Measuring emptiness: Validation of the Italian version of the Subjective Emptiness Scale in clinical and non-clinical populations

Abstract

Background: Although a feeling of emptiness is listed only as a symptom of the DSM-5 borderline personality disorder, it is commonly encountered in other disorders. The aim of this study was to validate the Italian version of the Subjective Emptiness Scale (SES-I), a 7-item self-report instrument assessing the feeling of emptiness. Methods: Participants in one clinical group (n = 63) and one non-clinical group (n = 48) completed the SES-I along with several other instruments. A principal component analysis was used to analyze the structure of the SES-I and Cronbach's alpha and Rho's Spearman were used to establish aspects of reliability and validity, respectively. Results: The SES-I has a unidimensional structure reflecting the core feature of the feeling of emptiness. It showed an excellent internal consistency (a = 0.92) and convergent validity, as demonstrated by significant correlations with scores on the Beck Depression Inventory – II and conceptually related scales and subscales of the Millon Clinical Multiaxial Inventory – III and Personality Inventory for DSM-5. Divergent validity was also demonstrated for the SES-I. SES-I scores in the clinical group were significantly higher than in the non-clinical group. A significant relationship was not found between the feeling of emptiness and self-harming behavior, impulsivity and acting-out. Limitations: A small sample size, several significant differences between the clinical and non-clinical groups and diagnostic heterogeneity in the clinical group limit generalizability of the study. Conclusion: The SES-I is a valid and reliable instrument, which should improve assessment of the feeling of emptiness and help clinicians better understand this complex phenomenon.

Keywords

• Emptiness
• Borderline personality disorder
• Depression
• Dysphoria
• Assessment
• Scale