings. The signal loss rate was comparable with that of other robotic devices used in MRI scanners. Emotional feelings induced by this stimulation method were comparable with those elicited in other sensory modalities.

CONCLUSIONS

The developed device could be used for cognitive-affective neuroscience research when conducting EEG and fMRI scans. The device should aid in standardizing affective tactile stimulation for research in psychology and cognitive neuroscience.

EEG captures affective touch: CT-optimal touch and neural oscillations

Tactile interactions are of developmental importance to social and emotional interactions across species. In beginning to understand the affective component of tactile stimulation, research has begun to elucidate the neural mechanisms that underscore slow, affective touch. Here, we extended this emerging body of work and examined whether affective touch (C tactile [CT]-optimal speed), as compared to nonaffective touch (non-CT-optimal speed) and no touch conditions, modulated EEG oscillations. We report an attenuation in alpha and beta activity to affective and nonaffective touch relative to the no touch condition. Further, we found an attenuation in theta activity specific to the affective, as compared to the nonaffective touch and no touch conditions. Similar to theta, we also observed an attenuation of beta oscillations during the affective touch condition, although only in parietal scalp sites. Decreased activity in theta and parietal-beta ranges may reflect attentional-emotional regulatory mechanisms; however, future work is needed to provide insight into the potential neural coupling between theta and beta and their specific role in encoding slow, tactile stimulation.

Hand or spoon? Exploring the neural basis of affective touch in 5-month-old infants

In adults, affective touch leads to widespread activation of cortical areas including posterior Superior Temporal Sulcus (pSTS) and Inferior Frontal Gyrus (IFG). Using functional Near Infrared Spectroscopy (fNIRS), we asked whether similar areas are activated in 5-month-old infants, by comparing affective to non-affective touch. We contrasted a human touch stroke to strokes performed with a cold metallic spoon. The hypothesis that adult-like activation of cortical areas would be seen only in response to the human touch stroke was not confirmed. Similar patterns of activation were seen in both conditions. We conclude that either the posterior STS and IFG have not yet developed selective responses to affective touch, or that additional social cues are needed to be able to identify this type of touch.

Construction and Validation of the Touch Experiences and Attitudes Questionnaire (TEAQ): A Self-report Measure to Determine Attitudes Toward and Experiences of Positive Touch

Despite growing interest in the beneficial effects of positive touch experiences throughout our lives, and individual differences in how these experiences are perceived, there is not yet available a contemporary self-report measure of touch experiences and attitudes, for which the factor structure has been validated. This article describes four studies carried out during the construction and validation of the Touch Experiences and Attitudes Questionnaire (TEAQ). The original TEAQ, containing 117 items relating to positive touch experiences was systematically constructed. Principal component analysis reduced this measure to 57 items and identified six components relating to touch experiences during childhood and adult experiences relating to current intimate touch and touch with friends and family. Three attitudinal components were identified relating to attitude to intimate touch, touch with unfamiliar people, and self-care. The structure of this questionnaire was confirmed through confirmatory factor analysis carried out on data obtained from a second sample. Good concurrent and predictive validity of the TEAQ compared to other physical touch measures currently available was identified. Known-group validity in terms of gender, marital status and age was determined, with expected group differences identified. This study demonstrates the TEAQ to have good face validity, internal consistency, construct validity in terms of discriminant validity, known-group validity and convergent validity, and criterion-related validity in terms of predictive validity and concurrent validity. We anticipate this questionnaire will be a valuable tool for the field of physical touch research.

Balancing body ownership: Visual capture of proprioception and affectivity during vestibular stimulation

The experience of our body as our own (i.e. body ownership) involves integrating different sensory signals according to their contextual relevance (i.e. multisensory integration). Until recently, most studies of multisensory integration and body ownership concerned only vision, touch and proprioception; the role of other modalities, such as the vestibular system and interoception, has been neglected and remains poorly understood. In particular, no study to date has directly explored the combined effect of vestibular and interoceptive signals on body ownership. Here, we investigated for the first time how Galvanic Vestibular Stimulation (left, right, sham), tactile affectivity (a reclassified interoceptive modality manipulated by applying touch at C-tactile optimal versus non-optimal velocities), and their combination, influence proprioceptive and subjective measures of body ownership during a rubber hand illusion paradigm with healthy participants (N = 26). Our results show that vestibular stimulation (left GVS) significantly increased proprioceptive drift towards the rubber hand during mere visual exposure to the rubber hand. Moreover, it also enhanced participants’ proprioceptive drift towards the rubber hand during manipulations of synchronicity and affective touch. These findings suggest that the vestibular system influences multisensory integration, possibly by re-weighting both the two-way relationship between proprioception and vision, as well as the three-way relationship between proprioception, vision and affective touch. We discuss these findings in relation to current predictive coding models of multisensory integration and body ownership.

•

We studied vestibular and affective contributions to body ownership.

•

We stimulated the vestibular system in a Rubber Hand paradigm with affective touch.

•

Right-hemisphere stimulation increased proprioceptive drift during vision of a RH.

•

Applying affective touch further increased proprioceptive drift.

•

Affective and vestibular signals may favour vision in multisensory integration.

Tune to touch: Affective touch enhances learning of face identity in 4-month-old infants

Touch provides more than sensory input for discrimination of what is on the skin. From early in development it has a rewarding and motivational value, which may reflect an evolutionary mechanism that promotes learning and affiliative bonding. In the present study we investigated whether affective touch helps infants tune to social signals, such as faces. Four-month-old infants were habituated to an individual face with averted gaze, which typically does not engage infants to the same extent as direct gaze does. As in a previous study, in the absence of touch, infants did not learn the identity of this face. Critically, 4-month-old infants did learn to discriminate this face when parents provided gentle stroking, but they did not when they experienced a non-social tactile stimulation. A preliminary follow-up eye-tracking study (Supplementary material) revealed no significant difference in the visual scanning of faces between touch and no-touch conditions, suggesting that affective touch may not affect the distribution of visual attention, but that it may promote more efficient learning of facial information.

Visual perception of the arm manipulates the experienced pleasantness of touch

Touch, such as a caress, can be interpreted as very pleasant. The emotional valence assigned to touch is likely related to certain bottom-up factors, such as optimal activation of C-tactile (CT) afferents. It is however unclear if besides somatosensory input, contextual factors related to the own body also play a role in the perceived pleasantness of touch. To test this, we manipulated visual appearance of the participant’s arm (veridical vision, no vision, pixelated moving statistic projected onto the arm (i.e. crawling skin)). We used slow velocity stroking (CT optimal stroking) with a soft brush to induce pleasant touch, and fast velocity stroking as a control condition. After each visual condition we asked participants (N = 23) to rate the emotional valence of the stroking they felt. After slow velocity stroking ratings on perceived pleasantness (but not on perceived unpleasantness) were modulated by visual condition, with veridical vision of the arm resulting in higher pleasantness ratings than both no vision and pixelated vision. We conclude that contextual processes affect the perceived pleasantness of touch. These findings shed a new light on the underlying mechanisms of how humans experience pleasant touch and show that pleasant touch not solely dependents on bottom up information.

Reading the mind in the touch: Neurophysiological specificity in the communication of emotions by touch

Touch is central to interpersonal interactions. Touch conveys specific emotions about the touch provider, but it is not clear whether this is a purely socially learned function or whether it has neurophysiological specificity. In two experiments with healthy participants (N = 76 and 61) and one neuropsychological single case study, we investigated whether a type of touch characterised by peripheral and central neurophysiological specificity, namely the C tactile (CT) system, can communicate specific emotions and mental states. We examined the specificity of emotions elicited by touch delivered at CT-optimal (3 cm/s) and CT-suboptimal (18 cm/s) velocities (Experiment 1) at different body sites which contain (forearm) vs. do not contain (palm of the hand) CT fibres (Experiment 2). Blindfolded participants were touched without any contextual cues, and were asked to identify the touch provider's emotion and intention. Overall, CT-optimal touch (slow, gentle touch on the forearm) was significantly more likely than other types of touch to convey arousal, lust or desire. Affiliative emotions such as love and related intentions such as social support were instead reliably elicited by gentle touch, irrespective of CT-optimality, suggesting that other top-down factors contribute to these aspects of tactile social communication. To explore the neural basis of this communication, we also tested this paradigm in a stroke patient with right perisylvian damage, including the posterior insular cortex, which is considered as the primary cortical target of CT afferents, but excluding temporal cortex involvement that has been linked to more affiliative aspects of CT-optimal touch. His performance suggested an impairment in ‘reading’ emotions based on CT-optimal touch. Taken together, our results suggest that the CT system can add specificity to emotional and social communication, particularly with regards to feelings of desire and arousal. On the basis of these findings, we speculate that its primary functional role may be to enhance the ‘sensual salience’ of tactile interactions.

•

Touch can convey specific emotions and intentions.

•

Slow gentle touch communicates love and intimacy regardless of CT fibre activation.

•

The CT system plays a specific role in mediating sensual touch.

•

Insula activation might be necessary in the arousing function of the CT system.

Does affective touch influence the virtual reality full body illusion?

The sense of how we experience our physical body as our own represents a fundamental component of human self-awareness. Body ownership can be studied with bodily illusions which are generated by inducing a visuo-tactile conflict where individuals experience illusionary ownership over a fake body or body part, such as a rubber hand. Previous studies showed that different types of touch modulate the strength of experienced ownership over a rubber hand. Specifically, participants experienced more ownership after the rubber hand illusion was induced through affective touch vs non-affective touch. It is, however, unclear whether this effect would also occur for an entire fake body. The aim of this study was, therefore, to investigate whether affective touch modulates the strength of ownership in a virtual reality full body illusion. To elicit this illusion, we used slow (3 cm/s; affective touch) and fast (30 cm/s; non-affective touch) stroking velocities on the participants' abdomen. Both stroking velocities were performed either synchronous or asynchronous (control condition), while participants viewed a virtual body from a first-person-perspective. In our first study, we found that participants experienced more subjective ownership over a virtual body in the affective touch condition, compared to the non-affective touch condition. In our second study, we found higher levels of subjective ownership for synchronous stimulation, compared to asynchronous, for both touch conditions, but failed to replicate the findings from study 1 that show a difference between affective and non-affective touch. We, therefore, cannot conclude unequivocally that affective touch enhances the full-body illusion. Future research is required to study the effects of affective touch on body ownership.

The Development of Tactile Perception

Touch is the first of our senses to develop, providing us with the sensory scaffold on which we come to perceive our own bodies and our sense of self. Touch also provides us with direct access to the external world of physical objects, via haptic exploration. Furthermore, a recent area of interest in tactile research across studies of developing children and adults is its social function, mediating interpersonal bonding. Although there are a range of demonstrations of early competence with touch, particularly in the domain of haptics, the review presented here indicates that many of the tactile perceptual skills that we take for granted as adults (e.g., perceiving touches in the external world as well as on the body) take some time to develop in the first months of postnatal life, likely as a result of an extended process of connection with other sense modalities which provide new kinds of information from birth (e.g., vision and audition). Here, we argue that because touch is of such fundamental importance across a wide range of social and cognitive domains, it should be placed much more centrally in the study of early perceptual development than it currently is.

The two dimensions of the body representation in women suffering from Anorexia Nervosa

A core symptom of Anorexia Nervosa (AN) is a severe alteration of body representations. Evidence from somatoperception studies point to a generic disturbances of somatosensory components of body representations. Here we have investigated whether AN patients (N=18) and controls differed in the perception of tactile stimuli differently oriented along the body axes. We tested the hypothesis that patients perceive and represent their body selectively larger in only one dimension. To this aim we used elementary tactile measures for tactile acuity (Von Frey's test and two-point discrimination thresholds - 2PD) and tactile discrimination measures. The rationale is based on the assumption that AN patients have a wider body representation, and that tactile body representation tasks (Tactile Distance task) oriented across the bodies (horizontally) are influenced by distorted body representations compared with tactile stimuli oriented along the bodies (vertically) which should not be influenced by body representations. Results showed that patients judged horizontal tactile stimuli significantly wider than the same stimuli oriented vertically.These results suggest that human brain perceives things differently based on body representations and that the beliefs concerning body size influence the specific somatosensory process of tactile experience.

Good vibrations: Global processing can increase the pleasantness of touch

Visual-tactile carry-over effects of global/local processing (attention to the whole, versus the details) have been reported under active touch conditions. We investigated whether carry-over effects of global/local processing also occur for passive touch and whether global/local processing has differential effects on affective and discriminative aspects of touch. Participants completed two tactile tasks involving pleasantness rating and discrimination of a set of tactile vibrations before and after completing a version of the Navon task that encouraged a focus on the global (n = 30), local (n = 30), or both (n = 30) features of a series of visual stimuli. In line with previous research suggesting a link between global processing and positive emotion, global processing increased pleasantness ratings of high-frequency (but not low-frequency) tactile vibrations. Local processing did not improve the ability to discriminate between vibrations of different frequencies, however. There was some evidence of a tactile-visual carry-over effect; prior local processing of tactile vibrations reduced global precedence during the Navon task in the control group. We have shown carry-over effects of global versus local processing on passive touch perception. These findings provide further evidence suggesting that a common perceptual mechanism determines processing level across modalities and show for the first time that prior global processing affects the pleasantness of touch.

Distinct neural networks underlying empathy for pleasant and unpleasant touch

In spite of considerable progress in the understanding of the neural mechanisms underlying the experience of empathy, the majority of previous investigations have focused on how we share negative affective states (and in particular pain) of others, whereas only few studies have targeted empathy for positive emotions. This bias has precluded addressing one of the central tenets of the shared representations account of empathy, which is that different networks should be engaged when empathizing with emotions that are represented on different neural levels. The aim of the present study was to overcome this limitation and to test whether empathy for pleasant and unpleasant affective touch is underpinned by different neural networks. To this end we used functional magnetic resonance imaging (fMRI), with two independent replication experiments (N = 18, N = 32), and a novel paradigm enabling the joint investigation of first-hand and vicarious responses to pleasant and unpleasant affect induced via visuo-tactile stimulation. This revealed that empathy is subserved by distinct neural networks, with those regions recruited in the first-hand experience of positive or negative affective states also being specifically recruited when empathizing with these respective states in others. More specifically, the first-hand and vicarious experience of pleasant touch commonly recruited medial orbitofrontal cortex (OFC), while unpleasant touch was associated with shared activation in the right fronto-insular cortex. The observation that specifically tailored subsystems of the human brain are engaged to share positive versus negative touch of others brings fresh evidence to one of the major goals of the social neuroscience of empathy: to identify which specific aspects of the affective states of others are shared, and what role this plays in enabling the understanding of the emotions of others.

Disturbances in affective touch in hereditary sensory & autonomic neuropathy type III

Hereditary sensory and autonomic neuropathy type III (HSAN III, Riley–Day syndrome, Familial Dysautomia) is characterised by elevated thermal thresholds and an indifference to pain. Using microelectrode recordings we recently showed that these patients possess no functional stretch-sensitive mechanoreceptors in their muscles (muscle spindles), a feature that may explain their lack of stretch reflexes and ataxic gait, yet patients have apparently normal low-threshold cutaneous mechanoreceptors. The density of C-fibres in the skin is markedly reduced in patients with HSAN III, but it is not known whether the C-tactile afferents, a distinct type of low-threshold C fibre present in hairy skin that is sensitive to gentle stroking and has been implicated in the coding of pleasant touch are specifically affected in HSAN III patients. We addressed the relationship between C-tactile afferent function and pleasant touch perception in 15 patients with HSAN III and 15 age-matched control subjects. A soft make-up brush was used to apply stroking stimuli to the forearm and lateral aspect of the leg at five velocities: 0.3, 1, 3, 10 and 30 cm/s. As demonstrated previously, the control subjects rated the slowest and highest velocities as less pleasant than those applied at 1–10 cm/s, which fits with the optimal velocities for exciting C-tactile afferents. Conversely, for the patients, ratings of pleasantness did not fit the profile for C-tactile afferents. Patients either rated the higher velocities as more pleasant than the slow velocities, with the slowest velocities being rated unpleasant, or rated all velocities equally pleasant. We interpret this to reflect absent or reduced C-tactile afferent density in the skin of patients with HSAN III, who are likely using tactile cues (i.e. myelinated afferents) to rate pleasantness of stroking or are attributing pleasantness to this type of stimulus irrespective of velocity.

•

C-tactile afferents in hairy skin are believed to mediate affective touch.

•

They are sensitive to slow brushing stimuli, which are perceived as pleasant.

•

It is not known whether C-tactile afferents are affected in HSAN III.

•

Ratings of pleasantness were reduced in 15 HSAN III patients compared to controls.

•

We suggest that the density of C-tactile afferents is reduced in HSAN III.