Affective Touch Experiences and Interpersonal Space in Anorexia Nervosa

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Method participants (76 patients with AN and 77 HCs) completed self-report questionnaires measuring eating-related symptoms, anxiety, depression, and affective touch experiences. IPS was assessed with a computer-based stop-distance task with different social conditions. Results patients with AN had higher eating-related, general, and body-image related symptoms than HCs; moreover, they reported lower quantity of affective touch both in childhood and adulthood, and more frequent negative affective touch experiences. In patients, lower affective touch and reduced touch-related comfort were associated with larger IPS, independent of anxiety and depression. No associations with IPS emerged in HCs. Conclusion The results highlighted a link between negative and reduced affective touch and social difficulties and avoidance in AN. The study remarks the relevance of affective touch experiences and their relation with implicit body-related mechanisms, suggesting addressing early tactile experiences and interpersonal functioning in clinical interventions. Level of Evidence Level III, casecontrol study based on selfreport questionnaires and behavioral task. anorexia nervosa affective touch body image interpersonal space bodily self-consciousness interpersonal avoidance Figures Figure 1 Figure 2 Figure 3 Introduction Anorexia Nervosa (AN) pervasively affects corporeal experience at the perceptual, cognitive, and emotional levels (Di Giuliano et al., 2025 ). Patients with AN, indeed, report a wide range of body-related symptoms, including body dissatisfaction, body image distortion (Stice & Shaw, 2002 ), body image avoidance, and body checking (Walker et al., 2018 ). While these symptoms are recognizable and explicitly reportable by individuals, they arise from an entangled connection with altered implicit body-related processes, such as body schema, multisensory integration, and interoception. Among these implicit mechanisms, touch perception is particularly relevant, though it has received comparatively little attention. Previous studies have shown that patients with AN overestimate the distance between tactile stimuli on their arms and abdomen (Keizer et al., 2012 ) and perceive horizontal tactile stimuli as wider than vertical ones (Spitoni et al., 2015). These data highlighted that distortions in body representation and concerns over body size can influence the processing of tactile information. However, the connection between body image disturbances and touch perception has not been explored regarding the affective component of touch. Interpersonal affective touch plays a fundamental role in emotional communication and social behaviors, and is also connected to psychological health, stress management, and body representation (Beltrán et al., 2020 ). Physiologically, affective touch is mediated by C-tactile afferent fibers, which transmit signals to the dorsal horn of the spinal cord, and from there to thalamic medial and intralaminar nuclei (Meijer et al., 2022 ). The signals are then conveyed to several cortical regions, including the superior temporal sulcus, the amygdala, the insula, and the anterior cingulate cortex, which are involved in the emotional evaluation of touch (Meijer et al., 2022 ). Alterations in affective touch have been observed in AN. For instance, Crucianelli et al. ( 2016 ) reported that patients with AN perceived the gentle touch as less pleasant than healthy control subjects (Crucianelli et al., 2016 ), while Davidovic et al. ( 2018 ) identified altered activity in the dorsal striatum, potentially impacting the evaluation of pleasant tactile stimuli (Davidovic et al., 2018 ). Despite these findings, no studies have yet explored how the individual history of affective touch relates to both self-report body image symptoms and implicit body mechanisms involved in social interactions, such as the regulation of interpersonal space (IPS; i.e., the space around the body in which we interact with others). In this context, recent studies have demonstrated that patients with AN prefer a larger distance to interact with others, compared to healthy control subjects (Longo, Scaliti, et al., 2024 ; Nandrino et al., 2017 ). However, the connection between IPS abnormalities and other potentially relevant variables (e.g., early experiences, body image symptoms) has not been deepened yet. Since affective touch represents the direct and primary channel of social communication, we suppose that its alteration in AN may influence interpersonal behavior and the modulation of social distance, consistent with the cited IPS disturbance in this population (Longo, Scaliti, et al., 2024 ; Nandrino et al., 2017 ). Given the emerging gaps in the literature, we aimed to: a) compare patients with AN and healthy control subjects on the quantity and quality of affective touch experience during the lifespan; b) confirm data on IPS modulation replicating our prior study design (Longo, Scaliti, et al., 2024 ), and extending it to a larger sample; c) investigate the connection between affective touch and explicit body-image symptoms such as body dissatisfaction, body avoidance, and body checking, as well as between affective touch and IPS. Method Participants We recruited 76 patients with AN at the Eating Disorder Center of the “Città della Salute e della Scienza” of the University of Turin, Italy. Inclusion criteria were: age above 18 years; diagnosis of AN according to DSM-5. Exclusion criteria were: comorbid psychotic disorder; cognitive or neurological impairment; current use of substances or alcohol. The control sample consisted of 77 healthy individuals recruited from medical students and residents aged 18 years or older. Exclusion criteria included: history of psychiatric disorders; cognitive or neurological impairment; current use of substances or alcohol. All subjects signed the informed consent. The study was approved by the Ethical Committee of the University of Turin under the registration number CS2/840 (approval date 20/12/2021). Materials and procedure All participants completed the computer-based task to evaluate IPS in different social conditions. The task is a modified version of the stop-distance paradigm, in which participants are asked to choose the preferred social distance from actors (male or female) approaching with different facial expressions (i.e., neutral, gaze turned laterally, friendly, threatening). A detailed description of the task is available in Longo, Scaliti, et al. ( 2024 ) and in the Supplementary Materials (Figure S1 ). The subjects completed the following self-report questionnaires: Eating Disorder Examination Questionnaire (EDEQ; Calugi et al., 2017 ): to assess the typical symptoms of eating disorders; Beck Depression Inventory (BDI; Beck, 1961 ) to investigate depression levels; State-Trait Anxiety Inventory (STAI; Spielberger, 2010 ) to measure current (state) and habitual (trait) levels of anxiety; Body Shape Questionnaire (BSQ; Marzola et al., 2022 ), Body Checking Questionnaire (BCQ; Calugi et al., 2006 ), Body Image Avoidance Questionnaire (BIAQ; Maïano et al., 2009 ) to explore the explicit attitudes toward body and body image. Tactile Biography Questionnaire (TBQ; Beltrán et al., 2020 ): the 28-item tool assesses the quantity of affective touch experienced during childhood and adulthood, also exploring the emotional valence associated with touch and the presence of negative events related to interpersonal contact. Statistical analysis Statistical analysis was conducted with RStudio and SPSS. Independent sample t-test was run to investigate differences in continuous variables between HCs and patients, with effect-size calculation with Cohen’s d; chi-squared was used for categorical variables, with Cramer’s V to assess effect size. The modulation of IPS in the task was analyzed using linear mixed-effects models (LMEM), as described in our previous work (Longo, Scaliti, et al., 2024 ). In particular, we run LMEM with the glmer function from the R package “lme4” to assess the differences in IPS between the two groups across several experimental conditions (please, for further details on the analysis, refer to Longo, Scaliti et al., 2024 ). Regression analysis was conducted to investigate the relationship between affective touch and body image-related symptoms, as well as between affective touch and IPS. In case of significant associations, hierarchical regressions were run to control for the role of depression and anxiety entered as covariates. Results Differences between patients with AN and HCs Patients with AN scored significantly higher than HCs in eating-related symptoms, anxiety, depression, and body-related symptoms (Supplementary Material S1). As regards affective touch, patients had lower scores in the childhood, comfort, and adulthood subscales of TBQ (Table 1 a; Fig. 1 ), and reported a significantly higher frequency of negative emotions and negative events related to interpersonal tactile touch compared to HCs (Table 1 b). Finally, patients had a significantly larger IPS than HCs in all conditions (chi squared = 10.653, p = .001; Supplementary Material S2). Table 1 a. Differences between patients with AN and HCs in affective touch. Patients with AN (n = 76) HC (n = 77) Mean (SD) Mean (SD) t p Cohen’s d TBQ_childhood 31.8 (10.8) 36.6 (9.0) 2.347 .022 .489 TBQ_comfort 18.6 (6.5) 23.9 (5.7) 4.235 .001 .872 TBQ_fondness 14.4 (3.1) 14.0 (2.4) − .675 .502 − .144 TBQ_adult 20.6 (7.1) 24.6 (5.9) 2.987 .004 .622 TBQ = Tactile Biography Questionnaire. Table 1 b. Differences between patients with AN and HCs in categorical variables of TBQ. Positive emotion Patients with AN (%) HC (%) Chi squared p V 55 83.6 10.357 .002 .311 Negative emotion 45 16.4 Negative event 62.5 31.3 9.921 .002 .304 No negative event 37.5 68.7 Affective touch and body image No significant associations emerged between TBQ subscales and body-related symptoms (i.e., body dissatisfaction measured with BSQ, body image avoidance measured with BIAQ, body checking measured with BCQ), either in patients with AN or in HCs (Fig. 2 ). TBQ = Tactile Biography Questionnaire; BAQ = Body Image Avoidance Questionnaire; BCQ = Body Checking Questionnaire; BSQ = Body Shape Questionnaire. Affective touch and IPS Negative significant associations were observed between IPS and quantity of affective touch experienced both in childhood and adulthood, and comfort associated with affective touch (Table 2 and Fig. 3 ); these associations survived the statistical adjustment for depression (step 2) and anxiety (step 3; Table 2 ). In the group of HCs, no significant associations between affective touch and IPS emerged (Fig. 3 ). Table 2 Associations between affective touch and IPS modulation in patients with AN. Step 1 Step 2 Step 3 β R 2 p β R 2 p β R 2 p TBQ_Childhood − .019 .111 .035 − .022 .209 .014 − .023 .217 .013 TBQ_Comfort − .041 .194 .004 − .042 .270 .003 − .042 .271 .003 TBQ_Fondness .022 .013 .479 .013 .062 .687 .012 .062 .712 TBQ_Adult − .027 .101 .046 − .036 .225 .009 -0.36 .227 .010 TBQ = Tactile Biography Questionnaire. Step 1 = association between TBQ and IPS; Step 2 = adjusted model for depression as measured with BDI; Step 3 = adjusted model for anxiety as measured with STAI. TBQ = Tactile Biography Questionnaire; IPS = Interpersonal Space. Adjusted associations between TBQ subscales and IPS in patients with AN. Heatmap shows β coefficients from Model 3 (adjusted for BDI and trait anxiety). Scatterplots represent partial regression plots. Discussion The following main findings emerged from the present study: 1) patients with AN, compared to HCs, had higher levels not only in eating-related and general psychopathology, but also in body-related self-reported symptoms; moreover, patients with AN experienced lower quantity of and lower comfort related to affective touch during the lifespan, and reported more frequent negative events associated to affective touch compared to HCs; finally, patients had a larger IPS than HCs; 2) affective touch did not correlate with any of the self-reported body-related symptoms either in patients with AN or in HCs; 3) in the group of patients with AN, negative correlations emerged between IPS and quantity of affective touch experienced both in childhood and adulthood, and comfort related to affective touch; these associations were independent of anxiety and depression. The lower quantity of affective touch in patients with AN than in HCs reflects the perception of lack of tactile nurturing and the touch deprivation reported by patients with AN both during childhood and adulthood (Gupta et al., 1995 ). Accordingly, in our study, patients had lower levels of comfort in affective touch than HCs, again, in line with the literature (Crucianelli et al., 2021 ). Moreover, patients had a higher frequency of negative events related to affective touch, and this is in accordance with the common presence of physically directed childhood trauma (both abuses and neglect) in patients with AN (Longo, Amodeo, et al., 2024 ), adding that, beyond the cited traumatic events, other subtle and daily experiences may also occur and contribute to negatively shaping the relationship with the body. These data, indeed, highlight that patients with AN often have a negative history of interpersonal bodily experience since infancy. This may have etiopathogenetic relevance, since it was established that the early affective touch experiences play a crucial role in bodily awareness and self-other boundaries construction (Beltrán et al., 2020 ), which are among the core pathogenetic nuclei of AN. In the present study, patients with AN showed a larger IPS compared to HCs, confirming the previous data on the topic (Longo, Scaliti, et al., 2024 ; Nandrino et al., 2017 ), and suggesting a strong disturbance of IPS in AN. Affective touch did not correlate with any body-related symptoms in either group. This is in contrast to previous studies stating a connection between affective touch and body image (Cazzato et al., 2021 ; Crucianelli et al., 2016 ). Differently, analysis of patients with AN revealed that a lower quantity of affective touch, both in childhood and adulthood, as well as a lower comfort related to affective touch, correlated with a higher preferred interpersonal distance. Crucianelli and colleagues ( 2016 ) described that affective touch in patients with AN elicited lower pleasantness than in HCs (Crucianelli et al., 2016 ); relatedly, in the present study, patients with AN reported more frequent negative emotions related to affective touch than the healthy group. These data together led us to speculate that affective touch modulates the IPS: patients can, indeed, connect the interpersonal closeness to an anticipation of affective touch, thus implicitly enlarging IPS boundaries as a defensive mechanism against negative emotions elicited by affective touch. Such a mechanism might also reflect the broader avoidance tendencies, central in AN (Haynos et al., 2015 ; Marzola et al., 2016 ). It was indeed described that anorexic symptoms could serve to avoid negative emotions as well as interpersonal relationships (Wildes et al., 2010 ); in our study, the avoidance of interpersonal proximity could aim to avoid, in turn, the negative emotions triggered by affective touch. However, despite the retrospective report on childhood tactile experiences, given the cross-sectional design of the present study, the causal relationship should be interpreted with caution. It is also worth noting that the association between affective touch and IPS remained significant also after controlling for anxiety and depression. It suggests that the observed relationship is not merely driven by emotional distress; it can be, instead, speculated that there is a specific link between affective touch and IPS. These results (i.e., affective touch did not correlate with self-reported bodily symptoms, but was associated with IPS modulation in patients with AN) highlighted that low affective touch, especially during childhood, is not linked to the way the body is explicitly perceived, but mainly to the way the body implicitly functions in social interactions with others, leading to larger IPS boundaries. However, longitudinal and mediational studies are needed to further explore the relationship between childhood affective touch and IPS. Overall, the results suggest considering the body-related symptoms of AN beyond the typical symptomatology and reportable body image disturbances. The personal history of interpersonal contact and affective touch, especially regarding infancy, should also be addressed, particularly in psychotherapy settings. Strength and limits The present study has the main strength of considering multiple facets of bodily experiences, taking into account both the subjective reportable symptoms and the implicit and behavioral perspectives. Moreover, the sample size and the adopted statistical analysis (i.e., mixed methods and covariate correction) contribute to the robustness of the findings. However, the following limitations should be acknowledged: the use of a cross-sectional design and self-report measures that increase the risk of recall biases, especially for data regarding infancy. Furthermore, a comparison between AN subtypes was not conducted. Future studies could adopt a longitudinal design and deepen the differences across different eating-related diagnoses beyond AN. What is already known on this subject There is growing evidence on the complexity of bodily-related disturbance in Anorexia Nervosa, with alterations going beyond the mere body image symptoms. Relatedly, previous studies described alterations in different implicit bodily functions, including the affective touch and the modulation of the interpersonal space. What this study adds This study provides new evidence on the complex interconnection among body image, bodily self-consciousness, and interpersonal dynamics, showing that reduced and negative affective touch experiences are specifically associated with the modulation of interpersonal space in patients with AN. Moreover, new data emerged showing that affective touch was not related to self-reported body image symptoms; this could suggest a dissociation between explicit body image disturbances and implicit bodily mechanisms involved in social interactions. Declarations Funding: This research received no external funding. Institutional Review Board Statement: The study was conducted in accordance with the Declaration of Helsinki, and approved by the Ethics Committee of Azienda Sanitaria Ospedaliera Città della Salute e della Scienza di Torino, protocol number CS2/840. Informed Consent Statement: Written informed consent was obtained from all subjects involved in the study. Data Availability Statement: The data that support the findings of the study are available from the corresponding author upon reasonable request. Conflicts of Interest: The authors declare no conflict of interest. Authors contribution Statement: Federica Toppino: conceptualization, data curation, writing – original draft. Benedetta Salis: data curation, writing – original draft . Eugenio Scaliti: formal analysis, writing – review and editing ; Francesco Bevione: data curation, writing – review and editing ; Matteo Panero: methodology, writing – review and editing. Annalisa Brustolin: writing – review and editing. Giovanni Abbate-Daga: supervision, methodology, writing – review and editing. Paola Longo: conceptualization, supervision, project administration, writing – review and editing. References Beck, A. T. (1961). Inventory for Measuring Depression. Archives of General Psychiatry , 561–571. Beltrán, M. I., Chris Dijkerman, H., & Keizer, A. (2020). Affective touch experiences across the lifespan: Development of the Tactile Biography questionnaire and the mediating role of attachment style. PLoS ONE , 15 (10 October), 1–20. https://doi.org/10.1371/journal.pone.0241041 Calugi, S., Dalle Grave, R., Ghisi, M., & Sanavio, E. (2006). Validation of the Body Checking Questionnaire (BCQ) in an Eating Disorders Population. Behavioural and Cognitive Psychotherapy , 34 , 233–242. Calugi, S., Milanese, C., Sartirana, M., El Ghoch, M., Sartori, F., Geccherle, E., Coppini, A., Franchini, C., & Dalle Grave, R. (2017). The Eating Disorder Examination Questionnaire: reliability and validity of the Italian version. Eating and Weight Disorders . https://doi.org/10.1007/s40519-016-0276-6 Cazzato, V., Sacchetti, S., Shin, S., Makdani, A., Trotter, P. D., & McGlone, F. (2021). Affective touch topography and body image. PLoS ONE , 16 (11 November), 1–24. https://doi.org/10.1371/journal.pone.0243680 Crucianelli, L., Cardi, V., Treasure, J., Jenkinson, P. M., & Fotopoulou, A. (2016). The perception of affective touch in anorexia nervosa. Psychiatry Research , 239 , 72–78. https://doi.org/10.1016/j.psychres.2016.01.078 Crucianelli, L., Demartini, B., Goeta, D., Nisticò, V., Saramandi, A., Bertelli, S., Todisco, P., Gambini, O., & Fotopoulou, A. (2021). The Anticipation and Perception of Affective Touch in Women with and Recovered from Anorexia Nervosa. Neuroscience , 464 , 143–155. https://doi.org/10.1016/j.neuroscience.2020.09.013 Davidovic, M., Karjalainen, L., Starck, G., Wentz, E., Björnsdotter, M., & Olausson, H. (2018). Abnormal brain processing of gentle touch in anorexia nervosa. Psychiatry Research - Neuroimaging , 281 (March 2017), 53–60. https://doi.org/10.1016/j.pscychresns.2018.08.007 Di Giuliano, M., de la Cruz, F., Schumann, A., Zopf, R., & Bär, K. J. (2025). Behavioral, neuronal, and physiological facets of multidimensional body image in anorexia nervosa: a scoping review. Journal of Eating Disorders , 13 (1). https://doi.org/10.1186/s40337-025-01191-4 Gupta, M. A., Gupta, A. K., Schork, N. J., & Watteel, G. N. (1995). Perceived touch deprivation and body image: some observations among eating disordered and non-clinical subjects. Journal of Psychosomatic Research , 39 (4), 459–464. https://doi.org/10.1016/0022-3999(94)00146-V Haynos, A. F., Crosby, R. D., Engel, S. G., Lavender, J. M., Wonderlich, S. A., Mitchell, J. E., Peterson, C. B., Crow, S. J., & Le Grange, D. (2015). Initial test of an emotional avoidance model of restriction in anorexia nervosa using ecological momentary assessment. Journal of Psychiatric Research , 68 , 134–139. https://doi.org/10.1016/j.jpsychires.2015.06.016 Keizer, A., Smeets, M. A. M., Dijkerman, H. C., van Elburg, A., & Postma, A. (2012). Aberrant somatosensory perception in Anorexia Nervosa. Psychiatry Research , 200 (2–3), 530–537. https://doi.org/10.1016/j.psychres.2012.05.001 Longo, P., Amodeo, L., Toppino, F., Abbate-Daga, G., Panero, M., & Martini, M. (2024). An updated report on trauma in Anorexia Nervosa: Confirmation and novel data. European Journal of Trauma and Dissociation , 8 (1), 100372. https://doi.org/10.1016/j.ejtd.2023.100372 Longo, P., Scaliti, E., Panero, M., Toppino, F., Brustolin, A., Salis, B., Lacidogna, M. C., Abbate-Daga, G., & Martini, M. (2024). A quantitative study on peripersonal space in anorexia nervosa and healthy subjects: Role of social variables and association with psychopathology. International Journal of Clinical and Health Psychology , 24 (3), 100476. https://doi.org/10.1016/j.ijchp.2024.100476 Maïano, C., Morin, A. J. S., Monthuy-Blanc, J., & Garbarino, J. M. (2009). The body image avoidance questionnaire: Assessment of its construct validity in a community sample of french adolescents. International Journal of Behavioral Medicine , 16 (2), 125–135. https://doi.org/10.1007/s12529-009-9035-7 Marzola, E., Martini, M., Longo, P., Toppino, F., Bevione, F., Delsedime, N., Abbate-Daga, G., & Preti, A. (2022). Psychometric properties of the Italian body shape questionnaire: an investigation of its reliability, factorial, concurrent, and criterion validity. Eating and Weight Disorders , 27 (8), 3637–3648. https://doi.org/10.1007/s40519-022-01503-6 Marzola, E., Panepinto, C., Delsedime, N., Amianto, F., Fassino, S., & Abbate-Daga, G. (2016). A factor analysis of the meanings of anorexia nervosa: Intrapsychic, relational, and avoidant dimensions and their clinical correlates. BMC Psychiatry , 16 (1), 1–9. https://doi.org/10.1186/s12888-016-0894-6 Meijer, L. L., Ruis, C., van der Smagt, M. J., Scherder, E. J. A., & Dijkerman, H. C. (2022). Neural basis of affective touch and pain: A novel model suggests possible targets for pain amelioration. Journal of Neuropsychology , 16 (1), 38–53. https://doi.org/10.1111/jnp.12250 Nandrino, J. L., Ducro, C., Iachini, T., & Coello, Y. (2017). Perception of Peripersonal and Interpersonal Space in Patients with Restrictive-type Anorexia. European Eating Disorders Review , 25 (3), 179–187. https://doi.org/10.1002/erv.2506 Spielberger, C. (2010). State-Trait Anxiety Inventory for Adults - Manual, Instrument and Scoring Guide. 1983 Consulting Psychologists Press, Inc. Mind Garden, Inc. Stice, E., & Shaw, H. E. (2002). Role of body dissatisfaction in the onset and maintenance of eating pathology: A synthesis of research findings. Journal of Psychosomatic Research , 53 (5), 985–993. https://doi.org/10.1016/S0022-3999(02)00488-9 Walker, D. C., White, E. K., & Srinivasan, V. J. (2018). A meta-analysis of the relationships between body checking, body image avoidance, body image dissatisfaction, mood, and disordered eating. International Journal of Eating Disorders , 51 (8), 745–770. https://doi.org/10.1002/eat.22867 Wildes, J. E., Ringham, R. M., & Marcus, M. D. (2010). Emotion avoidance in patients with anorexia nervosa: Initial test of a functional model. International Journal of Eating Disorders , 43 (5), 398–404. https://doi.org/10.1002/eat.20730 Additional Declarations No competing interests reported. Supplementary Files AffectivetouchinANSupplementaryMaterial.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 04 May, 2026 Reviewers agreed at journal 04 May, 2026 Reviewers invited by journal 04 May, 2026 Editor assigned by journal 03 May, 2026 Submission checks completed at journal 21 Apr, 2026 First submitted to journal 20 Apr, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9470025","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":634121680,"identity":"97122616-3a55-4c94-8560-67385acb2699","order_by":0,"name":"Federica Toppino","email":"","orcid":"","institution":"University of Turin","correspondingAuthor":false,"prefix":"","firstName":"Federica","middleName":"","lastName":"Toppino","suffix":""},{"id":634121682,"identity":"db8ec598-4287-41f3-89b3-8e606b6d4956","order_by":1,"name":"Benedetta Salis","email":"","orcid":"","institution":"University of Turin","correspondingAuthor":false,"prefix":"","firstName":"Benedetta","middleName":"","lastName":"Salis","suffix":""},{"id":634121683,"identity":"1305ad7b-f7e6-4c9c-9cf2-3e8d16cc62e2","order_by":2,"name":"Eugenio Scaliti","email":"","orcid":"","institution":"University of Turin","correspondingAuthor":false,"prefix":"","firstName":"Eugenio","middleName":"","lastName":"Scaliti","suffix":""},{"id":634121694,"identity":"d5928d33-78e7-4d04-9445-4cad33d699fb","order_by":3,"name":"Francesco Bevione","email":"","orcid":"","institution":"University of Turin","correspondingAuthor":false,"prefix":"","firstName":"Francesco","middleName":"","lastName":"Bevione","suffix":""},{"id":634121695,"identity":"eb71b53e-05c0-4cb8-bfa8-c52edf0f7260","order_by":4,"name":"Matteo Panero","email":"","orcid":"","institution":"University of Turin","correspondingAuthor":false,"prefix":"","firstName":"Matteo","middleName":"","lastName":"Panero","suffix":""},{"id":634121701,"identity":"fcfa1022-eee0-4387-a6a9-b729f9334573","order_by":5,"name":"Annalisa Brustolin","email":"","orcid":"","institution":"University of Turin","correspondingAuthor":false,"prefix":"","firstName":"Annalisa","middleName":"","lastName":"Brustolin","suffix":""},{"id":634121707,"identity":"e87325b8-4889-431c-86cd-c6eee71d4b10","order_by":6,"name":"Giovanni Abbate-Daga","email":"","orcid":"","institution":"University of Turin","correspondingAuthor":false,"prefix":"","firstName":"Giovanni","middleName":"","lastName":"Abbate-Daga","suffix":""},{"id":634121711,"identity":"48dffc08-6583-4608-9716-8a4f4eea3dbd","order_by":7,"name":"Paola Longo","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA4UlEQVRIiWNgGAWjYHACxgMMDBZgxgMGBgkQ3UBQzwGISgZmAyADyGJsJKgHpoUNRBK2xpz98IEDPxgk5Mz5Fx+r5t1hUcfPwNz+AJ8Wy560hIM9DBLGljOepd3mPSMhIdlAwGEGB3IMDvAwSCRuuHHG7DZvm4SEwQFCWs6/MTj4B6qlmDgtN3IMDoNtOd9jxkyUFqAXEg7LGEgYG9xgS5ac2yYhObOZsXEGPi3m/MkHH76psJEzOH/44Ie3bXX8/OztDz7gdRiclEiACjHjUw/XAgL8BwgoHQWjYBSMghELAODFSOc41k0QAAAAAElFTkSuQmCC","orcid":"","institution":"University of Turin","correspondingAuthor":true,"prefix":"","firstName":"Paola","middleName":"","lastName":"Longo","suffix":""}],"badges":[],"createdAt":"2026-04-20 09:38:21","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9470025/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9470025/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":109101870,"identity":"4f82c40b-8827-4eed-98df-d221e30f0b7e","added_by":"auto","created_at":"2026-05-12 14:30:27","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":302738,"visible":true,"origin":"","legend":"\u003cp\u003eDifferences between patients with AN and HCs in affective touch.\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-9470025/v1/dd4bd3b1e0422e8d4edb8ca1.png"},{"id":109101871,"identity":"e017b2dc-2c91-4a62-8b75-d54c48e4e767","added_by":"auto","created_at":"2026-05-12 14:30:27","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":238879,"visible":true,"origin":"","legend":"\u003cp\u003eAssociations between affective touch and body image symptoms in patients with AN and HCs.\u003c/p\u003e\n\u003cp\u003eTBQ = Tactile Biography Questionnaire; BAQ = Body Image Avoidance Questionnaire; BCQ = Body Checking Questionnaire; BSQ = Body Shape Questionnaire.\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-9470025/v1/2ccb624097687859ee4350fd.png"},{"id":109101969,"identity":"4b99d44b-e797-4748-8254-f1ddcdaaf541","added_by":"auto","created_at":"2026-05-12 14:30:35","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":221933,"visible":true,"origin":"","legend":"\u003cp\u003eAssociations between affective touch and IPS.\u003c/p\u003e\n\u003cp\u003eTBQ = Tactile Biography Questionnaire; IPS = Interpersonal Space.\u003c/p\u003e\n\u003cp\u003eAdjusted associations between TBQ subscales and IPS in patients with AN.\u003cbr\u003e\nHeatmap shows β coefficients from Model 3 (adjusted for BDI and trait anxiety). Scatterplots represent partial regression plots.\u003c/p\u003e","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-9470025/v1/4041be96192f2d1b5dfdae1c.png"},{"id":109204806,"identity":"d68b96ba-bde0-44a0-b535-1cac4b935cbb","added_by":"auto","created_at":"2026-05-13 15:02:19","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":959047,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9470025/v1/8a5338f6-1797-460f-b240-5c4cbc98b939.pdf"},{"id":109101971,"identity":"ac006d01-7a10-41d7-af86-13e92489937e","added_by":"auto","created_at":"2026-05-12 14:30:36","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":44811,"visible":true,"origin":"","legend":"","description":"","filename":"AffectivetouchinANSupplementaryMaterial.docx","url":"https://assets-eu.researchsquare.com/files/rs-9470025/v1/2870096c19b1f0d8cff35e92.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Affective Touch Experiences and Interpersonal Space in Anorexia Nervosa ","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAnorexia Nervosa (AN) pervasively affects corporeal experience at the perceptual, cognitive, and emotional levels (Di Giuliano et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). Patients with AN, indeed, report a wide range of body-related symptoms, including body dissatisfaction, body image distortion (Stice \u0026amp; Shaw, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2002\u003c/span\u003e), body image avoidance, and body checking (Walker et al., \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). While these symptoms are recognizable and explicitly reportable by individuals, they arise from an entangled connection with altered implicit body-related processes, such as body schema, multisensory integration, and interoception. Among these implicit mechanisms, touch perception is particularly relevant, though it has received comparatively little attention. Previous studies have shown that patients with AN overestimate the distance between tactile stimuli on their arms and abdomen (Keizer et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2012\u003c/span\u003e) and perceive horizontal tactile stimuli as wider than vertical ones (Spitoni et al., 2015). These data highlighted that distortions in body representation and concerns over body size can influence the processing of tactile information. However, the connection between body image disturbances and touch perception has not been explored regarding the affective component of touch.\u003c/p\u003e \u003cp\u003eInterpersonal affective touch plays a fundamental role in emotional communication and social behaviors, and is also connected to psychological health, stress management, and body representation (Beltr\u0026aacute;n et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Physiologically, affective touch is mediated by C-tactile afferent fibers, which transmit signals to the dorsal horn of the spinal cord, and from there to thalamic medial and intralaminar nuclei (Meijer et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). The signals are then conveyed to several cortical regions, including the superior temporal sulcus, the amygdala, the insula, and the anterior cingulate cortex, which are involved in the emotional evaluation of touch (Meijer et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAlterations in affective touch have been observed in AN. For instance, Crucianelli et al. (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) reported that patients with AN perceived the gentle touch as less pleasant than healthy control subjects (Crucianelli et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2016\u003c/span\u003e), while Davidovic et al. (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) identified altered activity in the dorsal striatum, potentially impacting the evaluation of pleasant tactile stimuli (Davidovic et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2018\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDespite these findings, no studies have yet explored how the individual history of affective touch relates to both self-report body image symptoms and implicit body mechanisms involved in social interactions, such as the regulation of interpersonal space (IPS; i.e., the space around the body in which we interact with others). In this context, recent studies have demonstrated that patients with AN prefer a larger distance to interact with others, compared to healthy control subjects (Longo, Scaliti, et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Nandrino et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). However, the connection between IPS abnormalities and other potentially relevant variables (e.g., early experiences, body image symptoms) has not been deepened yet.\u003c/p\u003e \u003cp\u003eSince affective touch represents the direct and primary channel of social communication, we suppose that its alteration in AN may influence interpersonal behavior and the modulation of social distance, consistent with the cited IPS disturbance in this population (Longo, Scaliti, et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Nandrino et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2017\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eGiven the emerging gaps in the literature, we aimed to: a) compare patients with AN and healthy control subjects on the quantity and quality of affective touch experience during the lifespan; b) confirm data on IPS modulation replicating our prior study design (Longo, Scaliti, et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2024\u003c/span\u003e), and extending it to a larger sample; c) investigate the connection between affective touch and explicit body-image symptoms such as body dissatisfaction, body avoidance, and body checking, as well as between affective touch and IPS.\u003c/p\u003e"},{"header":"Method","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eParticipants\u003c/h2\u003e \u003cp\u003eWe recruited 76 patients with AN at the Eating Disorder Center of the \u0026ldquo;Citt\u0026agrave; della Salute e della Scienza\u0026rdquo; of the University of Turin, Italy. Inclusion criteria were: age above 18 years; diagnosis of AN according to DSM-5. Exclusion criteria were: comorbid psychotic disorder; cognitive or neurological impairment; current use of substances or alcohol.\u003c/p\u003e \u003cp\u003eThe control sample consisted of 77 healthy individuals recruited from medical students and residents aged 18 years or older. Exclusion criteria included: history of psychiatric disorders; cognitive or neurological impairment; current use of substances or alcohol.\u003c/p\u003e \u003cp\u003e All subjects signed the informed consent. The study was approved by the Ethical Committee of the University of Turin under the registration number CS2/840 (approval date 20/12/2021).\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eMaterials and procedure\u003c/h3\u003e\n\u003cp\u003eAll participants completed the computer-based task to evaluate IPS in different social conditions. The task is a modified version of the stop-distance paradigm, in which participants are asked to choose the preferred social distance from actors (male or female) approaching with different facial expressions (i.e., neutral, gaze turned laterally, friendly, threatening). A detailed description of the task is available in Longo, Scaliti, et al. (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) and in the Supplementary Materials (Figure \u003cspan refid=\"MOESM1\" class=\"InternalRef\"\u003eS1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe subjects completed the following self-report questionnaires:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eEating Disorder Examination Questionnaire (EDEQ; Calugi et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2017\u003c/span\u003e): to assess the typical symptoms of eating disorders;\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eBeck Depression Inventory (BDI; Beck, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1961\u003c/span\u003e) to investigate depression levels;\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eState-Trait Anxiety Inventory (STAI; Spielberger, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2010\u003c/span\u003e) to measure current (state) and habitual (trait) levels of anxiety;\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eBody Shape Questionnaire (BSQ; Marzola et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2022\u003c/span\u003e), Body Checking Questionnaire (BCQ; Calugi et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2006\u003c/span\u003e), Body Image Avoidance Questionnaire (BIAQ; Ma\u0026iuml;ano et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2009\u003c/span\u003e) to explore the explicit attitudes toward body and body image.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eTactile Biography Questionnaire (TBQ; Beltr\u0026aacute;n et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2020\u003c/span\u003e): the 28-item tool assesses the quantity of affective touch experienced during childhood and adulthood, also exploring the emotional valence associated with touch and the presence of negative events related to interpersonal contact.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eStatistical analysis was conducted with RStudio and SPSS. Independent sample t-test was run to investigate differences in continuous variables between HCs and patients, with effect-size calculation with Cohen\u0026rsquo;s d; chi-squared was used for categorical variables, with Cramer\u0026rsquo;s V to assess effect size. The modulation of IPS in the task was analyzed using linear mixed-effects models (LMEM), as described in our previous work (Longo, Scaliti, et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). In particular, we run LMEM with the glmer function from the R package \u0026ldquo;lme4\u0026rdquo; to assess the differences in IPS between the two groups across several experimental conditions (please, for further details on the analysis, refer to Longo, Scaliti et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eRegression analysis was conducted to investigate the relationship between affective touch and body image-related symptoms, as well as between affective touch and IPS. In case of significant associations, hierarchical regressions were run to control for the role of depression and anxiety entered as covariates.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eDifferences between patients with AN and HCs\u003c/h2\u003e \u003cp\u003ePatients with AN scored significantly higher than HCs in eating-related symptoms, anxiety, depression, and body-related symptoms (Supplementary Material S1).\u003c/p\u003e \u003cp\u003eAs regards affective touch, patients had lower scores in the childhood, comfort, and adulthood subscales of TBQ (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1\u003c/span\u003ea; Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e), and reported a significantly higher frequency of negative emotions and negative events related to interpersonal tactile touch compared to HCs (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1\u003c/span\u003eb).\u003c/p\u003e \u003cp\u003eFinally, patients had a significantly larger IPS than HCs in all conditions (chi squared\u0026thinsp;=\u0026thinsp;10.653, p = .001; Supplementary Material S2).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ea. Differences between patients with AN and HCs in affective touch.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatients with AN (n\u0026thinsp;=\u0026thinsp;76)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHC\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;77)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean (SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMean (SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003et\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eCohen\u0026rsquo;s d\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTBQ_childhood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e31.8 (10.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36.6 (9.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.347\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e.022\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.489\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTBQ_comfort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18.6 (6.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23.9 (5.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.235\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.872\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTBQ_fondness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14.4 (3.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14.0 (2.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.675\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.502\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.144\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTBQ_adult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e20.6 (7.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24.6 (5.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.987\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e.004\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.622\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTBQ\u0026thinsp;=\u0026thinsp;Tactile Biography Questionnaire.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eb. Differences between patients with AN and HCs in categorical variables of TBQ.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePositive emotion\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatients with AN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHC\u003c/p\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eChi squared\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eV\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e83.6\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.357\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e.002\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.311\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNegative emotion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNegative event\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e62.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9.921\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e.002\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.304\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo negative event\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e68.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eAffective touch and body image\u003c/h2\u003e \u003cp\u003eNo significant associations emerged between TBQ subscales and body-related symptoms (i.e., body dissatisfaction measured with BSQ, body image avoidance measured with BIAQ, body checking measured with BCQ), either in patients with AN or in HCs (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eTBQ\u0026thinsp;=\u0026thinsp;Tactile Biography Questionnaire; BAQ\u0026thinsp;=\u0026thinsp;Body Image Avoidance Questionnaire; BCQ\u0026thinsp;=\u0026thinsp;Body Checking Questionnaire; BSQ\u0026thinsp;=\u0026thinsp;Body Shape Questionnaire.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eAffective touch and IPS\u003c/h3\u003e\n\u003cp\u003eNegative significant associations were observed between IPS and quantity of affective touch experienced both in childhood and adulthood, and comfort associated with affective touch (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e2\u003c/span\u003e and Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e); these associations survived the statistical adjustment for depression (step 2) and anxiety (step 3; Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn the group of HCs, no significant associations between affective touch and IPS emerged (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAssociations between affective touch and IPS modulation in patients with AN.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eStep 1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eStep 2\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003eStep 3\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eβ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eR\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eβ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eR\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eβ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eR\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTBQ_Childhood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.111\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.035\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.209\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.023\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.217\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.013\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTBQ_Comfort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.041\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.194\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.042\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.270\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.042\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.271\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTBQ_Fondness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.479\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.062\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.687\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.062\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.712\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTBQ_Adult\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.027\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.101\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.046\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.036\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.225\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-0.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.227\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.010\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTBQ\u0026thinsp;=\u0026thinsp;Tactile Biography Questionnaire.\u003c/p\u003e \u003cp\u003eStep 1\u0026thinsp;=\u0026thinsp;association between TBQ and IPS; Step 2\u0026thinsp;=\u0026thinsp;adjusted model for depression as measured with BDI; Step 3\u0026thinsp;=\u0026thinsp;adjusted model for anxiety as measured with STAI.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eTBQ\u0026thinsp;=\u0026thinsp;Tactile Biography Questionnaire; IPS\u0026thinsp;=\u0026thinsp;Interpersonal Space.\u003c/p\u003e \u003cp\u003eAdjusted associations between TBQ subscales and IPS in patients with AN.\u003c/p\u003e \u003cp\u003eHeatmap shows β coefficients from Model 3 (adjusted for BDI and trait anxiety). Scatterplots represent partial regression plots.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe following main findings emerged from the present study: 1) patients with AN, compared to HCs, had higher levels not only in eating-related and general psychopathology, but also in body-related self-reported symptoms; moreover, patients with AN experienced lower quantity of and lower comfort related to affective touch during the lifespan, and reported more frequent negative events associated to affective touch compared to HCs; finally, patients had a larger IPS than HCs; 2) affective touch did not correlate with any of the self-reported body-related symptoms either in patients with AN or in HCs; 3) in the group of patients with AN, negative correlations emerged between IPS and quantity of affective touch experienced both in childhood and adulthood, and comfort related to affective touch; these associations were independent of anxiety and depression.\u003c/p\u003e \u003cp\u003eThe lower quantity of affective touch in patients with AN than in HCs reflects the perception of lack of tactile nurturing and the touch deprivation reported by patients with AN both during childhood and adulthood (Gupta et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e1995\u003c/span\u003e). Accordingly, in our study, patients had lower levels of comfort in affective touch than HCs, again, in line with the literature (Crucianelli et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Moreover, patients had a higher frequency of negative events related to affective touch, and this is in accordance with the common presence of physically directed childhood trauma (both abuses and neglect) in patients with AN (Longo, Amodeo, et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2024\u003c/span\u003e), adding that, beyond the cited traumatic events, other subtle and daily experiences may also occur and contribute to negatively shaping the relationship with the body. These data, indeed, highlight that patients with AN often have a negative history of interpersonal bodily experience since infancy. This may have etiopathogenetic relevance, since it was established that the early affective touch experiences play a crucial role in bodily awareness and self-other boundaries construction (Beltr\u0026aacute;n et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2020\u003c/span\u003e), which are among the core pathogenetic nuclei of AN.\u003c/p\u003e \u003cp\u003eIn the present study, patients with AN showed a larger IPS compared to HCs, confirming the previous data on the topic (Longo, Scaliti, et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Nandrino et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2017\u003c/span\u003e), and suggesting a strong disturbance of IPS in AN.\u003c/p\u003e \u003cp\u003eAffective touch did not correlate with any body-related symptoms in either group. This is in contrast to previous studies stating a connection between affective touch and body image (Cazzato et al., \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Crucianelli et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). Differently, analysis of patients with AN revealed that a lower quantity of affective touch, both in childhood and adulthood, as well as a lower comfort related to affective touch, correlated with a higher preferred interpersonal distance. Crucianelli and colleagues (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) described that affective touch in patients with AN elicited lower pleasantness than in HCs (Crucianelli et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2016\u003c/span\u003e); relatedly, in the present study, patients with AN reported more frequent negative emotions related to affective touch than the healthy group. These data together led us to speculate that affective touch modulates the IPS: patients can, indeed, connect the interpersonal closeness to an anticipation of affective touch, thus implicitly enlarging IPS boundaries as a defensive mechanism against negative emotions elicited by affective touch. Such a mechanism might also reflect the broader avoidance tendencies, central in AN (Haynos et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Marzola et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). It was indeed described that anorexic symptoms could serve to avoid negative emotions as well as interpersonal relationships (Wildes et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2010\u003c/span\u003e); in our study, the avoidance of interpersonal proximity could aim to avoid, in turn, the negative emotions triggered by affective touch. However, despite the retrospective report on childhood tactile experiences, given the cross-sectional design of the present study, the causal relationship should be interpreted with caution.\u003c/p\u003e \u003cp\u003eIt is also worth noting that the association between affective touch and IPS remained significant also after controlling for anxiety and depression. It suggests that the observed relationship is not merely driven by emotional distress; it can be, instead, speculated that there is a specific link between affective touch and IPS.\u003c/p\u003e \u003cp\u003eThese results (i.e., affective touch did not correlate with self-reported bodily symptoms, but was associated with IPS modulation in patients with AN) highlighted that low affective touch, especially during childhood, is not linked to the way the body is explicitly perceived, but mainly to the way the body implicitly functions in social interactions with others, leading to larger IPS boundaries. However, longitudinal and mediational studies are needed to further explore the relationship between childhood affective touch and IPS.\u003c/p\u003e \u003cp\u003eOverall, the results suggest considering the body-related symptoms of AN beyond the typical symptomatology and reportable body image disturbances. The personal history of interpersonal contact and affective touch, especially regarding infancy, should also be addressed, particularly in psychotherapy settings.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eStrength and limits\u003c/h2\u003e \u003cp\u003eThe present study has the main strength of considering multiple facets of bodily experiences, taking into account both the subjective reportable symptoms and the implicit and behavioral perspectives. Moreover, the sample size and the adopted statistical analysis (i.e., mixed methods and covariate correction) contribute to the robustness of the findings.\u003c/p\u003e \u003cp\u003eHowever, the following limitations should be acknowledged: the use of a cross-sectional design and self-report measures that increase the risk of recall biases, especially for data regarding infancy. Furthermore, a comparison between AN subtypes was not conducted. Future studies could adopt a longitudinal design and deepen the differences across different eating-related diagnoses beyond AN.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eWhat is already known on this subject\u003c/h2\u003e \u003cp\u003eThere is growing evidence on the complexity of bodily-related disturbance in Anorexia Nervosa, with alterations going beyond the mere body image symptoms. Relatedly, previous studies described alterations in different implicit bodily functions, including the affective touch and the modulation of the interpersonal space.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eWhat this study adds\u003c/h2\u003e \u003cp\u003eThis study provides new evidence on the complex interconnection among body image, bodily self-consciousness, and interpersonal dynamics, showing that reduced and negative affective touch experiences are specifically associated with the modulation of interpersonal space in patients with AN. Moreover, new data emerged showing that affective touch was not related to self-reported body image symptoms; this could suggest a dissociation between explicit body image disturbances and implicit bodily mechanisms involved in social interactions.\u003c/p\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e This research received no external funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInstitutional Review Board Statement: \u003c/strong\u003eThe study was conducted in accordance with the Declaration of Helsinki, and approved by the Ethics Committee of Azienda Sanitaria Ospedaliera Citt\u0026agrave; della Salute e della Scienza di Torino, protocol number CS2/840.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed Consent Statement: \u003c/strong\u003eWritten informed consent was obtained from all subjects involved in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability Statement:\u003c/strong\u003e The data that support the findings of the study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eConflicts of Interest:\u003c/strong\u003e The authors declare no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors contribution Statement: Federica Toppino: \u003c/strong\u003econceptualization, data curation, writing \u0026ndash; original draft.\u003cstrong\u003e Benedetta Salis: \u003c/strong\u003edata curation, writing \u0026ndash; original draft\u003cstrong\u003e. Eugenio Scaliti: \u003c/strong\u003eformal analysis, writing \u0026ndash; review and editing\u003cstrong\u003e; Francesco Bevione: \u003c/strong\u003edata curation, writing \u0026ndash; review and editing\u003cstrong\u003e; Matteo Panero: \u003c/strong\u003emethodology, writing \u0026ndash; review and editing. \u003cstrong\u003eAnnalisa Brustolin: \u003c/strong\u003ewriting \u0026ndash; review and editing.\u003cstrong\u003e Giovanni Abbate-Daga: \u003c/strong\u003esupervision, methodology, writing \u0026ndash; review and editing.\u003cstrong\u003e Paola Longo: \u003c/strong\u003econceptualization, supervision, project administration, writing \u0026ndash; review and editing. \u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eBeck, A. T. (1961). Inventory for Measuring Depression. \u003cem\u003eArchives of General Psychiatry\u003c/em\u003e, 561\u0026ndash;571.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBeltr\u0026aacute;n, M. I., Chris Dijkerman, H., \u0026amp; Keizer, A. (2020). Affective touch experiences across the lifespan: Development of the Tactile Biography questionnaire and the mediating role of attachment style. \u003cem\u003ePLoS ONE\u003c/em\u003e, \u003cem\u003e15\u003c/em\u003e(10 October), 1\u0026ndash;20. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1371/journal.pone.0241041\u003c/span\u003e\u003cspan address=\"10.1371/journal.pone.0241041\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCalugi, S., Dalle Grave, R., Ghisi, M., \u0026amp; Sanavio, E. (2006). Validation of the Body Checking Questionnaire (BCQ) in an Eating Disorders Population. \u003cem\u003eBehavioural and Cognitive Psychotherapy\u003c/em\u003e, \u003cem\u003e34\u003c/em\u003e, 233\u0026ndash;242.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCalugi, S., Milanese, C., Sartirana, M., El Ghoch, M., Sartori, F., Geccherle, E., Coppini, A., Franchini, C., \u0026amp; Dalle Grave, R. (2017). The Eating Disorder Examination Questionnaire: reliability and validity of the Italian version. \u003cem\u003eEating and Weight Disorders\u003c/em\u003e. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s40519-016-0276-6\u003c/span\u003e\u003cspan address=\"10.1007/s40519-016-0276-6\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCazzato, V., Sacchetti, S., Shin, S., Makdani, A., Trotter, P. D., \u0026amp; McGlone, F. (2021). Affective touch topography and body image. \u003cem\u003ePLoS ONE\u003c/em\u003e, \u003cem\u003e16\u003c/em\u003e(11 November), 1\u0026ndash;24. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1371/journal.pone.0243680\u003c/span\u003e\u003cspan address=\"10.1371/journal.pone.0243680\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCrucianelli, L., Cardi, V., Treasure, J., Jenkinson, P. M., \u0026amp; Fotopoulou, A. (2016). The perception of affective touch in anorexia nervosa. \u003cem\u003ePsychiatry Research\u003c/em\u003e, \u003cem\u003e239\u003c/em\u003e, 72\u0026ndash;78. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.psychres.2016.01.078\u003c/span\u003e\u003cspan address=\"10.1016/j.psychres.2016.01.078\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCrucianelli, L., Demartini, B., Goeta, D., Nistic\u0026ograve;, V., Saramandi, A., Bertelli, S., Todisco, P., Gambini, O., \u0026amp; Fotopoulou, A. (2021). The Anticipation and Perception of Affective Touch in Women with and Recovered from Anorexia Nervosa. \u003cem\u003eNeuroscience\u003c/em\u003e, \u003cem\u003e464\u003c/em\u003e, 143\u0026ndash;155. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.neuroscience.2020.09.013\u003c/span\u003e\u003cspan address=\"10.1016/j.neuroscience.2020.09.013\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDavidovic, M., Karjalainen, L., Starck, G., Wentz, E., Bj\u0026ouml;rnsdotter, M., \u0026amp; Olausson, H. (2018). Abnormal brain processing of gentle touch in anorexia nervosa. \u003cem\u003ePsychiatry Research - Neuroimaging\u003c/em\u003e, \u003cem\u003e281\u003c/em\u003e(March 2017), 53\u0026ndash;60. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.pscychresns.2018.08.007\u003c/span\u003e\u003cspan address=\"10.1016/j.pscychresns.2018.08.007\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDi Giuliano, M., de la Cruz, F., Schumann, A., Zopf, R., \u0026amp; B\u0026auml;r, K. J. (2025). Behavioral, neuronal, and physiological facets of multidimensional body image in anorexia nervosa: a scoping review. \u003cem\u003eJournal of Eating Disorders\u003c/em\u003e, \u003cem\u003e13\u003c/em\u003e(1). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1186/s40337-025-01191-4\u003c/span\u003e\u003cspan address=\"10.1186/s40337-025-01191-4\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGupta, M. A., Gupta, A. K., Schork, N. J., \u0026amp; Watteel, G. N. (1995). Perceived touch deprivation and body image: some observations among eating disordered and non-clinical subjects. \u003cem\u003eJournal of Psychosomatic Research\u003c/em\u003e, \u003cem\u003e39\u003c/em\u003e(4), 459\u0026ndash;464. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/0022-3999(94)00146-V\u003c/span\u003e\u003cspan address=\"10.1016/0022-3999(94)00146-V\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHaynos, A. F., Crosby, R. D., Engel, S. G., Lavender, J. M., Wonderlich, S. A., Mitchell, J. E., Peterson, C. B., Crow, S. J., \u0026amp; Le Grange, D. (2015). Initial test of an emotional avoidance model of restriction in anorexia nervosa using ecological momentary assessment. \u003cem\u003eJournal of Psychiatric Research\u003c/em\u003e, \u003cem\u003e68\u003c/em\u003e, 134\u0026ndash;139. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.jpsychires.2015.06.016\u003c/span\u003e\u003cspan address=\"10.1016/j.jpsychires.2015.06.016\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKeizer, A., Smeets, M. A. M., Dijkerman, H. C., van Elburg, A., \u0026amp; Postma, A. (2012). Aberrant somatosensory perception in Anorexia Nervosa. \u003cem\u003ePsychiatry Research\u003c/em\u003e, \u003cem\u003e200\u003c/em\u003e(2\u0026ndash;3), 530\u0026ndash;537. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.psychres.2012.05.001\u003c/span\u003e\u003cspan address=\"10.1016/j.psychres.2012.05.001\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLongo, P., Amodeo, L., Toppino, F., Abbate-Daga, G., Panero, M., \u0026amp; Martini, M. (2024). An updated report on trauma in Anorexia Nervosa: Confirmation and novel data. \u003cem\u003eEuropean Journal of Trauma and Dissociation\u003c/em\u003e, \u003cem\u003e8\u003c/em\u003e(1), 100372. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.ejtd.2023.100372\u003c/span\u003e\u003cspan address=\"10.1016/j.ejtd.2023.100372\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLongo, P., Scaliti, E., Panero, M., Toppino, F., Brustolin, A., Salis, B., Lacidogna, M. C., Abbate-Daga, G., \u0026amp; Martini, M. (2024). A quantitative study on peripersonal space in anorexia nervosa and healthy subjects: Role of social variables and association with psychopathology. \u003cem\u003eInternational Journal of Clinical and Health Psychology\u003c/em\u003e, \u003cem\u003e24\u003c/em\u003e(3), 100476. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.ijchp.2024.100476\u003c/span\u003e\u003cspan address=\"10.1016/j.ijchp.2024.100476\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMa\u0026iuml;ano, C., Morin, A. J. S., Monthuy-Blanc, J., \u0026amp; Garbarino, J. M. (2009). The body image avoidance questionnaire: Assessment of its construct validity in a community sample of french adolescents. \u003cem\u003eInternational Journal of Behavioral Medicine\u003c/em\u003e, \u003cem\u003e16\u003c/em\u003e(2), 125\u0026ndash;135. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s12529-009-9035-7\u003c/span\u003e\u003cspan address=\"10.1007/s12529-009-9035-7\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMarzola, E., Martini, M., Longo, P., Toppino, F., Bevione, F., Delsedime, N., Abbate-Daga, G., \u0026amp; Preti, A. (2022). Psychometric properties of the Italian body shape questionnaire: an investigation of its reliability, factorial, concurrent, and criterion validity. \u003cem\u003eEating and Weight Disorders\u003c/em\u003e, \u003cem\u003e27\u003c/em\u003e(8), 3637\u0026ndash;3648. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s40519-022-01503-6\u003c/span\u003e\u003cspan address=\"10.1007/s40519-022-01503-6\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMarzola, E., Panepinto, C., Delsedime, N., Amianto, F., Fassino, S., \u0026amp; Abbate-Daga, G. (2016). A factor analysis of the meanings of anorexia nervosa: Intrapsychic, relational, and avoidant dimensions and their clinical correlates. \u003cem\u003eBMC Psychiatry\u003c/em\u003e, \u003cem\u003e16\u003c/em\u003e(1), 1\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1186/s12888-016-0894-6\u003c/span\u003e\u003cspan address=\"10.1186/s12888-016-0894-6\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMeijer, L. L., Ruis, C., van der Smagt, M. J., Scherder, E. J. A., \u0026amp; Dijkerman, H. C. (2022). Neural basis of affective touch and pain: A novel model suggests possible targets for pain amelioration. \u003cem\u003eJournal of Neuropsychology\u003c/em\u003e, \u003cem\u003e16\u003c/em\u003e(1), 38\u0026ndash;53. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1111/jnp.12250\u003c/span\u003e\u003cspan address=\"10.1111/jnp.12250\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNandrino, J. L., Ducro, C., Iachini, T., \u0026amp; Coello, Y. (2017). Perception of Peripersonal and Interpersonal Space in Patients with Restrictive-type Anorexia. \u003cem\u003eEuropean Eating Disorders Review\u003c/em\u003e, \u003cem\u003e25\u003c/em\u003e(3), 179\u0026ndash;187. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1002/erv.2506\u003c/span\u003e\u003cspan address=\"10.1002/erv.2506\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSpielberger, C. (2010). State-Trait Anxiety Inventory for Adults - Manual, Instrument and Scoring Guide. \u003cem\u003e1983 Consulting Psychologists Press, Inc. Mind Garden, Inc.\u003c/em\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStice, E., \u0026amp; Shaw, H. E. (2002). Role of body dissatisfaction in the onset and maintenance of eating pathology: A synthesis of research findings. \u003cem\u003eJournal of Psychosomatic Research\u003c/em\u003e, \u003cem\u003e53\u003c/em\u003e(5), 985\u0026ndash;993. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/S0022-3999(02)00488-9\u003c/span\u003e\u003cspan address=\"10.1016/S0022-3999(02)00488-9\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWalker, D. C., White, E. K., \u0026amp; Srinivasan, V. J. (2018). A meta-analysis of the relationships between body checking, body image avoidance, body image dissatisfaction, mood, and disordered eating. \u003cem\u003eInternational Journal of Eating Disorders\u003c/em\u003e, \u003cem\u003e51\u003c/em\u003e(8), 745\u0026ndash;770. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1002/eat.22867\u003c/span\u003e\u003cspan address=\"10.1002/eat.22867\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWildes, J. E., Ringham, R. M., \u0026amp; Marcus, M. D. (2010). Emotion avoidance in patients with anorexia nervosa: Initial test of a functional model. \u003cem\u003eInternational Journal of Eating Disorders\u003c/em\u003e, \u003cem\u003e43\u003c/em\u003e(5), 398\u0026ndash;404. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1002/eat.20730\u003c/span\u003e\u003cspan address=\"10.1002/eat.20730\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"eating-and-weight-disorders-studies-on-anorexia-bulimia-and-obesity","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"eawd","sideBox":"Learn more about [Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity](https://www.springer.com/journal/40519)","snPcode":"40519","submissionUrl":"https://submission.nature.com/new-submission/40519/3","title":"Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"anorexia nervosa, affective touch, body image, interpersonal space, bodily self-consciousness, interpersonal avoidance","lastPublishedDoi":"10.21203/rs.3.rs-9470025/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9470025/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003ethe present study explored affective touch in anorexia nervosa (AN) by: a) comparing patients with AN and healthy control subjects (HCs) on the quality and quantity of affective touch experiences across the lifespan; b) investigating the association between affective touch and body-image related symptoms; c) assessing the link between affective touch and interpersonal space (IPS).\u003c/p\u003e\u003ch2\u003eMethod\u003c/h2\u003e \u003cp\u003eparticipants (76 patients with AN and 77 HCs) completed self-report questionnaires measuring eating-related symptoms, anxiety, depression, and affective touch experiences. IPS was assessed with a computer-based stop-distance task with different social conditions.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003epatients with AN had higher eating-related, general, and body-image related symptoms than HCs; moreover, they reported lower quantity of affective touch both in childhood and adulthood, and more frequent negative affective touch experiences. In patients, lower affective touch and reduced touch-related comfort were associated with larger IPS, independent of anxiety and depression. No associations with IPS emerged in HCs.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe results highlighted a link between negative and reduced affective touch and social difficulties and avoidance in AN. The study remarks the relevance of affective touch experiences and their relation with implicit body-related mechanisms, suggesting addressing early tactile experiences and interpersonal functioning in clinical interventions.\u003c/p\u003e\u003ch2\u003eLevel of Evidence\u003c/h2\u003e \u003cp\u003eLevel III, casecontrol study based on selfreport questionnaires and behavioral task.\u003c/p\u003e","manuscriptTitle":"Affective Touch Experiences and Interpersonal Space in Anorexia Nervosa","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-12 14:26:56","doi":"10.21203/rs.3.rs-9470025/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"266752589706992163384514606761074046214","date":"2026-05-04T11:58:58+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"112938020032841526905645364014772325484","date":"2026-05-04T08:53:43+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-05-04T08:35:55+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-05-03T14:59:10+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-21T17:22:26+00:00","index":"","fulltext":""},{"type":"submitted","content":"Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity","date":"2026-04-20T09:21:42+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"eating-and-weight-disorders-studies-on-anorexia-bulimia-and-obesity","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"eawd","sideBox":"Learn more about [Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity](https://www.springer.com/journal/40519)","snPcode":"40519","submissionUrl":"https://submission.nature.com/new-submission/40519/3","title":"Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"31cde282-e21f-4b0d-a9cb-cbc5a35df642","owner":[],"postedDate":"May 12th, 2026","published":true,"recentEditorialEvents":[{"type":"reviewerAgreed","content":"266752589706992163384514606761074046214","date":"2026-05-04T11:58:58+00:00","index":7,"fulltext":""},{"type":"reviewerAgreed","content":"112938020032841526905645364014772325484","date":"2026-05-04T08:53:43+00:00","index":6,"fulltext":""},{"type":"reviewersInvited","content":"2","date":"2026-05-04T08:35:55+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-05-03T14:59:10+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-12T14:26:57+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-12 14:26:56","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9470025","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9470025","identity":"rs-9470025","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}