Construction and Validation of a Self-report Subjective Emptiness Scale

Abstract

Subjective emptiness is a psychiatric symptom that is primarily assessed and studied as a criterion of borderline personality disorder, even though research suggests that it may have clinical importance beyond that diagnosis. The aim of this series of studies was to develop and validate a standalone self-report measure of subjective emptiness. A systematic, multistep approach to identifying test content was used to generate 88 items that were then trimmed to 53 via ratings of interviews with patients and experts. This preliminary scale was administered to a sample of 544 university students, and a trimmed version was given to two samples oversampled for clinical problems ( n = 1,067; n = 1,016). A five-item measure fit a unidimensional model well and had satisfactory internal consistency across these samples. External validity analyses suggested that emptiness, as measured by the Subjective Emptiness Scale, is strongly related to a number of clinical constructs, particularly in the internalizing domain, indicating that emptiness is an important construct to consider in its own right, independent of its presence in the borderline criterion set.

Trajectories of adaptive and disturbed identity dimensions in adolescence: developmental associations with self-esteem, resilience, symptoms of depression, and borderline personality disorder features

“…Finally, and rather unexpectedly at first, LGCM indicated a linear increase in lack of identity, a less common and pathological variant of identity dysfunctioning, which comes with feelings of inner emptiness and fragmentation. Although these feelings have been mainly considered within individuals with BPD or psychotic disorders ( 74 – 76 ), recent work shows that a lack of identity and feelings of inner emptiness are also experienced by individuals without mental health diagnoses ( 77 , 78 ). A study among college students found that almost one in five students experience emptiness ( 79 ), and a recent study by Martin and Levy ( 80 ) indicated that feelings of emptiness were consistently endorsed by 10% of 22,217 US college students and significantly increased in women.…”

Chronic feelings of emptiness in a large undergraduate sample: Starting to fill the void

“…The experience of emptiness across normative nonpathological experiences and various psychological difficulties raises the question of whether or not the concept is best conceptualized as a transdiagnostic one, which would be consistent with trends in the field (Insel et al, 2010). This is the approach taken by Price et al (2020) in the creation of their multiitem subjective emptiness scale, which consistent with a transdiagnostic approach was found to be unidimensional. Another approach would be to conceptualize emptiness from a developmental psychopathology approach (Levy, 2005) with attention to equifinality, multifinality, and the differences in the mechanisms and experiences of emptiness across borderline and narcissistic personality disorder, major depression, persistent depression, and even schizophrenia.…”

“…Creation of a measure that would capture greater variance in feelings of emptiness could provide greater clinical utility and better distinguish between diagnostic groups. Along these lines, Price et al (2020) have developed a measure of emptiness based on factor analysis of items from existing measures in an effort to develop a transdiagnostic measure. Future studies would also benefit from a prospective design that is meant to track symptoms of emptiness over time.…”

The relationship between emptiness and suicide and self‐injury urges in borderline personality disorder

“…To address the first hypothesis, two GEE analyses were conducted to examine whether emptiness at baseline predicted higher SSI urges at baseline. Given that research on the construct of emptiness and how it can be most accurately measured is still in its early stages (Miller et al, 2020; Price et al, 2022), it is currently unknown whether the construct of emptiness has a meaningful zero point, like many psychological constructs (Blanton & Jaccard, 2006). Thus, to increase the interpretability of the results, the emptiness variable was centered by subtracting the grand mean from all observations (Enders & Tofighi, 2007).…”

“…One symptom that is particularly linked to SSI in BPD is chronic feelings of emptiness (Miller et al, 2021). While chronic emptiness is a diagnostic symptom of BPD (APA, 2022), research suggests that emptiness represents a transdiagnostic construct involving a feeling of absence and detachment that is experienced on an intrapersonal, interpersonal, and existential level (Price et al, 2022). Among those with BPD, emptiness is one of the slowest symptoms to remit compared to other BPD symptoms and is often experienced as severe and chronic (Zanarini et al, 2016).…”