Pleasant touch perception in borderline personality disorder and its relationship with disturbed body representation

Abstract

Background Borderline personality disorder (BPD) is characterized by altered perception of affective stimuli, including abnormal evaluation of nociceptive input. However, whether or not perceptual alterations are present for its positive counterpart, i.e. pleasant touch (PT), has not yet been examined. Methods In the present study, we applied standardized PT stimuli to the hands of 25 patients with BPD and 25 healthy controls (HC) and compared their perception. We used the affect-modulated acoustic startle response as a physiological correlate of affective processing. We further explored the effect of PT stimulation on dissociative experiences in BPD. Results Compared to HC, BPD perceived PT as less pleasant and less intense. The effect on perceived valence of touch was large even after controlling for the effect of reduced perceived intensity of touch (ƞ2 = .29). We further found qualitative alterations in touch perception in BPD, who rated the touch as significantly rougher and firmer compared to HC. There was a positive correlation between perceived valence of touch and changes in dissociative experiences in terms of body ownership of the stimulated body part from pre to post stimulation, suggesting that a more negative evaluation of touch is associated with an increase in body-related dissociative experiences, while a positive perception of touch might be related to a reduction of these dissociative experiences. Conclusions Our results confirm BPD-associated disturbances in the processing of affective somatosensory stimuli and indicate that not only pain perception but also pleasant touch perception is diminished in BPD. We discuss the role of altered touch perception for BPD psychopathology and its potential role for new treatment approaches.

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

“…Individuals with a history of BPD differed from HCs in all three assessed facets of their appraisal of social touch. As predicted and in line with literature ( 62 ), our data revealed not only a lower liking of pleasant touch in the BPD group, but also identified positive social touch as the domain especially affected in BPD. This is in line with prior findings about a negative bias in decoding positive social cues in BPD ( 87 , 88 ).…”

“…Both, BPD and ACE have been associated with insecure attachment in adulthood ( 58 – 61 ). In line with the aforementioned, individuals with BPD perceive social touch as less pleasant compared to healthy individuals ( 62 ). This suggests that the lack of physical proximity during “physical distancing” affects these individuals to a lower extent.…”

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“…From previous literature, gently stroking the skin at a medium velocity (3–10 m/s, Löken et al, 2009 ) activates a special subclass of receptors that code for pleasant touch. We predict that people with high levels of depersonalisation experiences will rate affective touch experiences as significantly less pleasant and less vivid than the typical controls ( Ciaunica et al, 2021c , Löffler et al, 2022 ). As above, demand characteristics would again have to be controlled for, or ruled out, in experimental tests ( Lush et al, 2020 ).…”

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