Performance Pay and Low Grade Stress: An Experimental Study

Ioannis Theodossiou* (Corresponding Author), Keith Bender, Julia Allan

*Corresponding author for this work

Research output: Contribution to journalArticle


BACKGROUND: Although recent economics literature suggests a link between performance pay (PRP) and ill health, this finding is contested on the grounds that this link is plagued by endogeneity between the two variables of interest. OBJECTIVE: This study investigates the adverse effects of performance pay on stress which is an important determinant of physical health. METHODS: Forty subjects were randomly assigned to two equal groups; either being paid by performance or being paid a flat fee. Both objective (saliva samples to measure cortisol elevation) and subjective (self-reported stress level) measures of stress were obtained before and after participation in the experiment. This experimental methodology purges the effects of self-selection into performance pay and identifies the direction of causation from performance pay to stress which is measured by cortisol levels. RESULTS: Those who were paid for their performance experienced higher levels of stress, both in terms of perceived stress and in terms of objectively measured cortisol levels, compared to those who were paid a flat fee for minimum performance. CONCLUSIONS: Performance related pay induces objectively measurable stress. Self-reported stress levels and the objective stress measure obtained by measuring cortisol move in a similar direction for the PRP and nonPRP groups, but only the cortisol group shows statistically significant differences between the PRP and nonPRP. This also suggests that individuals are underestimating the stress due to performance pay.
Original languageEnglish
JournalWORK: A Journal of Prevention, Assessment & Rehabilitation
Publication statusAccepted/In press - 19 Oct 2019


  • performance-related pay
  • real-effort experiment
  • stress
  • cortisol

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