The perception of affective touch in anorexia nervosa

Anorexia nervosa (AN) is a disorder characterized by restricted eating, fears of gaining weight, and body image distortions. The etiology remains unknown; however impairments in social cognition and reward circuits contribute to the onset and maintenance of the disorder. One possibility is that AN is associated with reduced perceived pleasantness during social interactions. We therefore examined the perception of interpersonal, 'affective touch' and its social modulation in AN. We measured the perceived pleasantness of light, dynamic stroking touches applied to the forearm of 25 AN patients and 30 healthy controls using C Tactile (CT) afferents-optimal (3 cm/s) and non-optimal (18 cm/s) velocities, while simultaneously displaying images of faces showing rejecting, neutral and accepting expressions. CT-optimal touch, but not CT non-optimal touch, elicited significantly lower pleasantness ratings in AN patients compared with healthy controls. Pleasantness ratings were modulated by facial expressions in both groups in a similar fashion; namely, presenting socially accepting faces increased the perception of touch pleasantness more than neutral and rejecting faces. Our findings suggest that individuals with AN have a disordered, CT-based affective touch system. This impairment may be linked to their weakened interoceptive perception and distorted body representation.