Abstract
People differ in their touch preferences and in the ways in which they touch others. People who are blind are particularly sensitive to tactile stimulation as a result of sensory compensation, and sense of touch can support their interpersonal communication. In the article presented here, we aimed to explore whether visual status predicts preferences for touch behaviors involving strangers; specifically, we examined touch-seeking and touch-avoidance in non-intimate interpersonal situations. Our study, whose participants comprised 43 individuals with congenital blindness, 53 individuals with adventitious blindness, and 47 sighted controls, showed that visual status does not predict touch-seeking or social touch-avoidance. We also observed similar gender differences in all participating groups, with women avoiding social touch more than men in non-intimate interpersonal situations involving strangers.
Touch is an important aspect of human lives, and interpersonal tactile contact generates most emotional experiences out of all possible types of haptic stimulation (Gallace & Spence, 2010). Touch is one of the first sensations we experience after birth, and it continues to be extremely important throughout a child’s development (e.g., Chugani et al., 2001; Maclean, 2003; Nelson, 2007; White & Castle, 1964). Gentle touch, massage, and “skin-to-skin” contact (Ferber et al., 2008) can further lead to numerous positive consequences, including decreased pain and discomfort in infants (Bellieni et al., 2007), or lower rates of health-related problems among preterm babies (Daga et al., 1998; Dieter et al., 2003; Field et al., 2006, 2008; Jay, 1982; Weiss et al., 2004).
Positive effects of interpersonal touch are also observed among adults. Touch can decrease heart rate and blood pressure (Ditzen et al., 2007; Drescher et al., 1980, 1985; Grewen et al., 2003; Lynch et al., 1974), alleviate stress-related cortisol response (Ditzen et al., 2007), and increase oxytocin levels (Heinrichs et al., 2003; Henricson et al., 2008). Interpersonal touch can also play an important role in creation and strengthening of social bonds (Gallace & Spence, 2010; McGlone et al., 2014).
Uninvited touch from a stranger is, nevertheless, experienced as offensive, intrusive, or threatening, in most cases (Sussman & Rosenfeld, 1978); and many types of touch can be associated with sexual harassment (Lee & Guerrero, 2001), particularly in Western culture (Remland et al., 1995). One of the reasons of the discordant responses to interpersonal touch is that, overall, touch is considered very intimate (Beier & Sternberg, 1977). Consequently, despite all positive consequences of touch, people differ in their touch preferences and ways they touch others. For example, research shows that social anxiety is associated with more negative responses to touch, so are social reticence (Fromme et al., 1989) and autism, a disorder involving multiple problems related with social interactions (Baranek et al., 2006).
Many studies show that people with blindness are particularly sensitive to tactile stimulation as a result of sensory compensation (i.e., enhanced sensitivity of functioning modalities resulting from deprivation in one or more senses; Kupers & Ptito, 2014). Further, people with blindness often use their sense of touch in social situations. Since touch can convey emotions (Hertenstein et al., 2006), it most probably supports interpersonal communication among those who are blind. Nevertheless, it is unclear whether the use of the sense of touch is particularly preferred by people with blindness, especially in interpersonal situations involving strangers. Here, we aimed to explore whether visual status predicts preferences for touch-seeking and touch-avoidance in non-intimate contacts with strangers.
Methods
Ethical approval
This study was approved by the institutional ethical board and was performed in accordance with the Declaration of Helsinki for Medical Research involving Human Subjects. All participants provided written, informed consent prior to their inclusion in the study; the consent form was read aloud to the participants with blindness.
Participants
The study comprised three groups: individuals with congenital blindness (19 men and 24 women aged between 16 and 64 years, M = 34.4, SD = 11.4); individuals with adventitious blindness (28 men and 25 women aged between 23 and 65 years, M = 48.4, SD = 10.6); and sighted controls, which were roughly matched with the two groups with blindness in terms of age and gender distribution (21 men and 26 women aged between 20 and 64 years, M = 38.5, SD = 14.1). For the purpose of this study, adventitious blindness was defined as loss of vision during the course of one’s life. Within the two samples with blindness, all individuals declared total blindness (no light perception). The participants with blindness were recruited in local associations of people who are blind, schools for blind students, and by means of personal contacts of the participants. The sighted individuals were found by means of leaflets and press releases.
Methods
To compare social touch preferences for the participating groups, we used a modified version of the Social Touch Questionnaire (Wilhelm et al., 2001). The Social Touch Questionnaire is a validated tool used for self-assessment of one’s responses to touch in social situations. The original publication of this questionnaire showed high internal consistency (Cronbach’s α = .89). For the purpose of this research, we selected all items that were related with interpersonal touch in non-intimate relationships (encounters with strangers) or that asked about general touch preferences (an exception to this rule is item number 16, “I feel disgusted when I see public displays of intimate affection” since it was related to vision). The resulting questionnaire contained 12 items (1, 2, 4, 5, 7, 8, 10, 13, 15, 17, 18, and 20; see Wilhelm et al., 2001). A group of three people who are blind (one man and two women) reviewed the scale and were consulted to ensure that it was appropriate for a group of blind individuals to answer all of the selected questions. Based on their suggestions, we removed two further items that were described as being “potentially embarrassing” or “difficult,” or because survey participants may find them “uncomfortable to answer.” The items we removed based on this feedback were numbers 5, “I feel embarrassed if I have to touch someone in order to get their attention,” and 17, "It would make me feel anxious if someone I had just met touched me on the wrist." We further excluded item number 8, “I’d feel uncomfortable if a professor touched me on the shoulder in public” since we learned that many people who would participate in our study had never studied (nor would they ever study) at university.
Similar to the original version of the scale, the participants were asked to “indicate how characteristic or true each of the following statements is of you” on a 0–4 (not at all to extremely) scale. In order to standardize the testing conditions, the questions were read aloud by research assistants to all participants, including the sighted group.
For the purpose of data analysis, we further computed two scores: 1. Touch-avoidance (i.e., “I feel uncomfortable if I make physical contact with a stranger on the bus or subway”). Scores were an average of items 2, 7, 10, 13, and 15 (reversed); a higher average score in this subscale indicates a higher rate of avoidance of touch by strangers. 2. Touch-seeking (i.e., “I generally seek physical contact with others”). Scores were an average of items 1, 4, 18, and 20; a higher average score in this subscale indicates a higher rate of touch-seeking.
The data were analyzed by means of ANCOVA analysis, with visual status (no visual impairment vs. congenital blindness vs. adventitious blindness) and gender (male vs. female) as between-subject factors; age was treated as a covariate. Further, we analyzed the Pearson’s r correlations between (1) age and both touch scores and (2) sightedness loss duration and both touch scores.
Results
Touch aversion and touch-seeking subscales—descriptive statistics and sightedness effects.
We found a significant gender difference in stranger touch-avoidance scores, F(1, 136) = 20.96, p < .001, η2 = .13. Post hoc tests with Bonferroni corrections indicated that women declared higher stranger touch-avoidance (M = 2.48 vs. M = 1.86, p < .001), and this finding was true for all participating groups (Figure 1). The main effect of gender on the touch-seeking score was nonsignificant (p = .15), and so was the interactive effect of sightedness and gender (p = .33). Stranger touch avoidance in men and women across participating samples.
We did not observe significant correlations between age and touch-seeking (r = −0.05, p = .54) or age and stranger touch-avoidance (r = 0.15, p = .07) across all participants, although the correlation on a trend level for the stranger touch-avoidance scores indicated that our participants tended to be more touch-avoidant with age. This tendency was driven by the significant correlation of age and stranger touch-avoidance within the sighted control group (r = 0.37, p = .01), while no such effect was found in participants with adventitious blindness (r = 0.16, p = .25) or congenital blindness (r = −0.04, p = .78). For touch-seeking, the age-touch preferences correlations proved not to be significant in the participating groups (sighted people: r = −0.18, p = .24; people with adventitious blindness: r = −0.17, p = .21; people with congenital blindness: r = 0.14, p = .38). Neither the stranger touch-avoidance nor the touch-seeking scores were significantly related to sightedness loss duration in the group of people with adventitious blindness (ps > .53). Raw data for this submission can be found in Supplementary File 1.
Discussion
The most important finding of our research is that visual status did not differentiate touch-seeking or touch-avoidance behaviors in non-intimate contacts with strangers. We also observed similar gender differences in all participating groups, with women avoiding the touch of strangers more than men. Further, the age-related increase in touch-avoidance was less pronounced in the groups with blindness as compared to the participants without visual impairments. Overall, our findings indicated that the visual status was not an important predictor of touch-seeking or attitudes toward the touch of strangers in non-intimate relationships.
Touch, even that received in non-intimate relationships, has strong behavioral consequences. Gentle touch from an unknown nurse can lower the stress response before surgery (Whitcher & Fisher, 1979), and waiters who touch their customers receive, on average, higher tips (Crusco & Wetzel, 1984). Further, people can communicate their emotions to other unknown individuals by mere touch (Hertenstein et al., 2006). Our findings show that touch preferences in non-intimate interactions are not determined by one’s visual status since individuals who are blind exhibited similar levels of stranger touch-avoidance and touch-seeking behaviors as compared to sighted controls. These results are particularly interesting in the context of a large body of research showing enhanced tactile processing in blindness (Kupers & Ptito, 2014). People with blindness were found to have enhanced vibrotactile perception (Wan et al., 2010); better haptic angle discrimination task (Alary et al., 2008); and heightened tactile spatial acuity, as shown by discrimination of 3D shapes (Norman & Bartholomew, 2011) or grating orientation tasks (Goldreich & Kanics, 2003; Norman & Bartholomew, 2011; Van Boven et al., 2000, but see Grant et al., 2000). They also exhibited better short-term tactile memory than did people without visual impairments (Papagno et al., 2017). Interestingly, the tactile acuity in blindness was found to be much less affected by aging than in people with unimpaired vision (Goldreich & Kanics, 2003). As suggested by Van Boven and colleagues (2000), the superior performance in tasks that relate to daily activities of people with blindness may represent an adaptive, behavioral correlate of their cortical plasticity.
The only significant effects we observed in our research were related to gender differences. Overall, in all participating groups, touch-avoidance was more pronounced among women than it was among men. Although previous studies show that females are more likely to touch and be touched in social situations (Sorokowska et al., 2021), for women, familiarity is an important determinant of the affective consequences of touch (Heslin et al., 1983). Women consider a touch from a close person pleasant, while for men familiarity is not as important as the gender (Heslin et al., 1983) or attractiveness of tactile interaction partner. As discussed in the introduction, touch generally conveys intimacy, and our study showed that uninvited intimate contact is especially aversive for women, regardless of their visual status.
Among controls without visual impairment, touch-avoidance in non-intimate relationships was positively correlated with the age of the participants. This result is consistent with research showing more frequent interpersonal touching behaviors in younger people, as compared with older adults (Rands & Levinger, 1979), and age-related increase in interpersonal distances in various social situations (Gérin-Lajoie et al., 2006; Sorokowska et al., 2017; Webb & Weber, 2003). Interestingly, the age-related increase in touch-avoidance was not statistically significant among people with adventitious blindness, and close to zero among participants with congenital blindness. We may present some hypotheses as to why older people with blindness did not exhibit the same touch-avoidance as older participants without visual impairment. First, physical contact with strangers can be particularly common in blindness, and people who are blind are exposed to such a type of touch throughout their lives. For individuals who are blind, touch is a way to explore new places and environments. Individuals with blindness experience touch from others when they ask for directions in unknown places, like shopping malls or when traveling. Holding an arm of a stranger can also help them navigate through difficult terrain or dangerous surroundings. It is possible that—although people with blindness do not necessarily seek it—they gradually become less sensitized to social touch in non-intimate relationships. This possibility is in contrast to elderly people without visual impairment, for whom physical contact with strangers can be something uncommon and aversive. Relatedly, interpersonal distance preference seems to be, at least to some extent, shaped by experience within a particular culture (Sorokowska et al., 2017). People with congenital blindness are deprived of a possibility to observe social behaviors of other individuals, and, as a result, they are less likely to be influenced by social norms in interpersonal haptic behaviors. Consequently, socially learned touch-avoidance in older age can be less pronounced in their case. Nevertheless, at this stage of research, these explanations remain hypothetical and more studies necessary to answer these questions in a conclusive manner.
There are certain implications of this study that practitioners might find useful in their daily interactions with individuals with visual impairments (i.e., those who are blind or have low vision). Visual status did not affect the declared touch preferences in our study since the only difference between the two groups of participants with blindness in our study were the less pronounced correlations of touch aversion in terms of age in the groups with blindness. Although touch is common and seemingly natural in contacts with individuals with visual impairments, one needs to remember that touch is considered very intimate (Beier & Sternberg, 1977), and can, therefore, be too intimate when it is not invited or approved. To avoid unnecessary stress or awkwardness when touching someone, it is definitely recommended that a person ask for consent when considering any type of physical contact with others, regardless of their visual status. This recommendation includes touch that might seem “technically” supportive to individuals who are blind, like helping them navigate to a seat.
It needs to be mentioned that the current research had certain limitations that could be addressed in further studies on blindness and touch preferences. The individuals involved in our study were volunteers, and it would be worthwhile to explore the observed patterns in larger and more representative samples of people with and without visual impairments. Preferably, to better understand the effects of sightedness on the observed outcomes, such research could also include individuals with low vision and cross-sectional data collected among children and adolescents with visual impairments. Given the cultural differences in touching behaviors (Remland et al., 1995) and touch preferences (Gallace & Spence, 2010), future studies could also involve individuals from different countries.
The second limitation of our study is that we used self-reports collected with a modified survey that had not been validated for individuals who are blind. We also decided to eliminate two of the questions from the original survey that the three members of the pilot group thought might be embarrassing for our subjects to answer. It is possible that those questions would have provided more information about the studied subject and could have been a source of differentiation among the participating groups. Researchers who wish to replicate this study might want to reconsider our decision to eliminate these questions, and could supplement the self-reports with observational or behavioral data or both. Another idea to extend the scope of the research on touch and blindness would be a comparison of preferred touch from strangers versus close people, like friends or family. Previous research with sighted individuals showed that people are quite consistent when listing the areas of their bodies areas that they would allow to be touched, according to the relationship they have with the individual doing the touching (Suvilehto et al., 2015). It seems interesting to test whether similar touch aversion in individuals with and without blindness would also translate into a similar perception of touch to various body parts by strangers, friends and family members.
Supplemental Material
sj-xlsx-1-jvb-10.1177_0145482X211047625 – Supplemental Material for Touch-Avoidance and Touch-Seeking in Non-intimate Relationships: The Null Effects of Sightedness
Supplemental Material, sj-xlsx-1-jvb-10.1177_0145482X211047625 for Touch-Avoidance and Touch-Seeking in Non-intimate Relationships: The Null Effects of Sightedness by Agnieszka Sorokowska, Michal Mikolaj Stefańczyk, JustynaPłachetka, Olga Dudojć, Krzysztof Ziembik, Dominika Chabin and Ilona Croy in Journal of Visual Impairment & Blindness
Footnotes
Acknowledgments
The sponsor had no role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. The authors thank all the participants for their cooperation and Natalia Wernecka, Anna Trzepizur and Kacper Podgórniak for their help with data collection.
Declaration of conflicting interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Polish National Science Centre OPUS Grant (#2017/25/B/HS6/00561) in which AS was employed.
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References
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