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Effect of compassion meditation on neuroendocrine, innate immune and behavioral responses to psychosocial stress
Open accessAbstract
Meditation practices may impact physiological pathways that are modulated by stress and relevant to disease. While much attention has been paid to meditation practices that emphasize calming the mind, improving focused attention, or developing mindfulness, less is known about meditation practices that foster compassion. Accordingly, the current study examined the effect of compassion meditation on innate immune, neuroendocrine and behavioral responses to psychosocial stress and evaluated the degree to which engagement in meditation practice influenced stress reactivity. Sixty-one healthy adults were randomized to 6 weeks of training in compassion meditation (n=33) or participation in a health discussion control group (n=28) followed by exposure to a standardized laboratory stressor (Trier social stress test [TSST]). Physiologic and behavioral responses to the TSST were determined by repeated assessments of plasma concentrations of interleukin (IL)-6 and cortisol as well as total distress scores on the Profile of Mood States (POMS). No main effect of group assignment on TSST responses was found for IL-6, cortisol or POMS scores. However, within the meditation group, increased meditation practice was correlated with decreased TSST-induced IL-6 (r(p)=-0.46, p=0.008) and POMS distress scores (r(p)=-0.43, p=0.014). Moreover, individuals with meditation practice times above the median exhibited lower TSST-induced IL-6 and POMS distress scores compared to individuals below the median, who did not differ from controls. These data suggest that engagement in compassion meditation may reduce stress-induced immune and behavioral responses, although future studies are required to determine whether individuals who engage in compassion meditation techniques are more likely to exhibit reduced stress reactivity.
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“Of the 14 studies with the highest quality ratings, 10 (71%) reported significant positive associations [437–443] or increased immune functions in response to a R/S intervention [444–447].”
From Religion, Spirituality, and Health: The Research and Clinical Implications (2012) · cites this paper as [439]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Other forms of behavioral interventions that have been used for the treatment of fear-and anxiety-based disorder, such as community-based educational intervention, exercise, yoga, and mediation, have also been associated with decreases in inflammation (Bower and Irwin, 2016;Pace et al, 2009;Villablanca et al, 2015).”
From Inflammation in Fear- and Anxiety-Based Disorders: PTSD, GAD, and Beyond (2017) · cites this paper as Pace et al, 2009
Experimental — accuracy not yet measuredIn the citing paper
“While more recent studies have recognized the importance of using social evaluative threat as the stressor rather than a generic emotional film, scripts or slides, (Creswell et al., 2007; Pace et al., 2009; Weinstein et al., 2009), none were intervention studies with clinical samples.”
From Mindfulness-Based Cognitive Therapy Improves Emotional Reactivity to Social Stress: Results from a Randomized Controlled Trial (2012) · cites this paper as Pace et al., 2009
In the citing paper
“These results suggest that CM reduces stress-induced subjective distress and immune response.”
From Loving-Kindness and Compassion Meditation: Potential for Psychological Interventions (2011) · cites this paper as Pace et al., 2009
In the citing paper
“Second, the CM was taught by a highly expert teacher and practitioner with many years of training, whereas the active control was taught by graduate students with certainly little expertise, training or even practice with the protocol.”
From Loving-Kindness and Compassion Meditation: Potential for Psychological Interventions (2011) · cites this paper as Pace et al., 2009
In the citing paper
“However, a major limitation of this study was that the stress test was administered after, rather than before, CM training. Therefore, it is possible that associations between CM practice time and outcome in the stress task might have been due to differences in participants’ stress response rather than due to the practice itself”
From Loving-Kindness and Compassion Meditation: Potential for Psychological Interventions (2011) · cites this paper as Pace et al., 2009
In the citing paper
“First, they do not offer any clear alternative active psychological intervention procedure that has been practiced with the similar rigor of the CM.”
From Loving-Kindness and Compassion Meditation: Potential for Psychological Interventions (2011) · cites this paper as Pace et al., 2009
In the citing paper
“The groups showed no difference in plasma cortisol or interleukin-6 concentration.”
From Loving-Kindness and Compassion Meditation: Potential for Psychological Interventions (2011) · cites this paper as Pace et al., 2009
In the citing paper
“Therefore, the active control condition is hardly better than a treatment-as-usual comparison.”
From Loving-Kindness and Compassion Meditation: Potential for Psychological Interventions (2011) · cites this paper as Pace et al., 2009
In the citing paper
“However, increased meditation practice was associated with decreased stress-induced interleukin-6 and subjective reports of distress in the meditation group.”
From Loving-Kindness and Compassion Meditation: Potential for Psychological Interventions (2011) · cites this paper as Pace et al., 2009
In the citing paper
“as well as a reduction of interleukin-6 release in response to a psychosocial stressor [23].”
From Short-term compassion training increases prosocial behavior in a newly developed prosocial game (2011) · cites this paper as [23]
In the citing paper
“The more time participants had actually spent training, the stronger the reduction in interleukin-6 release, suggesting a dose-dependent effect of compassion training.”
From Short-term compassion training increases prosocial behavior in a newly developed prosocial game (2011) · cites this paper as [23]
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“however mechanisms driving the changes are unknown (Pace et al., 2009, 2010; Paul-Labrador et al., 2006; Schneider et al., 2005). J Behav Med (2015) 38:28–38 29”
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“Other interventions, including participation in a mind-body skills group program [73,74], or aerobic exercise program [75–78] provide”
BackgroundSeifert, G., Jeitler, M., Stange, R., Michalsen, A., Cramer, H., Brinkhaus, B., Esch, T., Kerckhoff, A., Paul, A. E., Teut, M., et al. (2020) · Frontiers in Medicine · doi:10.3389/fmed.2020.587749 · Cited by 68
Przyrembel, M., & Singer, T. (2018) · Consciousness and Cognition · doi:10.1016/j.concog.2018.04.004 · Cited by 77
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Learning as a Path, Not a Goal: Contemplative Pedagogy – Its Principles and Practices
Grace, F. (2011) · Teaching Theology & Religion · doi:10.1111/j.1467-9647.2011.00689.x · Cited by 64
Pre-existing brain function predicts subsequent practice of mindfulness and compassion meditation
Mascaro, J. S., Rilling, J. K., Negi, L. T., & Raison, C. L. (2012) · NeuroImage · doi:10.1016/j.neuroimage.2012.12.021 · Cited by 63
“Importantly, CBCT does appear to affect empathic accuracy (Mascaro et al., 2012), depressive symptoms (Desbordes et al., 2012), and stress physiology (Pace et al., 2009, 2010, 2012).”
BackgroundResultInfluentialSelf-citationSchakel, L., Veldhuijzen, D. S., Crompvoets, P. I., Bosch, J. A., Cohen, S., van Middendorp, H., Joosten, S. A., Ottenhoff, T. H. M., Visser, L. G., & Evers, A. W. M. (2019) · Psychotherapy and Psychosomatics · doi:10.1159/000501645 · Cited by 70
Nature of Human IntelligencePreprint
Dayathilake, K. L. S. (2017) · PsyArXiv (OSF Preprints) · doi:10.31234/osf.io/t8cqn · Cited by 63
Arch, J. J., Landy, L. N., & Brown, K. W. (2016) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2016.03.009 · Cited by 63
Montero-Marín, J., Navarro-Gil, M., Puebla-Guedea, M., Luciano, J. V., Van Gordon, W., Shonin, E., & García-Campayo, J. (2018) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2017.00307 · Cited by 61
“Compassion has been a focus of research in recent years with findings indicating that it is associated with positive emotions (19) and can reduce stress-induced immune and behavioral responses (20).”
BackgroundCortisol Level Modulated by Integrative Meditation in a Dose‐dependent Fashion
Fan, Y., Tang, Y., & Posner, M. I. (2014) · Stress and Health · doi:10.1002/smi.2497 · Cited by 62
“A number of studies have demonstrated the effectiveness of stress reduction interventions in influencing psychological and physiological parameters and health outcomes in health and disease (Carlson, Speca, Faris & Patel, 2007; Pace et al., 2009).”
BackgroundKoszycki, D., Thake, J., Mavounza, C., Daoust, J.-P., Taljaard, M., & Bradwejn, J. (2016) · The Journal of Alternative and Complementary Medicine · doi:10.1089/acm.2015.0108 · Cited by 57
“35 High levels of baseline trait self-compassion 36 and self-compassion training 37,38 have also been found to attenuate biological indices of stress reactivity to acute social evaluative threat in healthy adults, providing empirical support for the notion that self-compassion promotes well-being…”
Mindfulness meditation regulates anterior insula activity during empathy for social pain.
Laneri, D., Krach, S., Paulus, F. M., Kanske, P., Schuster, V., Sommer, J., & Müller‐Pinzler, L. (2017) · Human Brain Mapping · doi:10.1002/hbm.23646 · Cited by 61
“Earlier studies could already show that meditation has beneficial effects on mood and health [Fredrickson et al., 2008; Pace et al., 2009], it increases prosocial behavior [Leiberg et al., 2011] and reduces sharing of negative affect in trained meditation novices [Klimecki et al., 2014].”
BackgroundCompassionate education from preschool to graduate school
Jazaieri, H. (2018) · Journal of Research in Innovative Teaching & Learning · doi:10.1108/jrit-08-2017-0017 · Cited by 76
“To date, while formal, evidenced-based, secular[1], compassion training programs exist for adults (e.g. Gilbert and Proctor, 2006, 2010; Jazaieri et al., 2013; Neff and Germer, 2013; Pace et al., 2009; for a review, see Kirby, 2016) and data from these programs suggest that compassion can indeed be “taught’ ” these co…”
BackgroundInfluentialBerk, L., Bellinger, D. L., Koenig, H. G., Daher, N. S., Pearce, M., Robins, C. J., Nelson, B., Shaw, S. F., Cohen, H. J., & King, M. (2015) · Open Journal of Psychiatry · doi:10.4236/ojpsych.2015.53028 · Cited by 63
“Spiritual interventions have also been shown to alter pro-/anti-inflammatory cytokine levels [35] [36], decrease cortisol [36]-[38], and lower specific catecholamines such as epinephrine and norepinephrine [39] [40].”
BackgroundThe neural mediators of kindness-based meditation: a theoretical model
Mascaro, J. S., Darcher, A., Negi, L. T., & Raison, C. L. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.00109 · Cited by 58
“The optimistic outlook on such a negative cycle is that compassion practices may present an equally powerful intervention that targets the cycle at multiple sites by augmenting both subjective feelings of social connectivity and the biological systems that support it (Pace et al., 2009, 2013).”
BackgroundResultSelf-citationThe Role of Mindfulness in Healthcare Reform: A Policy Paper
Ruff, K. M., & Mackenzie, E. R. (2009) · EXPLORE · doi:10.1016/j.explore.2009.10.002 · Cited by 63
Pilot study of a compassion meditation intervention in chronic pain
Chapin, H. L., Darnall, B. D., Seppala, E. M., Doty, J. R., Hah, J. M., & Mackey, S. (2014) · Journal of Compassionate Health Care · doi:10.1186/s40639-014-0004-x · Cited by 59
“Compassion interventions are also associated with increased positive emotions [54], feelings of social connectedness [55], pro-social behavior [56] and improved health outcomes in the form of optimized immune and stress responses [57].”
BackgroundNedeljkovic, M., Ausfeld-Hafter, B., Streitberger, K., Seiler, R., & Wirtz, P. H. (2012) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2011.12.007 · Cited by 60
“However, this rate is comparable to a prior TSST study examining mind-body practices (Pace et al., 2009) and does not seem unusual in studies examining Taiji effects on psychological well-being (Wang et al.”
InfluentialNavarro-Gil, M., Lopez-del-Hoyo, Y., Modrego-Alarcón, M., Montero-Marin, J., Van Gordon, W., Shonin, E., & Garcia-Campayo, J. (2020) · Mindfulness · doi:10.1007/s12671-018-0896-1 · Cited by 58
“The following four intervention protocols are principally based on compassion: (i) Cognitively based Compassion Training (CBCT; Pace et al. 2009) that has been shown to * Jesus Montero-Marin jmonteromarin@hotmail.com 1 Primary Care Prevention and Health Promotion Research Network (RedIAPP),…”
BackgroundMethodInfluentialThe Effects of Stress and Meditation on the Immune System, Human Microbiota, and Epigenetics.
Househam, A. M., Peterson, C. T., Mills, P. J., & Chopra, D. (2017) · PubMed · Cited by 57
Ducar, D. M., Penberthy, J. K., Schorling, J. B., Leavell, V. A., & Calland, J. F. (2020) · EXPLORE · doi:10.1016/j.explore.2019.07.015 · Cited by 56
Mastering Resilience in Oncology: Learn to Thrive in the Face of Burnout
Hlubocky, F. J., Rose, M., & Epstein, R. M. (2017) · American Society of Clinical Oncology Educational Book · doi:10.1200/edbk_173874 · Cited by 60
Ko, C. M., Grace, F., Chavez, G. N., Grimley, S. J., Dalrymple, E. R., & Olson, L. E. (2018) · Journal of American College Health · doi:10.1080/07448481.2018.1431913 · Cited by 56
“sion meditation has been shown to decrease self-report and physiological markers of stress.(29,30) Research in K-12 educational system has shown how mindfulness and meditation have been integrated into the”
BackgroundNgô, T.-L. (2014) · Sante Mentale au Quebec · doi:10.7202/1023988ar · Cited by 54
“Depuis, plusieurs revues et méta-analyses ont conclu que les traitements basés sur la pleine conscience, l’acceptation et la compassion promeuvent la santé physique et mentale (Chen, Yang, Wang et Zhang, 2012 ; Chiesa, Calati et Serretti, 2011 ; Davis et Hayes, 2011 ; Fjorback et al., 2011 ;…”
BackgroundPsychopathy to Altruism: Neurobiology of the Selfish–Selfless Spectrum
Sonne, J., & Gash, D. M. (2018) · Frontiers in Psychology · doi:10.3389/fpsyg.2018.00575 · Cited by 67
“…been shown to result in voluntary activation of components of the sympathetic nervous system, changes in plasma catecholamine and serum cortisol concentrations, and an attenuation of the innate immune response as measured by plasma cytokines (Kox et al., 2014) and IL-6 markers (Pace et al., 2009).”
BackgroundCompassion for self versus other: A critical review of compassion training research
Quaglia, J. T., Soisson, A., & Simmer‐Brown, J. (2020) · The Journal of Positive Psychology · doi:10.1080/17439760.2020.1805502 · Cited by 62
“Other-Compassion Trainings Self-Oriented Outcomes Other-Oriented Outcomes Compassion-Focused Therapy (Gilbert, 2009) Compassion Cultivation Training (Goldin & Jazaieri, 2017) Self-Compassion Scale (Neff, 2003) Compassion Scale (Pommier et al., 2019) Mindful Self-Compassion Program (Germer & Neff, 2013) Cognitively-Bas…”
BackgroundInfluentialCousineau, T. M., Hobbs, L., & Arthur, K. C. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.01602 · Cited by 67
Integrating Breathing Techniques Into Psychotherapy to Improve HRV: Which Approach Is Best?
Steffen, P. R., Bartlett, D., Channell, R., Jackman, K. N., Cressman, M., Bills, J., & Pescatello, M. S. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.624254 · Cited by 62
Meditation: Should a cardiologist care?
Olex, S., Newberg, A. B., & Figueredo, V. M. (2013) · International Journal of Cardiology · doi:10.1016/j.ijcard.2013.06.086 · Cited by 60
Dakwar, E., & LEVIN, F. R. (2009) · Harvard Review of Psychiatry · doi:10.1080/10673220903149135 · Cited by 61
Kox, M., Stoffels, M., Smeekens, S. P., van Alfen, N., Gomes, M., Eijsvogels, T. M. H., Hopman, M. T. E., van der Hoeven, J. G., Netea, M. G., & Pickkers, P. (2012) · Psychosomatic Medicine · doi:10.1097/psy.0b013e3182583c6d · Cited by 53
Mindfulness‐Based Stress Reduction
Salmon, P. G., Sephton, S. E., & Dreeben, S. J. (2011) · Wiley eBooks · doi:10.1002/9781118001851.ch6 · Cited by 57
A short Mindfulness retreat can improve biological markers of stress and inflammation
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Combining Virtual Reality and Biofeedback to Foster Empathic Abilities in Humans
Schoeller, F., Bertrand, P., Gerry, L. J., Jain, A., Horowitz, A. H., & Zenasni, F. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2018.02741 · Cited by 58
“Compassion meditation training is a technique for improving emotional self-regulation (Pace et al., 2009), and previous research has demonstrated effects of compassion training techniques on decreased stress-related behavioral and neurobiological responses (Carson et al.”
MethodWatt, T. T., Ceballos, N. A., Kim, S., Pan, X., & Sharma, S. (2019) · Journal of Child & Adolescent Trauma · doi:10.1007/s40653-019-00270-4 · Cited by 53
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Silva, B. R. O.-D., & Dodson‐Lavelle, B. (2012) · Cited by 48
Metadata
- Authors
- Pace, T. W. W., Negi, L. T., Adame, D. D., Cole, S. P., Sivilli, T. I., Brown, T. D., Issa, M. J., & Raison, C. L.
- Affiliations
- Emory University (US)
- Weill Cornell Medicine (US)
- Corresponding author
- Raison, Charles L.
- Venue
- Psychoneuroendocrinology
- Publisher
- Elsevier BV
- Published
- 2009-01
- Volume
- 34
- Issue
- 1
- Pages
- 87-98
- ISSN
- 0306-4530 (ISSN-L)
- PMC
- PMC2695992
- OpenAlex
- W2101119621
- Cited by
- 748
- References
- 59
- Citations by year
- 2026: 18 · 2025: 29 · 2024: 25 · 2023: 78 · 2022: 41 · 2021: 39 · 2020: 58 · 2019: 50 · 2018: 43 · 2017: 55 · 2016: 43 · 2015: 42 · 2014: 58 · 2013: 45 · 2012: 57
- FWCI
- 24.54
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychoneuroendocrinology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Deutsches Krebsforschungszentrum
- National Institutes of Health (UL1TR000454)
- National Institute of Mental Health (K23MH064619)
- National Center for Research Resources (UL1RR025008, M01RR000039, M01-RR-0039)
- National Center for Advancing Translational Sciences
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Keywords
- compassion meditation, psychosocial stress, stress reactivity, Trier Social Stress Test, interleukin-6, cortisol, innate immunity, neuroendocrine response
- MeSH terms
- Adolescent, Empathy, Female, Humans, Hydrocortisone, Immunity, Innate, Male, Stress, Physiological, Stress, Psychological, Time Factors, Interleukin-6, Meditation, Young Adult
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