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Self-compassion and social stress: Links with subjective stress and cortisol responses

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The present study investigated links between self-compassion and responses to social stress. Participants (N = 102) were randomly assigned to a self-compassion training or a comparison condition and engaged in the Trier Social Stress Test for Groups (TSST-G). Measures of trait self-compassion, subjective perceptions of stress, and salivary cortisol were collected. Participants with higher trait self-compassion had significantly lower subjective and cortisol responses to stress during the TSST-G than did participants with lower trait self-compassion. Participants in the self-compassion training condition did not have significantly lower responses to stress. Results suggest that trait self-compassion is linked with subjective and physiological responses to a social-evaluative stressor. Implications for trait self-compassion and self-compassion training on subjective and physiological responses to stress are discussed.
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Self and Identity
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Self-compassion and social stress: Links with
subjective stress and cortisol responses
Sarah Ketay, Lindsey A. Beck & Juli Dajci
To cite this article: Sarah Ketay, Lindsey A. Beck & Juli Dajci (2022): Self-compassion and
social stress: Links with subjective stress and cortisol responses, Self and Identity, DOI:
10.1080/15298868.2022.2117733
To link to this article: https://doi.org/10.1080/15298868.2022.2117733
Published online: 29 Aug 2022.
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Self-compassion and social stress: Links with subjective stress
and cortisol responses
Sarah Ketay
a
, Lindsey A. Beck
b
and Juli Dajci
a
a
Department of Psychology, University of Hartford, West Hartford, CT, USA;
b
Marlboro Institute for Liberal
Arts & Interdisciplinary Studies, Emerson College, Boston, MA, USA
ABSTRACT
The present study investigated links between self-compassion and
responses to social stress. Participants (N = 102) were randomly
assigned to a self-compassion training or a comparison condition
and engaged in the Trier Social Stress Test for Groups (TSST-G).
Measures of trait self-compassion, subjective perceptions of stress,
and salivary cortisol were collected. Participants with higher trait
self-compassion had signicantly lower subjective and cortisol
responses to stress during the TSST-G than did participants with
lower trait self-compassion. Participants in the self-compassion
training condition did not have signicantly lower responses to
stress. Results suggest that trait self-compassion is linked with
subjective and physiological responses to a social-evaluative stres-
sor. Implications for trait self-compassion and self-compassion
training on subjective and physiological responses to stress are
discussed.
ARTICLE HISTORY
Received 10 January 2022
Accepted 22 August 2022
Published online 31 August
2022
KEYWORDS
self-compassion; subjective
stress; social stress; cortisol
response
Like many of Jane Austen’s characters, Pride and Prejudice’s Elizabeth Bennet lived under
a microscope of constant social evaluation, with every move observed and judged by
others. Though we live in a less socially prescribed time, any college student would likely
report that social evaluation can be especially unnerving. Indeed, stressors consisting of
social-evaluative elements reliably elicit a physiological stress response (Dickerson &
Kemeny, 2004), and there is a clearly established link between social-evaluative stressors
and negative mental and physical health outcomes (Segerstrom & Miller, 2004; Von
Dawans et al., 2018). Although social evaluation may be unavoidable, research suggests
that constructive approaches to stressors may regulate both subjective and physiological
responses. Self-compassion, for example, may be a key resource in healthier psychophy-
siological responses to social-evaluative stressors. Ne (2003a) dened self-compassion as
three interrelated dimensions: (1) Mindfulness (i.e., acknowledging one’s emotions or
suering without judgment or over-identication), (2) self-kindness (i.e., approaching
oneself with kindness in the face of failures), and (3) common humanity (i.e., acknowl-
edging that failures and suering are part of the shared human experience). Self-
compassion fosters resilience in the face of stress (Cunha et al., 2016; Ne & McGehee,
2010) and appears to be linked with a whole host of benets, from psychological (Bluth &
CONTACT Sarah Ketay ketay@hartford.edu University of Hartford, East Hall, 200 Bloomfield Avenue, West
Hartford, CT 06117, USA
SELF AND IDENTITY
https://doi.org/10.1080/15298868.2022.2117733
© 2022 Informa UK Limited, trading as Taylor & Francis Group
Ne, 2018) to self-reported physical health (Sirois, 2020). Therefore, the present study
explores how trait self-compassion and self-compassion training are associated with both
subjective and physiological responses to social-evaluative stressors.
Trait self-compassion and psychophysiological responses to stress
Trait self-compassion has been linked with lower levels of self-reported stress, neuroti-
cism, and depression, and higher levels of life satisfaction, social connectedness, and
subjective well-being (Leary et al., 2007; Neely et al., 2009; Ne, 2003b; Ne et al., 2007).
Meta-analyses have found strong associations among higher levels of self-compassion,
lower levels of anxiety, and higher levels of overall psychological well-being (MacBeth &
Gumley, 2012; Marsh et al., 2018; Zessin et al., 2015). Together, this work contributes to
evidence that people higher in self-compassion may show a buered response to stress
(Ne et al., 2007; Pires et al., 2018) in both cross-sectional and longitudinal settings. For
example, self-compassion appears to provide benets by reducing perceived stress over
time, as demonstrated in a longitudinal study over six months (Stutts et al., 2018).
Self-compassion may also oer a protective eect by reducing physiological responses
to social-evaluative stressors. The hypothalamic-pituitary-adrenal (HPA) axis regulates the
body’s response to stressors (Dickerson & Kemeny, 2004). The HPA axis is the primary
hormonal stress reactivity system and shapes long-term patterns of the psychological
stress response (Rodrigues et al., 2009). In the present research, we focus on the stress
hormone cortisol – a commonly measured biomarker of the psychosocial stress response
(Kirschbaum et al., 1993, Sapolsky, 2015) – because it is the primary downstream product
of an activated HPA axis. Cortisol exerts global eects in the body by helping the body
adjust to environmental challenges and regulating functions like blood pressure, immune
response, and inammation (Padgett & Glaser, 2003). Furthermore, chronic activation or
dysregulation of this system may aect physical and mental health through multiple
pathways (McEwen, 1998).
A number of studies have used the Trier Social Stress Test (TSST) to examine psycho-
physiological responses to social-evaluative stressors, with many focusing on cortisol
reactivity (e.g., Dickerson & Kemeny, 2004; Helminen et al., 2019; Kudielka et al., 2007;
Liu et al., 2017). This laboratory-based paradigm typically includes a public speaking and
arithmetic challenge in front of a disarmingly neutral panel of evaluators. The TSST
consistently elicits reliable cortisol responses and reports of high subjective stress, in
part due to the uncontrollable nature of the activity (Dickerson & Kemeny, 2004; Kudielka
et al., 2007). To examine the eects of psychosocial stressors on groups of participants,
von Dawans et al. (2011) developed the TSST-G, a modied version of the TSST for groups.
Recently, this method has been utilized for research on topics such as how stress manage-
ment aects cortisol reactivity to psychosocial stressors (Domes et al., 2019) and how
laughter yoga aects cortisol responses to psychosocial stressors (Meier et al., 2021).
A subset of research has employed the TSST to measure how individuals’ hormonal
stress response to psychosocial stressors may vary due to dierences in traits such as self-
compassion and mindfulness (Bluth et al., 2016; Brown et al., 2012), or how interventions
such as self-compassion or mindfulness training may shape hormonal response to psy-
chosocial stressors (described in the following section; Arch et al., 2014; Creswell et al.,
2014; Morton et al., 2020). Recent research has shown that people higher in trait self-
2S. KETAY ET AL.
compassion have lower cortisol output during the TSST, as well as higher emotional well-
being (Bluth et al., 2016), and related research has shown that people higher in trait
mindfulness have lower cortisol responses to the TSST, as well as lower negative aect
and anxiety (Brown et al., 2012). However, given the relatively small number of studies
conducted to date, the link between cortisol responses and trait self-compassion is not
fully clear.
Self-compassion training and psychophysiological responses to stress
Most research to date has conceptualized self-compassion as a dispositional trait.
However, a self-compassionate mind-set (or state) can also be induced. Recent studies
suggest that self-compassion can be gained through training or intervention, and that
such training may provide psychological benets. For example, in a randomized con-
trolled study, individuals who completed a mindful self-compassion training showed
higher levels of self-compassion, mindfulness, and well-being (Ne & Germer, 2013).
Other research has linked a brief self-compassion intervention to lower subjective stress
and sympathetic nervous system response – but not lower cortisol response – during the
TSST (Arch et al., 2014). Although self-compassion training seems to reduce subjective
perceptions of stress, evidence has been mixed for whether self-compassion training
reduces physiological stress via cortisol responses. Some self-compassion interventions
have shown no eects on cortisol levels (Arch et al., 2014), whereas related mindfulness
interventions have shown lower cortisol levels (Brown et al., 2012; Matousek et al., 2010)
or higher cortisol levels (Creswell et al., 2014). In sum, emerging evidence suggests that
self-compassion training may help reduce negative psychological stress responses to
social-evaluative stressors, although eects on cortisol remain unclear. Therefore, further
examination of the specic role of self-compassion training on cortisol is needed.
The present study
A small yet increasing number of studies have shown that higher trait self-compassion or
participation in self-compassion training might help reduce responses to stress. However,
no studies to date have investigated self-compassion from both trait and state perspec-
tives and considered links with subjective and physiological responses to social-evaluative
stressors. Therefore, in the present study we have taken an integrated approach to
understanding these processes by examining the roles of trait self-compassion and self-
compassion training in subjective and physiological responses to a social-evaluative
stressor. We also have attempted to replicate prior research (i.e., Arch et al., 2014) linking
self-compassion training to lower subjective stress, and to extend this research by testing
the ecacy of a brief self-compassion training, via one 20-minute-long session using
guided audio meditation. Similar brief training sessions have been found to be eective in
mindfulness and compassion training, but none have been examined in the context of
self-compassion training. For example, guided audio meditations, such as loving-kindness
and compassion meditations, have been linked with decreased subjective and physiolo-
gical stress in response to a social-evaluative stressor (T. W. Pace et al., 2009; T. W. W. Pace
et al., 2010).
SELF AND IDENTITY 3
In the present study, participants completed either a brief self-compassion
training or a comparison activity, and then engaged in the Trier Social Stress Test
in a small group setting (the TSST-G). Participants reported their perceptions of
stress during the TSST-G to assess their subjective responses to stress and provided
saliva samples to assess their physiological responses to stress, which reected their
cortisol levels (1) immediately prior to the start of the study, (2) while completing
the self-compassion training or the comparison activity, and (3) while engaging in
the TSST-G. Consistent with prior work, we predicted that participants with higher
trait self-compassion would report lower perceptions of stress and show lower
levels of cortisol during the TSST-G. We also predicted that participants who
completed the brief self-compassion training would report lower perceptions of
stress during the TSST-G than would participants who completed the comparison
activity. We did not make specic predictions about whether participants who
completed the brief self-compassion training would show lower cortisol levels
during the TSST-G, given the mixed evidence for potential eects of self-
compassion training on cortisol levels.
Method
Participants
One hundred two participants (71% female; M
AGE
= 18.85; SD
AGE
= 1.37; 54% White,
24% Latinx, 18% Black, 2% Asian, 2% unreported) were recruited through the
Psychology Department subject pool at a private university in the Northeastern
United States. Although a priori power analyses were not conducted for this study,
the sample size is similar to (N = 105; Arch et al., 2014, 2016) or larger than (N = 66;
Creswell et al., 2014) previous studies examining self-compassion or mindfulness
training and subjective and physiological responses to social evaluative stress
across two or more conditions. Participants were randomly assigned to the self-
compassion training condition (n = 53) or the comparison condition (n = 49) upon
signing up for the experiment. Experimental sessions were conducted in groups
averaging four people per group. This study was advertised with the title,
“Adjustment to College”. The study was described as involving questionnaires
about social and personality factors, listening to a recording, and completing
a brief thinking task. The study description also indicated that salivary samples
would be collected at three time points to examine the biological response to the
activities. Data was collected in Spring Semester 2018, and was completed prior to
nals period since that is a time of greater academic stress for many students and
may have aected stress responses. All participants gave informed consent when
they arrived for the experiment and were debriefed when they completed the
experiment. Participants received course credit for participating in the experiment.
The debrieng process explained that the TSST-G was meant to induce stress and
provided background on self-compassion and contact information for the campus
counseling center.
4S. KETAY ET AL.
Procedure
Audio recording
Self-compassion training condition. Participants in the self-compassion training condi-
tion listened to a 20-minute audio recording of the Self-Compassion/Loving-Kindness
meditation (available at self-compassion.org), guided by Dr. Kristin Ne, Ph.D. and
designed to increase levels of self-compassion. This guided meditation blends traditional
components of self-compassion and loving-kindness meditation, and touches on the
three aspects of self-compassion: mindfulness, self-kindness, and common humanity.
For example, instructions included tuning into the sounds in the room, placing a hand
over the heart, and oering the same acceptance and support to oneself that would be
given to a friend. Guided audio loving-kindness and compassion meditations have pre-
viously been employed in research examining psychological well-being (Graser &
Stangier, 2018) and cortisol stress reactivity (Engert et al., 2017). Loving-kindness medita-
tions typically follow a format of imagining someone you care about and sending them
love and warmth, and then expanding out to your community, followed by the entire
world. The guided audio recording in the present study is an adaptation of the loving-
kindness format, with an expanded focus on loving-kindness toward oneself mixed with
the three aspects of self-compassion.
Comparison condition. Participants in the comparison condition listened to a 20-minute
audio recording of a section of a book titled, The Natural History and Antiquities of Selborne
(White, 1908). This recording has previously been used and validated as a neutral com-
parison in guided relaxation (Cropley et al., 2007) and employed as a control recording in
a mindfulness-based meditation intervention study (Zeidan et al., 2015).
Writing Prompt
Following the audio recording, participants were given 5 minutes to respond to one of
two writing prompts (both adapted from Breines & Chen, 2012; Leary et al., 2007).
Participants in the self-compassion training condition wrote a response to the prompt:
“Imagine a weakness that you have. Write about this weakness from a compassionate and
understanding perspective, such as that of a warm and supportive friend. What would you
say?” Participants in the comparison condition wrote a response to the prompt: “Imagine
a weakness that you have. Write about this weakness from a perspective of evaluating
your positive versus negative qualities.” The comparison condition prompt was similar to
the self-compassion training condition prompt in that it asked participants to reect on
a personal weakness, but it diered in that it asked participants to focus on self-validation
rather than self-compassion. These similarities and dierences between prompts were
intended to ensure that the prompt in the self-compassion training condition would tap
into specic elements of self-compassion, rather than general elements of positive self-
talk shared across both prompts.
Group Trier Social Stress Test (TSST-G)
After listening to the audio recording and responding to the writing prompt, all partici-
pants engaged in the TSST-G (von Dawans et al., 2011), a standardized, group-based task
that induces social-evaluative threat as a psychosocial stressor in a controlled
SELF AND IDENTITY 5
environment. All participants were instructed to prepare for a mock job interview for their
dream job, with the ultimate goal of convincing the hiring committee (composed of two
female trained evaluators who were senior undergraduates) that they were the most
suitable candidate for the job. Additionally, they were informed that their sessions would
be recorded by cameras (though their sessions were not actually recorded, and partici-
pants were debriefed accordingly at the end of the study). Participants were given
2 minutes to prepare a speech for the mock job interview, and then guided to the
evaluation room to begin the interview in small groups. The two evaluators, who were
trained to maintain neutral expressions throughout the interview, asked participants to
stand, one at a time, and begin their 2-minute speech. After each participant had
completed the speech, they completed an arithmetic task. In this task, the two trained
evaluators asked each participant to serially subtract 16 from their assigned number (for
example, 4,307) for a total of 80 seconds. If participants made an arithmetic mistake, they
were told, “Mistake; please start again from the beginning.”
Post-TSST-G feedback
After completing the TSST-G, participants in the self-compassion training condition were
given the following feedback by the researcher, in order to further emphasize self-
compassion: “You might wonder why we had you do this task. It’s because we are measur-
ing the stress response, and everyone gets stressed out after this task. Several people have
told me that they feel bad about their performance in this study, so I hope you won’t be
hard on yourself. Everyone nds it dicult to speak in front of others, and everyone in this
study has had a hard time with the mock job interview and the arithmetic task, so I don’t
think there’s any reason to feel really bad about it. This task doesn’t have any eect on
anything in your life, so not performing as you wanted to doesn’t really matter anyway.”
Participants in the comparison condition were not given any feedback following the TSST-G.
Measures
Trait self-compassion
Trait self-compassion was measured via the Self-Compassion Scale (SCS; Ne, 2003b),
a 26-item survey assessing the three components of self-compassion (mindfulness, self-
kindness, and common humanity). Participants responded to all items using 5-point
scales (1 = almost never; 5 = almost always). This scale shows high validity and reliability
across populations (Ne et al., 2017). In the present study, overall trait self-compassion
was assessed as an average score across all subscales (M
SELF-COMPASSION TRAINING CONDITION
= 3.12, SD
SELF-COMPASSION TRAINING CONDITION
= 0.69; M
COMPARISON CONDITION
= 3.11,
SD
COMPARISON CONDITION
= 0.64; α = .93) rather than as individual subscales, following Ne
et al. (2017) and Tóth-Király et al. (2017), who validated and supported the use of a total
score across subscales as an overall measure of self-compassion.
Subjective responses to stress: Self-reported perceptions of stress
Self-reported perceptions of stress were measured immediately following the completion
of the TSST-G (and the delivery of the researcher’s feedback, for participants in the self-
compassion training condition) with an adapted version of the Subjective Units of Distress
Scale (SUDS; Wolpe, 1990). Participants were asked to rate the perceived intensity of their
6S. KETAY ET AL.
distress or nervousness using a 100-point scale, with lower scores/0 indicating no stress
and higher scores/100 indicating signicant and impairing stress.
Physiological responses to stress: Salivary cortisol
Salivary swabs were collected to assess cortisol levels at three time points throughout the
experimental session: (1) 10 minutes after giving informed consent and having a sip of
water to facilitate a clean saliva sample (capturing cortisol levels immediately prior to the
session), (2) 10 minutes after listening to the audio recording during the self-compassion
training or comparison activity (capturing cortisol levels during the audio recording), and
(3) 10 minutes after completing the TSST-G (capturing cortisol levels during the TSST-G).
Swabs were placed under the tongue for 90 seconds for saliva collection, and then
samples were sealed in a cryogenic vial and stored in a 20°C freezer. Salivary cortisol
concentrations at each time point reect levels approximately 15 to 20 minutes prior to
sample collection (Stansbury & Gunnar, 1994). Therefore, the rst saliva sample reects
cortisol levels just before the start of the study, the second saliva sample reects cortisol
levels while listening to the audio recording in the self-compassion training condition or
the comparison condition, and the third saliva sample reects cortisol levels while enga-
ging in the TSST-G. Saliva collection was performed using Salimetrics Oral Swab
(Salimetrics, LLC) and analyzed via enzyme immunoassay. Intra-assay coecients of
variability were 6.6% and inter-assay coecients of variability were 9.9%. To control for
diurnal uctuations in cortisol (Schultheiss & Stanton, 2009), all experimental sessions
were completed between 2 p.m. and 7 p.m.
Results
Analytic strategy
We tested linear regression models predicting self-reported perceptions of stress using
the REGRESSION procedure in SPSS 22.0. We tested growth curve models predicting
cortisol using the linear mixed-eects models (MIXED) procedure in SPSS 22.0; this
approach allowed us to model cortisol responses as nested within individuals over time.
In all models, continuous variables were grand-mean centered and categorical variables
were dummy-coded (following Aiken & West, 1991) by coding condition as 0 for the
comparison condition and 1 for the self-compassion training condition and by coding
gender as 0 for men and 1 for women.
We used analogous sets of models to test our key outcomes of subjective responses
and physiological responses to a social-evaluative stressor. Specically, we tested whether
participants’ subjective responses to stress during the TSST-G (assessed via their self-
reported perceptions of stress) could be predicted from (1) their trait levels of self-
compassion and (2) the brief self-compassion training. We also tested whether partici-
pants’ physiological responses to stress during the TSST-G (assessed via their cortisol
levels) could be predicted from (1) their trait levels of self-compassion and (2) the brief
self-compassion training.
SELF AND IDENTITY 7
Subjective responses to stress: Self-reported perceptions of stress
Data preparation and preliminary analyses
We rst excluded data from two participants who did not complete the measure of
subjective responses to stress. Therefore, all models predicting self-reported perceptions
of stress included 100 participants. An initial analysis of potential gender eects indicated
that gender did not signicantly predict participants’ perceptions of stress, β = 0.09,
SE = 4.95, t(98) = 0.85, p = .396, 95% CI [−5.600, 14.028], so the following analyses did
not control for gender.
Does trait self-compassion predict self-reported perceptions of stress?
We rst examined whether participants’ trait self-compassion would predict their sub-
jective responses to stress during the TSST-G. As expected, participants’ trait self-
compassion signicantly predicted their self-reported perceptions of stress, β = −0.37,
SE = 3.13, t(98) = −3.92, p < .001, 95% CI [−18.461, −6.049]; participants with higher trait
self-compassion reported lower perceptions of stress in response to the social-evaluative
stressor than did participants with lower trait self-compassion.
1
Does the brief self-compassion training predict self-reported perceptions of stress?
We next examined whether the brief self-compassion training would predict participants’
subjective responses to stress during the TSST-G. The self-compassion training did not
signicantly predict participants’ self-reported perceptions of stress, β = −0.13, SE = 4.46, t
(98) = −1.33, p = .187, 95% CI [−14.779, 2.920]; participants did not report dierent percep-
tions of stress based on whether they were in the self-compassion training condition or the
comparison condition. However, the pattern of results was in the predicted direction.
Participants in the self-compassion training condition reported non-signicantly lower
perceptions of stress (M = 49.90, SD = 22.98) in response to the social-evaluative stressor
than did participants in the comparison condition (M = 55.83, SD = 21.50).
Physiological responses to stress: Salivary cortisol
Data preparation
We rst excluded data from two participants who were missing all saliva samples, as well as
data from one participant who had saliva samples with cortisol values outside of the
normative range (i.e., ≥ 4 μg/dL; Aardal & Holm, 1995). The cortisol distribution remained
skewed after excluding these data, so we used a base-10 logarithmic transformation to
normalize the data. Cortisol samples with values three standard deviations or more from the
mean of the log-transformed scores were removed (treated as missing); three samples were
removed across two participants. Given that three samples per participant were required to
estimate growth curve models (described below), the data from these two participants also
were excluded. Therefore, all models predicting cortisol included 97 participants.
Adjustments for medication use
Given the potential eects of medication (Granger et al., 2009), caeine (e.g., Lovallo et al.,
2005), and nicotine (e.g., Steptoe & Ussher, 2006) on salivary cortisol, we asked partici-
pants to indicate whether or not they had recently used any of the following medications
8S. KETAY ET AL.
or substances: Antihistamines, oral contraceptives, nasal steroids, caeine, and nicotine
(coded as 0 for No and 1 for Yes in subsequent analyses). We adjusted for medication and
substance use (following Ge et al., 2016) by rst regressing the log-transformed cortisol
values for saliva samples at each of the three time points on antihistamines, oral contra-
ceptives, nasal steroids, caeine, and nicotine. We then trimmed all medications and
substances that did not signicantly predict cortisol levels at that time point and t the
models again. Finally, we added together the intercept values (i.e., means) and the
residuals from the nal models, which removed variability in cortisol that might be
attributed to medication or substance use.
2
Preliminary analyses
As described in the methods, saliva samples were collected at three time points to
assess participants’ cortisol levels (1) immediately prior to the start of the study, (2)
while listening to the audio recording in the self-compassion training condition or
the comparison condition, and (3) while engaging in the TSST-G. We plotted each
participant’s log-transformed cortisol levels over time, which revealed curvilinear
patterns in cortisol levels. Therefore, we modeled time using a linear term and
a quadratic term to reect these curvilinear patterns. This approach allowed us to
assess participants’ cortisol levels from the start of the study through the audio
recording activity and the TSST-G.
Table 1 shows the timing of each saliva sample and mean cortisol value for each
time point. We centered time at the third saliva sample by subtracting the mean
value of time at the third sample from each participant’s time value, which gave
the third sample a value of zero and set the time of the other samples relative to
this zero-point. We chose to center time at the third saliva sample so that the
intercept of the model would reect participants’ cortisol levels during the TSST-G,
the linear term of the model would reect participants’ rate of cortisol change
during the TSST-G, and the quadratic term of the model would reect participants’
change in cortisol slope or curvature over the entire trajectory (i.e., from the start
of the study through the TSST-G). An initial analysis of potential gender eects
indicated that gender signicantly predicted participants’ cortisol trajectories.
Therefore, the following analyses controlled for gender.
3
Does trait self-compassion predict cortisol levels?
We rst examined whether participants’ trait self-compassion would predict their cortisol
levels (see, Table 2). Participants’ trait self-compassion signicantly predicted their cortisol
levels during the TSST-G, Estimate = −0.08, SE = 0.04, t(92.99) = −2.02, p = .046, 95% CI
[−0.167, −0.002]. As shown in Figure 1, participants with higher trait self-compassion had
Table 1. Mean collection times and cortisol levels for saliva samples.
Saliva Sample Sample Collection Time (in Hours)
a
Mean (SD) of Log-Transformed Cortisol (ng/ml)
1 −0.98 0.52 (0.32)
2 −0.48 0.40 (0.30)
3 0.00 0.53 (0.36)
a
Centered at the third saliva sample
SELF AND IDENTITY 9
lower levels of cortisol in response to the social-evaluative stressor than did participants
with lower trait self-compassion.
4
Does the brief self-compassion training predict cortisol levels?
We next examined whether the brief self-compassion training would predict parti-
cipants’ cortisol levels (see, Table 3). The self-compassion training did not signi-
cantly predict participants’ cortisol levels during the TSST-G, Estimate = 0.11,
SE = 0.06, t(93.01) = 1.90, p = .061, 95% CI [−0.005, 0.217]; participants did not
show dierent cortisol levels based on whether they were in the self-compassion
training condition or the comparison condition.
Table 2. Multilevel model testing whether trait self-compassion predicted participants’ cortisol levels
during the Trier Social Stress Test for Groups (TSST-G).
Predictor Estimate SE t(df) p 95% CI
Intercept 0.66 0.06 10.21 (97.02) < .001 [0.531, 0.788]
Linear effect of time 0.91 0.19 4.92 (106.61) < .001 [0.544, 1.277]
Quadratic effect of time 0.87 0.16 5.36 (104.99) < .001 [0.548, 1.191]
Gender −0.18 0.08 −2.40 (97.28) .018 [−0.338, −0.032]
Gender x linear effect of time −0.59 0.22 −2.71 (105.70) .008 [−1.019, −0.157]
Gender x quadratic effect of time −0.54 0.19 −2.84 (104.16) .005 [−0.913, −0.162]
Trait self-compassion −0.08 0.04 −2.02 (92.99) .046 [−0.167, −0.002]
Time was centered at the third saliva sample so that the intercept of the model would reflect participants’ cortisol levels
during the TSST-G, the linear term of the model would reflect participants’ rate of cortisol change during the TSST-G,
and the quadratic term of the model would reflect participants’ change in cortisol slope or curvature over the entire
cortisol trajectory (i.e., from the start of the study through the TSST-G).
Figure 1. Participants’ cortisol trajectories plotted by high and low 1 SD from the Mean) levels of
their trait self-compassion. Note. Participants with higher trait self-compassion had significantly lower
levels of cortisol during the Trier Social Stress Test for Groups (TSST-G) than did participants with lower
trait self-compassion.
10 S. KETAY ET AL.
Discussion
The present study has taken an integrated approach to understanding links between self-
compassion and responses to social-evaluative stress. We have explored self-compassion
from both trait and state perspectives, and we have explored responses to stress from
both subjective and physiological perspectives. Each of these perspectives oers insight
into the experience of social-evaluative stress and the role of self-compassion. Specically,
results revealed that people with higher trait self-compassion reported lower perceptions
of stress and showed lower cortisol levels in response to the social-evaluative stressor.
However, people in the self-compassion training condition neither reported lower per-
ceptions of stress nor showed lower cortisol levels in response to the social-evaluative
stressor compared to people in the comparison condition. These results suggest that trait
self-compassion is linked with both subjective responses (via self-reported perceptions of
stress) and physiological responses (via cortisol levels) to a social-evaluative stressor.
Trait self-compassion and subjective and physiological responses to
social-evaluative stress
We found that individuals with higher trait self-compassion reported lower subjective
stress in response to the social-evaluative stressor. This nding aligns well with recent
meta-analyses linking higher trait self-compassion with lower stress and anxiety (MacBeth
& Gumley, 2012; Marsh et al., 2018; Zessin et al., 2015). We also found that individuals with
higher trait self-compassion showed lower levels of cortisol in response to the social-
evaluative stressor. This nding is consistent with the developing idea that trait self-
compassion is associated with reduced physiological reactivity to stress (Bluth et al., 2016;
Luo et al., 2018), as well as with previous research demonstrating that trait mindfulness is
associated with lower cortisol responses to the TSST (Brown et al., 2012).
Altogether, emerging evidence suggests that individuals who are higher in trait self-
compassion may benet from reduced subjective and physiological responses to stress.
What about individuals who are lower in trait self-compassion? Self-compassion is a skill
that can be trained, although the amount of training needed to impact subjective and
physiological responses to stress is yet to be determined. As far as the authors are aware,
the present study is the rst to examine how a one-time, 20-minute self-compassion
training is linked with responses to stress, although such brief trainings have been shown
Table 3. Multilevel model testing whether the brief self-compassion training predicted participants’
cortisol levels during the Trier Social Stress Test for groups (TSST-G).
Predictor Estimate SE t(df) p 95% CI
Intercept 0.59 0.07 8.34 (105.27) < .001 [0.450, 0.731]
Linear effect of time 0.91 0.19 4.91 (106.73) < .001 [0.542, 1.276]
Quadratic effect of time 0.87 0.16 5.36 (105.24) < .001 [0.547, 1.190]
Gender −0.16 0.08 −2.11 (95.58) .038 [−0.317, −0.009]
Gender x linear effect of time −0.59 0.22 −2.70 (105.80) .008 [−1.018, −0.156]
Gender x quadratic effect of time −0.54 0.19 −2.84 (104.38) .005 [−0.913, −0.162]
Self-compassion training 0.11 0.06 1.90 (93.01) .061 [−0.005, 0.217]
Time was centered at the third saliva sample so that the intercept of the model would reflect participants’ cortisol levels
during the TSST-G, the linear term of the model would reflect participants’ rate of cortisol change during the TSST-G,
and the quadratic term of the model would reflect participants’ change in cortisol slope or curvature over the entire
cortisol trajectory (i.e., from the start of the study through the TSST-G).
SELF AND IDENTITY 11
to inuence stress in similar domains. For instance, three days of 25-minute mindfulness
meditation training resulted in lower subjective stress but higher cortisol reactivity to the
TSST (Creswell et al., 2014).
Self-compassion training and subjective and physiological responses to
social-evaluative stress
Contrary to expectations, the brief self-compassion training did not signicantly predict
people’s subjective responses to stress. However, the general pattern of results was in the
expected direction, with people in the self-compassion training condition reporting non-
signicantly lower perceptions of stress compared to people in the comparison condition.
This pattern is in line with previous ndings suggesting that self-compassion training is
associated with lower overall self-reported stress. This link has been observed in
a randomized controlled trial of burnout among psychologists (Eriksson et al., 2018)
and in studies of assessment anxiety (McEwan et al., 2018) and subjective stress in
response to the TSST (Arch et al., 2014) among undergraduate students.
In the present study, the lack of a statistically signicant association between self-
compassion training and lower subjective stress may be due to the short nature of the
self-compassion training. In contrast to the 20-minute training used in the present study,
previous work has used multiple sessions of self-compassion training over several days
(Arch et al., 2014) or weeks (Eriksson et al., 2018; McEwan et al., 2018). Even short
interventions of 5 to 15 minutes per day, spread over weeks, have been found to be
eective in reducing subjective stress in previous studies, suggesting that self-
compassion may take time to develop. However, in an undergraduate sample, partici-
pants showed decreases in negative aect after a one-time, 12-minute intervention of
a compassion guided audio recording (Hirshberg et al., 2018). Together, these studies
point to the need for further investigation of one-time, brief interventions and the
capacity for meaningful stress reduction or stress buering eects.
Our study also explored whether people who completed the brief self-compassion
training would show lower cortisol levels in response to the social-evaluative stressor,
given the mixed evidence for potential eects of self-compassion training on cortisol
levels. People in the self-compassion training condition did not show signicantly lower
cortisol levels in response to the social-evaluative stressor compared to people in the
comparison condition. These ndings align with previous work (Arch et al., 2014) showing
that a brief self-compassion training was not associated with lower cortisol responses to
the same type of social-evaluative stressor used in the present study (the TSST). Similar
interventions involving mindfulness training have found reductions in stress via multiple
biological systems, including sympathetic nervous system responses and immune
responses, yet mixed results have been found for cortisol responses. For example, in
one study, meditation training moderated anticipatory cortisol responses to a social-
evaluative stressor (Turan et al., 2015). However, in another study, a brief mindfulness
training was associated with increased cortisol responses to the TSST (Creswell et al.,
2014), suggesting stress sensitization or increased arousal. Still other studies have shown
a lack of eects of mindfulness training on cortisol responses (Nyklíček et al., 2013).
We oer three explanations for the conicting data on the links between self-
compassion training (or similar training such as mindfulness) and cortisol responses to
12 S. KETAY ET AL.
stress. First, cortisol responses and subjective, self-reported responses may reect dier-
ent – but related – information about people’s responses to social-evaluative stressors. On
the one hand, happiness (also known as subjective well-being) is thought to be measured
most accurately via self-report, and stress, like happiness, is subjective in nature. On the
other hand, self-report measures may be susceptible to the social desirability bias or
inaccuracy due to lack of self-awareness, whereas biological markers like cortisol are not
subject to the same types of response biases. Therefore, a multi-measurement approach
that includes both subjective and physiological responses can strengthen the reliability of
data on stress responses. Second, self-compassion training may inuence cortisol
responses to stress, but may require further training or extended practice before lowering
cortisol responses. For example, related work has found that integrative meditation
training modulated cortisol reactivity to an acute stressor in dose-dependent fashion,
depending on how many weeks of training were completed (Fan et al., 2014). In fact,
a recent study found that a 3-month compassion-based socio-aective training signi-
cantly reduced both self-reported and cortisol stress reactivity to a psychosocial challenge
(the TSST; Engert et al., 2017). Therefore, longer and perhaps longitudinal self-compassion
training sessions should be explored to determine their inuence on cortisol responses to
stress. Third, dierences in the comparison conditions used across studies may amplify or
attenuate potential eects of self-compassion training. The present research, for example,
provided a relatively conservative test of potential eects of self-compassion training by
using a comparison condition that shared general elements of positive self-talk with the
self-compassion training condition, in order to help ensure that any potential dierences
between conditions could be attributed to specic elements of self-compassion.
However, perhaps a neutral control condition would have provided a less conservative
test and revealed signicant eects of the self-compassion training. Future research could
explore this possibility by testing eects of self-compassion trainings against multiple
comparison conditions (e.g., positive self-talk comparison, neutral control).
Limitations and future directions
One aim of the present study was to determine the potential eects of a brief self-
compassion training on subjective and physiological responses to stress. As already
noted, we found no signicant dierences for the self-compassion training versus the
comparison condition on these responses. The shortest self-compassion intervention that
we are currently aware of consists of a 10-minute self-compassion recording repeated for
four days in a row (Arch et al., 2014, 2016). As discussed earlier, it is possible that self-
compassion training must be repeated to show meaningful eects on cortisol responses
to social-evaluative stressors. This possibility reects the need for randomized controlled
trials and longitudinal studies involving varying lengths of self-compassion training. It is
worthwhile to nd the briefest intervention possible that ts into today’s busy schedules,
and future longitudinal studies can elucidate the staying power of learned self-
compassion. A multi-system approach measuring multiple physiological systems also
will oer a fuller picture of the links between self-compassion and dierent components
of the stress response, such as HPA-axis, sympathetic nervous system, cardiac, and
immune reactivity.
SELF AND IDENTITY 13
It is also important to note that throughout the present study, we have interpreted
a lowered cortisol response to a social-evaluative stressor as benecial. A lowered
response would indeed be benecial for those experiencing anxiety and heightened
responses to stress. However, cortisol response is also a measure of arousal, and an
appropriate cortisol response to a social-evaluative stressor should be considered. For
example, a majority of studies have shown blunted cortisol reactivity in people with post-
traumatic stress disorder (Morris et al., 2012). In this light, lowered but not blunted cortisol
reactivity may be a healthy outcome of any stress reduction training.
In addition, the present study sample was primarily female and composed of partici-
pants from similar backgrounds in terms of age, college education levels, and geographi-
cal region, and is therefore less generalizable. Although the sample size is relatively small,
previous studies have had similar (N = 105; Arch et al., 2014, 2016) or smaller (N = 66;
Creswell et al., 2014) sample sizes. However, future research should include larger and
more diverse samples of participants (e.g., in terms of gender, age, education, geogra-
phical region, etc.) to increase representation and generalizability.
To capture the more immediate eects of self-compassion interventions on subjective
stress and state self-compassion, future research may wish to incorporate measures of
subjective stress and the recently developed and validated state self-compassion scales
(State Self-Compassion Scales; Ne et al., 2021) directly before and after self-compassion
interventions. Examining individual, social, and cognitive factors that might moderate the
links between self-compassion interventions and subjective and physiological responses
to social-evaluative stressors are also worth pursuing. For example, future work might
examine whether trait self-compassion moderates the eects of self-compassion inter-
ventions. Although the present work was not suciently powered to test trait self-
compassion as a potential moderator, future work could explore the possibility that
individuals who have lower levels of trait self-compassion might benet more from self-
compassion interventions, relative to individuals who already have higher levels of trait
self-compassion. If trait self-compassion does emerge as a signicant moderator of self-
compassion interventions in future studies, this nding also might help explain the
absence of signicant eects of self-compassion training in the present study. As another
example, experienced meditators have been shown to perceive less stress during social-
evaluative stressors and to have lowered biological responses to stress (Rosenkranz et al.,
2016). Therefore, individual dierences in previous meditation history or baseline anxiety
levels may be moderating factors in the link between self-compassion and responses to
stress. As a nal example, following a social-evaluative speech task, the cortisol trajec-
tories of socially-oriented versus nonsocially-oriented thinkers showed dierent patterns
(Vine et al., 2019). This nding suggests that how people think about relationships may
shape their physiological responses to a social performance task. Given that in the present
study, the TSST was conducted in groups, it would be valuable to examine how social
thinking might aect this dynamic. For instance, do participants feel social support versus
increased social evaluation from their peers in the task? In essence, does being part of
a group alleviate or add to the demands of a social-evaluative stressor?
Finally, the present study indicates that higher levels of trait self-compassion were
associated with lower perceptions of stress and lower cortisol levels in response to
a social-evaluative stressor. At the same time, the self-compassion training did not aect
perceptions of stress or cortisol levels, which may suggest that other possible mechanisms
14 S. KETAY ET AL.
underly the links between higher self-compassion and lower subjective and physiological
stress. Related research has started to investigate the mechanisms underlying self-
compassion as a stress buer and has found several possibilities. Self-compassionate
individuals demonstrate less use of maladaptive strategies for responding to stress,
such as rumination (Butz & Stahlberg, 2018; Ne et al., 2007; Raes, 2010) and experiential
avoidance (Yela et al., 2020), and research has demonstrated strong associations between
maladaptive psychological responses to stress and physiological reactivity to stress. For
example, the literature reveals links between rumination and increased cortisol reactivity
to moderate social-evaluative stress (Vrshek-Schallhorn et al., 2018; Zoccola & Dickerson,
2012). Therefore, it is likely that an adaptive psychological response, with less rumination
or experiential avoidance, is associated with a more appropriate physiological response to
stress. Additional mechanisms may include a potential cascade eect of acceptance
leading to lower subjective stress, in turn leading to lower physiological stress. For
instance, self-compassion is linked with increased acceptance of one’s own imperfections
(Zhang et al., 2019) and is a potential mediator of the relationship between mindfulness
and subjective stress (Rodriguez et al., 2015). Exploring how dierent components of self-
compassion may predict stress responses also would provide insight into the particular
aspects of self-compassion that may be driving eects on stress. The Self-Compassion
Scale (Ne, 2003) can be broken down into six validated subscales that include items that
measure self-kindness, self-judgment, common humanity, isolation, mindfulness, and
over-identication. Future research should also address the links between self-
compassion and stress and other outcomes, like the stress hormone alpha-amylase,
other physiological measures such as blood pressure, and health outcomes such as overall
well-being. Overall, it would be worth exploring the underlying mechanisms or specic
components of self-compassion that link self-compassion with lower subjective and
physiological stress to further understand these processes.
Conclusions
The present study provides further support for the idea that higher levels of trait self-
compassion are linked with lower subjective and physiological responses to stress and
higher overall well-being. Individuals who are higher in trait self-compassion seem to
show reduced responses to social-evaluative stressors, which may oer myriad benets in
terms of emotional and physical well-being. Our study suggests that though self-
compassion is also a skill that can be learned, a longer duration of training (potentially
over the course of a few weeks) may be necessary before a relationship with stress
response is detectable. Further investigation is warranted into the relatively unexplored
yet potentially impactful links between self-compassion and subjective perceptions of
and physiological responses to social-evaluative stress.
Notes
1. We also re-ran this analysis to examine whether participants’ trait self-compassion would
predict their self-reported perceptions of stress when controlling for condition (i.e., self-
compassion training vs. comparison condition). Participants’ trait self-compassion continued
SELF AND IDENTITY 15
to signicantly predict their self-reported perceptions of stress, β = −0.37, SE = 3.11, t
(97) = −3.92, p < .001, 95% CI [−18.371, −6.010], when controlling for condition.
2. We also re-ran our key analyses (reported below) to examine whether participants’ trait self-
compassion and self-compassion training would predict their cortisol levels without adjusting
for medication and substance use. The eects remained the same across both sets of models,
with one exception: Participants’ trait self-compassion no longer signicantly predicted their
cortisol levels during the TSST-G in the model that did not adjust for medication and
substance use, Estimate = −0.08, SE = 0.04, t(92.99) = −1.86, p = .067, 95% CI [−0.165,
0.006], although the eect remained in the predicted direction.
3. We also re-ran our key analyses (reported below) to examine whether gender would mod-
erate potential eects of trait self-compassion and self-compassion training on participants’
cortisol levels. Gender did not signicantly moderate the association between trait self-
compassion and participants’ cortisol levels, Estimate = −0.06, SE = 0.12, t(91.99) = −0.50,
p = .620, 95% CI [−0.294, 0.176], or the association between self-compassion training and
participants’ cortisol levels, Estimate = 0.00, SE = 0.12, t(92.00) = 0.01, p = .992, 95% CI [−0.244,
0.246].
4. We also re-ran this analysis to examine whether participants’ trait self-compassion would
predict their cortisol levels when controlling for condition (i.e., self-compassion training vs.
comparison condition). Participants’ trait self-compassion continued to signicantly predict
their cortisol levels during the TSST-G, Estimate = −0.08, SE = 0.04, t(91.99) = −2.03, p = .046,
95% CI [−0.165, −0.002], when controlling for condition.
Disclosure statement
No potential conict of interest was reported by the author(s).
ORCID
Sarah Ketay http://orcid.org/0000-0003-2247-4736
Lindsey A. Beck http://orcid.org/0000-0003-4351-2594
Juli Dajci http://orcid.org/0000-0001-8541-5982
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