Poster presentation at the annual North American Society for the Study of Personality Disorders conference in New York

1. Development and Refinement of a Self-Report Scale for Measuring Subjective Emptiness
Stephanie L. Price1, Heike I.M. Mahler1, Christopher J. Hopwood2, Marie Thomas1, Kristyana Kern1, Tyan Carrico1
1California State University San Marcos, 2Michigan State University
Item Generation. Items written by researchers and
clinical participants were generated based on a
literature review, thematic analysis of transcripts
from online mental health forums, and in-depth
interviews with participants diagnosed with BPD
(n = 18). Content validity was evaluated by an expert
panel (n = 15) and the items were piloted with a
sample of undergraduate students (n = 53).
Participants. Participants who did not complete
90% or more of the items on the survey were
excluded from analysis.
These initial results support our identification of
a pool of 17 items with strong psychometric
characteristics for the assessment of subjective
emptiness. This scale has considerable
potential for future research on this important
but understudied aspect of personality
pathology.
We will next further refine this scale by
exploring demographic effects and by
conducting more extensive tests of internal
structure and external correlates.
Funding was provided by the RISE grant (GM-
64783).
Introduction
Table 1. Demographic characteristics of the samples.
Characteristic Sample
Clinical
(n = 1,066)
Student
(n = 543)
Age, years, mean ± SD 29.78 ± 11.48 20.22 ± 3.17
Gender
Female, No. (%) 715 (67.1%) 416 (76.6%)
Male 342 (32.1%) 126 (23.2%)
Ethnicity
Caucasian (Non-Latino), No. (%) 873 (81.9%) 145 (26.7%)
African American 24 (2.3%) 17 (3.1%)
Hispanic/Latino 44 (4.1%) 241 (44.4%)
Asian/Pacific Islander 34 (3.2%) 78 (14.4%)
Other 80 (7.5%) 59 (10.9%)
Education
Did Not Graduate from High School,
No. (%)
40 (3.8%) -
High School Diploma/G.E.D. 162 (15.2%) -
Some College 451 (42.3%) -
Bachelor’s Degree 268 (25.1%) -
Postgraduate Degree 141 (13.2%) -
Treatment
Taking Psychiatric Medication, No. (%) 692 (64.9%) 35 (6.4%)
Attending Therapy 520 (48.8%) 39 (7.2%)
Although emptiness is a clinically important
symptom and a diagnostic criterion for borderline
personality disorder, research on emptiness is
limited relative to other borderline features such as
emotional lability or self-harming behavior. The
development of existing emptiness scales has
entailed exclusive reliance on student samples, lack
of formal content validity testing, and use of a limited
selection of validation measures yielding insufficient
evidence of construct validity.
In this poster we present the initial results of a study
designed to develop a measure of emptiness using
student and clinical samples. A thorough approach
to establishing content validity was utilized, and a
range of psychometric considerations for item
selection were incorporated.
In this study we used a construct validation
strategy to develop a unidimensional measure
of emptiness. Construct validation (Loevinger,
1957) occurs in three stages: content validation,
internal validation, and external validation. In the
first stage, we established the content for the
instrument by reviewing the literature,
interviewing key informants, and consulting with
a panel of experts. In the second stage, we
established the internal validity of the scale by
examining item-total correlations. In the third
stage, we established external validity by
comparing scores across clinical and student
populations and by correlating the measures
with a range of convergent and discriminant
measures.
We were specifically expecting the measure to
correlate strongly with measures of depression,
and borderline features, to correlate negatively
with meaning in life, and to correlate weakly with
impulsivity. We also expected it to correlate
more strongly with the emptiness criterion of
borderline personality than the other criteria. We
additionally examined the reading level of items.
All of these parameters were considered in an
item-trimming process that pared the original
measure down to the 17 items listed in Table 2.
Method
Results
Discussion
Measures. Student and clinical participants were administered the initial 53 items along with validating measures of depression, borderline personality, subjective emptiness,
meaning in life, and impulsivity.
Procedure. This study was approved by the Institutional Review Board. Participants were recruited using convenience and referral sampling on websites and social media
platforms targeting people with various psychiatric diagnoses. After clicking a URL link in the online announcement, they were directed to a survey website where they provided
consent, completed the questionnaires, and were debriefed. Clinical participants did not receive compensation. The student sample received course credit for participating.
Method (cont.)
Strategy
Sample Mean
Standard
Deviation
Skew
Item-Total
Correlation
Flesch
Kincaid
Grade
Level
Depression BPD
Average BPD Score
(Excluding
Emptiness
Criterion)
Emptiness
Criterion
Meaning
in Life
Impulsivity
I have a void inside of me.
Clinical 2.63 1.06 -0.06 .73
0.6
.60 .57 .32 .71 -.52 .14
Student 1.53 0.72 1.39 .69 .61 .59 .34 .58 -.39 .23
I feel empty inside.
Clinical 2.60 1.08 -0.05 .78
3.7
.63 .58 .32 .76 -.57 .16
Student 1.47 0.68 1.37 .74 .66 .62 .36 .66 -.47 .25
I am watching the world go by
without me.
Clinical 2.77 1.12 -0.28 .74
2.3
.59 .46 .27 .54 -.59 .16
Student 1.51 0.76 1.43 .66 .46 .47 .28 .43 -.44 .27
I feel as though I am disconnected
from the world.
Clinical 2.81 1.06 -0.32 .73
3.7
.59 .49 .29 .53 -.54 .18
Student 1.51 0.75 1.32 .73 .55 .56 .34 .51 -.46 .28
My life is lacking life.
Clinical 2.81 1.09 -0.35 .78
0.5
.62 .46 .26 .57 -.61 .13
Student 1.57 0.78 1.24 .72 .60 .52 .31 .49 -.51 .27
I feel absent in my own life.
Clinical 2.48 1.15 0.05 .78
0.6
.62 .52 .31 .56 -.56 .20
Student 1.33 0.65 2.07 .81 .59 .55 .34 .50 -.46 .21
No matter what I do, I still feel
unfulfilled.
Clinical 2.72 1.09 -0.24 .74
3.7
.59 .53 .32 .55 -.55 .22
Student 1.44 0.72 1.64 .75 .60 .56 .33 .52 -.48 .23
I feel like I am forced to exist.
Clinical 2.41 1.23 0.16 .74
0.8
.59 .54 .32 .56 -.53 .15
Student 1.27 0.66 2.76 .71 .53 .52 .32 .43 -.40 .20
I am living a life that is drained of
emotion.
Clinical 2.12 1.07 0.54 .62
3.7
.43 .41 .23 .50 -.48 .13
Student 1.31 0.62 2.25 .67 .54 .48 .28 .46 -.44 .29
I am nothing more than the mask I
wear.
Clinical 2.13 1.13 0.51 .68
1
.48 .51 .31 .48 -.46 .17
Student 1.25 0.58 2.54 .65 .47 .50 .31 .40 -.36 .27
I feel hollow.
Clinical 2.40 1.11 0.17 .83
1.3
.61 .58 .33 .70 -.55 .17
Student 1.29 0.61 2.37 .77 .57 .57 .34 .54 -.44 .25
I feel like a body without a soul.
Clinical 1.91 1.12 0.82 .71
2.3
.49 .50 .30 .56 -.48 .16
Student 1.18 0.51 3.21 .66 .45 .52 .33 .42 -.42 .28
I feel all alone in the world.
Clinical 2.50 1.16 0.05 .74
0.6
.60 .53 .31 .57 -.51 .16
Student 1.37 0.69 2.01 .71 .60 .53 .32 .48 -.43 .21
I am in the world but not part of it.
Clinical 2.42 1.14 0.13 .79
0.1
.56 .49 .29 .54 -.58 .16
Student 1.27 0.64 2.71 .68 .46 .49 .31 .38 -.34 .22
I don't see the point in doing
anything.
Clinical 2.45 1.18 0.13 .76
3.8
.60 .53 .31 .58 -.63 .20
Student 1.25 0.62 2.76 .64 .50 .51 .31 .43 -.42 .25
My life does not feel as meaningful
as I would like it to feel.
Clinical 3.10 1.02 -0.75 .72
3.4
.61 .55 .26 .56 -.58 .15
Student 1.58 0.85 1.43 .74 .60 .57 .34 .56 -.51 .24
My life does not feel as fulfilling as I
would like it to feel.
Clinical 3.09 1.04 -0.73 .71
3.4
.59 .43 .24 .55 -.57 .14
Student 1.62 0.87 1.29 .70 .57 .50 .30 .51 -.50 .19
Table 2. Characteristics of selected items.