Feeling Hollow: Examining the Presence, Emotional Correlates, and Regulation of Emptiness in Borderline Personality Disorder

This study examines whether 1) emptiness at baseline and emptiness in response to stressors (i.e., emptiness reactivity) is elevated in BPD relative to clinical and healthy controls (HCs), 2) whether emptiness reactivity predicts emotion reactivity across different indices of emotion, 3) and whether emptiness can be reduced using emotion regulation strategies (i.e., distraction, mindfulness). Participants (N = 120) with either BPD, generalized anxiety disorder (GAD), or HCs provided measurements of emptiness, self-reported emotion, skin conductance response (SCR), and respiratory sinus arrhythmia (RSA) at baseline, following a stressor, and while implementing an ER strategy. Results revealed that baseline emptiness was highest in the BPD group and that increases in emptiness predicted increases and decreases in emotional reactivity via self-report and RSA, respectively. Only distraction predicted greater reductions in emptiness compared to simply reacting across groups. Therefore, distraction may be most effective in reducing emptiness in the short-term compared to mindfulness.