Feelings of emptiness, pathological personality traits, and suicidal risk: an exploratory study using the modified subjective emptiness scale in an Italian general population sample

Introduction – Subjective emptiness is a painful affective experience increasingly recognized as transdiagnostic and multidimensional. Yet, empirical assessment of its multidimensional nature remains limited. Because emptiness stems from instability in self-organization and emotional integration, it is closely connected to personality functioning. Previous studies found that identity pathology and emptiness independently predicted suicidal ideation, with emptiness partially mediating the relationship between identity disturbance and suicidality. This study developed and validated the Modified Subjective Emptiness Scale (M-SES), a 25-item instrument designed to capture the phenomenological facets of emptiness and examined its associations with maladaptive personality traits and suicidal ideation in a community sample. Methods – Participants were 202 adults (71.3% female; M = 41.2, SD = 14.4) who completed the M-SES, PID-5-SF, BSI, and C-SSRS. Confirmatory factor analysis tested the hypothesized four-factor structure. Reliability, convergent validity, and mediation analyses were performed using standard indices. Results – Confirmatory factor analysis supported a four-factor structure—Physical/Bodily emptiness, Interpersonal/Social disconnection, Dissatisfaction/Lack of purpose, and Severity/Self-level impairment—showing good fit indices. A second-order factor model confirmed that the four dimensions load on a higher-order Subjective Emptiness factor. All M-SES dimensions correlated strongly with Negative Affectivity and Detachment, and moderately with Psychoticism, supporting convergent validity. Regression analyses showed that Interpersonal/Social disconnection uniquely predicted suicidal ideation severity. Mediation analyses revealed significant indirect effects of Detachment and Psychoticism on suicidal ideation via interpersonal emptiness, while Disinhibition exerted only a direct effect. Discussion – Findings support the M-SES as a psychometrically sound measure capturing both the structural and affective dimensions of subjective emptiness. Interpersonal emptiness emerged as a central experiential pathway linking maladaptive personality traits to suicidal ideation, emphasizing its clinical relevance as a target for assessment and intervention. Future studies should extend validation to clinical populations and longitudinal designs.