From the Department of Humanities, University of Urbino "Carlo Bo" (Italy) (Drs. D'Agostino and Rossi Monti, and Mr. Pepi); University of Sydney Medical School, Nepean Clinical School, Discipline of Psychiatry, Sydney, Australia (Dr. Starcevic).
Harv Rev Psychiatry. 2020 Sep/Oct;28(5):287-295. doi: 10.1097/HRP.0000000000000269.
A feeling of emptiness is commonly encountered in clinical practice, but it is poorly understood, with incongruent approaches to its definition and possible role in various disorders. This review examines the conceptualization of the feeling of emptiness and its place in psychopathology. We found an imbalance between theoretical approaches to this phenomenon and empirical research, and argue that more studies using adequate assessment tools are needed. Based on our literature review, we propose that a feeling of emptiness is a complex, negative emotional state that is experienced in different ways by different individuals. This feeling includes a physical or bodily component, a component of aloneness or social disconnectedness, and a component of a deep sense of personal unfulfillment or lack of purpose. The feeling of emptiness is related to other emotional states (dysphoria, boredom, loneliness, and numbness) and overlaps to some extent with them. Although the feeling of emptiness is most often considered in the context of borderline personality disorder, it is also encountered in depression, narcissistic personality disorder, and schizophrenia spectrum disorders, with its features potentially varying between different conditions. The feeling of emptiness may lead to nonsuicidal self-injury and may also have an important relationship with suicidality. We conclude by offering suggestions for further research, emphasizing a need to refine the multidimensional conceptualization of the feeling of emptiness and to better understand its manifestations and relationships with other emotions within various forms of psychopathology.
空虚感在临床实践中很常见，但人们对此了解甚少，对其定义和在各种障碍中的可能作用的方法也不一致。这篇综述探讨了空虚感的概念化及其在精神病理学中的地位。我们发现，对这一现象的理论方法与实证研究之间存在不平衡，我们认为需要更多使用适当评估工具的研究。基于我们的文献综述，我们提出空虚感是一种复杂的、消极的情绪状态，不同的人以不同的方式体验这种感觉。这种感觉包括身体或身体成分、孤独或社会脱节的成分，以及深刻的个人不满足或缺乏目标的成分。空虚感与其他情绪状态（抑郁、无聊、孤独和麻木）有关，并在一定程度上与之重叠。尽管空虚感通常被认为是边缘型人格障碍的背景下，但它也出现在抑郁症、自恋型人格障碍和精神分裂症谱系障碍中，其特征在不同的情况下可能有所不同。空虚感可能导致非自杀性自伤，也可能与自杀意念有重要关系。我们最后提出了进一步研究的建议，强调需要细化空虚感的多维概念化，并更好地理解其在各种精神病理学形式中的表现及其与其他情绪的关系。
