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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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Compassion protects against vital exhaustion and negative emotionality
Saarinen, A. I. L., Keltikangas‐Järvinen, L., Viding, E. M., Dobewall, H., Kaseva, K., Lehtimäki, T. J., Raitakari, O. T., & Hintsanen, M. (2021) · Motivation and Emotion · doi:10.1007/s11031-021-09878-2 · Cited by 16
Rahangdale, R. R., Tender, T., Balireddy, S., Pasupuleti, M., & Hariharapura, R. C. (2022) · Canadian Journal of Microbiology · doi:10.1139/cjm-2021-0242 · Cited by 15
Leppma, M. (2011) · Journal of International Crisis and Risk Communication Research · Cited by 12
Wang, I., & Ok-Kyeong, C. (2011) · Korean Journal of Health Psychology · doi:10.17315/kjhp.2011.16.4.003 · Cited by 12
Erickson, T. M., Mayer, S. E., Lopez‐Duran, N. L., Scarsella, G. M., McGuire, A. P., Crocker, J., & Abelson, J. L. (2017) · Stress · doi:10.1080/10253890.2017.1368489 · Cited by 12
“Whereas recent studies found that writing a supportive letter to a friend (relative to a control group) reduced systolic blood pressure but not cortisol responses to the TSST (Inagaki & Eisenberger, 2016), and compassion meditation did not alter cortisol responses to the TSST (Pace et al., 2009), our findings confirm…”
BackgroundResultSaarinen, A. I. L., Keltikangas‐Järvinen, L., Dobewall, H., Ahola‐Olli, A., Salmi, M., Lehtimäki, T. J., Raitakari, O. T., Jalkanen, S., & Hintsanen, M. (2021) · Developmental Psychobiology · doi:10.1002/dev.22070 · Cited by 14
“, 2019) and, previously, intervention studies have demonstrated that compassion-training interventions are linked to decreased concentrations of CRP and decreased responses of IL-6, cortisol, and adrenocorticotropic hormone (ACTH) to psychosocial stress (Abelson et al., 2014; Pace et al., 2009).”
Backgroundde Krijger, E., Willems, R., ten Klooster, P., Bakker, E., Miedema, H., Drossaert, C., & Bohlmeijer, E. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.895850 · Cited by 11
“In the past years many studies found evidence for a negative relationship between self-compassion and distress or mental illness in response to stressful circumstances (Pace et al., 2009; MacBeth and Gumley, 2012; Finlay-Jones et al., 2015; Zeller et al., 2015; Galla, 2016; Barlow et al., 2017; Stutts et al., 2018; Hu…”
BackgroundThe Influence of Meditative Interventions on Immune Functioning: A Meta-Analysis
Oyler, D. L., Hulett, J. M., Pratscher, S. D., Price‐Blackshear, M. A., Murphy, E. A., & Bettencourt, B. A. (2023) · Mindfulness · doi:10.1007/s12671-023-02157-w · Cited by 12
Koenig, H. G., VanderWeele, T. J., & Peteet, J. R. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780190088859.003.0001 · Cited by 12
A neuroscience perspective on the plasticity of the social and relational brain
Singer, T. (2025) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.15319 · Cited by 18
O’Driscoll, D., & McAleese, M. (2022) · Counselling and Psychotherapy Research · doi:10.1002/capr.12447 · Cited by 11
Stress, Negative Emotions, and Inflammation
Gouin, J., Hantsoo, L. V., & Kiecolt‐Glaser, J. K. (2011) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780195342161.013.0054 · Cited by 14
Shared possible selves, other-focus, and perceived wellness of couples with prostate cancer.
Wilson, S. J., Barrineau, M. J., Butner, J., & Berg, C. A. (2014) · Journal of Family Psychology · doi:10.1037/fam0000015 · Cited by 11
Gim, W.-S., 김경일, & Shin, K. (2014) · Korean Journal of Health Psychology · doi:10.17315/kjhp.2014.19.2.004 · Cited by 11
Ho, R., Sing, C. Y., & Wong, V. P. Y. (2016) · Social Work in Health Care · doi:10.1080/00981389.2016.1231153 · Cited by 11
“A previous study also demonstrated that engaging in compassion meditation exercises could reduce stressinduced immune and behavioral responses (Pace et al., 2009).”
BackgroundSabel, B. A., Cárdenas‐Morales, L., & Gao, Y. (2017) · JOURNAL OF CURRENT GLAUCOMA PRACTICE · doi:10.5005/jp-journals-10028-1237 · Cited by 11
RESILIENCE, AGENCY, AND EVERYDAYLOJONGIN THE TIBETAN DIASPORA
Lewis, S. E. (2018) · Contemporary Buddhism · doi:10.1080/14639947.2018.1480153 · Cited by 11
“Compassion meditation that stems from lojong has been adapted in Western clinical settings to support a variety of psycho-social interventions with positive results (Mascaro et al. 2013; Pace et al. 2009).”
BackgroundPsychometric properties of the German version of the fears of compassion scales
Biermann, M., Bohus, M., Gilbert, P., Vonderlin, R., Cornelisse, S., Osen, B., Graser, J., Brüne, M., Ebert, A., Lyssenko, L., et al. (2020) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2496 · Cited by 14
“…self-compassion (MSC; K. D. Neff & Germer, 2013), compassion cultivation training (CCT; Jinpa, 2010); cognitively based compassion training (CBCT; Pace et al., 2009), cultivating emotional balance (CEB; Kemeny et al., 2012) and loving-kindness (LKM) or compassion meditation (CM; Wallmark,…”
BackgroundPilot Study of Compassion Meditation Training to Improve Well-being Among Older Adults
Malaktaris, A. L., Lang, A. J., Casmar, P. V., Baca, S. A., Hurst, S., Jeste, D. V., & Palmer, B. W. (2020) · Clinical Gerontologist · doi:10.1080/07317115.2020.1839826 · Cited by 14
“CM and related meditative practices have also been shown to have beneficial effects on stress-related physiological functions that can affect health and mortality (Creswell et al., 2012; Mascaro, Negi, & Raison, 2017; Pace et al., 2009).”
BackgroundMatos, M., Gonçalves, E., Palmeira, L., Melo, I., Steindl, S. R., & Gomes, A. A. (2021) · Current Psychology · doi:10.1007/s12144-021-02311-4 · Cited by 13
Meditation: Empirical Research and Future Directions
MacDonald, D. A., WALSH, R. N., & Shapiro, S. L. (2013) · Wiley eBooks · doi:10.1002/9781118591277.ch24 · Cited by 11
Effects of meditation experience on functional connectivity of distributed brain networksPreprint
Hasenkamp, W. M., & Barsalou, L. W. (2017) · doi:10.31231/osf.io/82ayf · Cited by 11
Luo, X., Shen, Y., Sun, L., Qi, X., Hong, J., Wang, Y., Che, X., & Lei, Y. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.05.117 · Cited by 10
Mind-Body Interventions for Rehabilitation Medicine
Pieczynski, J., Cosio, D., Pierce, W., & Serpa, J. G. (2020) · Physical Medicine and Rehabilitation Clinics of North America · doi:10.1016/j.pmr.2020.07.008 · Cited by 10
Empathic Skills Training in Virtual Reality: A Scoping Review
Gerry, L. J., Billinghurst, M., & Broadbent, E. (2022) · IEEE Conference on Virtual Reality and 3D User Interfaces Abstracts and Workshops (VRW) · doi:10.1109/vrw55335.2022.00054 · Cited by 10
Niu, Y., Buranarugsa, R., & Kuhirunyaratn, P. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20146323 · Cited by 12
“During the Tai Chi practice sessions, the subjects were instructed to maintain their abdominal breathing, meditation and physical and mental relaxation; deep breathing and meditative states contribute to relaxation and stress reduction in the mind and body and may have a positive effect on body composition by modulati…”
Pace, T. W. W., Dodds, S. E., Sikorskii, A. E., Badger, T. A., Segrin, C. G., Negi, L. T., Harrison, T., & Crane, T. E. (2019) · Trials · doi:10.1186/s13063-019-3320-9 · Cited by 15
Self-citationLearning Compassion and Meditation: A Mixed-Methods Analysis of the Experience of Novice Meditators
Mascaro, J. S., Florian, M. P., Ash, M. J., Palmer, P. K., Sharma, A., Kaplan, D. M., Palitsky, R., Grant, G. H., & Raison, C. L. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.805718 · Cited by 18
Self-citationInflammation and Traumatic Stress
Gill, J., & Szanton, S. L. (2011) · Journal of the American Psychiatric Nurses Association · doi:10.1177/1078390311418652 · Cited by 10
Lane, C. B., Brauer, E., & Mascaro, J. S. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1184032 · Cited by 15
Mascaro, J., Palmer, P., Ash, M. J., Florian, M. P., Kaplan, D., Palitsky, R., Cole, S. P., Shelton, M., Raison, C., & Grant, G. H. (2025) · PLoS ONE · doi:10.1371/journal.pone.0313602 · Cited by 12
Self-citationTeng, J., Massar, S. A. A., & Lim, J. (2022) · Scientific Reports · doi:10.1038/s41598-022-06342-0 · Cited by 9
Zhang, D., & Shen, J. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.1072548 · Cited by 18
“Students with a high degree of selfcompassion will improve their defense mechanisms, motivate positive behaviors (Pace et al., 2009) and adopt a more positive coping style (Leary et al.”
BackgroundBirkett, & Melissa, M. (2014) · Cited by 9
Titanji, B. K., Tejani, M., Farber, E. W., Mehta, C. C., Pace, T. W., Meagley, K., Gavegnano, C., Harrison, T., Kokubun, C. W., Negi, S. D., et al. (2021) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0000000000002874 · Cited by 9
Self-citationThe Application of Loving-kindness Meditation from Psychological Perspective
Zeng, X., Shuangyang, L. I. U., & Liu, X. (2013) · Advances in Psychological Science · doi:10.3724/sp.j.1042.2013.01466 · Cited by 10
Fostering Positive Changes in Health and Social Relationships in Children
Lozada, M., Carro, N., Kapelmayer, M., Kelmanowicz, V., Czar, A., & D’Adamo, P. (2017) · Springer eBooks · doi:10.1007/978-3-319-51787-2_9 · Cited by 9
Jung, Y.-H., Lee, U. S., Jang, J. H., & Kang, D. (2016) · Psychiatry Investigation · doi:10.4306/pi.2016.13.3.333 · Cited by 10
Explorations into the nature and function of compassionPreprint
Gilbert, P. (2018) · MindRxiv (OSF Preprints) · doi:10.31231/osf.io/tz49q · Cited by 12
Self-Compassion and Social Anxiety: A Scoping Review
Slivjak, E. T., Majid, F. A., Wrigley, J., Russell, S., Zielony, L., & Arch, J. J. (2024) · Mindfulness · doi:10.1007/s12671-024-02450-2 · Cited by 15
“However, this conclusion was based on only two studies (Pace et al., 2009, 2010), both of which were conducted among adults not screened for social anxiety.”
Oxytocin Modulation in Mindfulness-Based Pain Management for Chronic Pain
Aygün, O., Mohr, E., Duff, C., Matthew, S., & Schoenberg, P. L. A. (2024) · Life · doi:10.3390/life14020253 · Cited by 11
“There is some previous evidence supporting the notion that meditation induces immune response, notably affecting the IL-6 marker, and that this is suggested to be linked to stress reduction [124,125].”
BackgroundWesarg, C., Gallistl, M., Niconchuk, M., Böckler, A., O’Malley, B., & Engert, V. (2024) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2024.107036 · Cited by 11
“Much in line with this reasoning, previous research has linked compassion to better emotion regulation (Weng et al., 2013) and lower stress reactivity (Engert et al., 2017; Pace et al., 2009).”
Result
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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