Perceived Isolation in Self-Compassion Scale as a Subtyping Marker for Severe Anorexia Nervosa

This study aimed to examine the differences in self-compassion (SC) subcomponents between anorexia nervosa (AN) subtypes, restricting type (ANR) and binge-eating/purging type (ANBP), with a focus on perceived isolation and self-judgment. This retrospective exploratory study included 40 patients with AN at a Japanese tertiary hospital. The participants completed the Self-Compassion Scale, Patient Health Questionnaire-9, and Eating Disorder Examination Questionnaire. Between-group comparisons were conducted using t-tests, and logistic regression was used to identify predictors of the AN subtype. The ANBP group was older at the time of assessment and had longer illness duration than the ANR group. They also showed significantly more depressive symptoms, more severe eating pathologies, and lower SC scores. Specifically, patients with ANBP had significantly lower scores on the self-judgment and isolation subscales. Logistic regression showed that higher isolation scores predicted ANBP subtype (odds ratio = 4.50, 95% confidence interval: 1.40–25.0, p = 0.0086), independent of depression and eating symptoms. Perceived isolation is more prominent in ANBP and may reflect the affective and interpersonal dysfunction characteristics of this subtype. Targeting these SC dimensions may be important for the development of subtype-specific interventions. Compassion-based approaches offer therapeutic benefits, particularly for individuals with purging behaviors.