Hein Katherine E, Glass Isabel V, Frankenburg Frances R, Fitzmaurice Garrett M, Zanarini Mary C
Oklahoma State University, Stillwater, OK, USA.
McLean Hospital, Belmont, MA, USA.
J Affect Disord. 2025 Mar 1;372:234-240. doi: 10.1016/j.jad.2024.11.075. Epub 2024 Nov 27.
Patients with borderline personality disorder (BPD) suffer from a variety of affective symptoms, including emptiness. Emptiness has received less attention, yet causes severe suffering and impairment. This study's primary aim was to compare the severity of emptiness over time in 290 patients with BPD to 72 patients with other personality disorders (OPD), and its secondary aim was to identify clinical and psychosocial predictors of severity of feelings of emptiness over 24 years of prospective follow-up. Inpatients meeting rigorous criteria for BPD or meeting DSM criteria for OPD were assessed at baseline, then reassessed every two years for 24 years. Severity of feelings of emptiness was assessed via self-report. Severity of emptiness was significantly higher at baseline for patients with BPD than with OPD, but declined at a similar rate over time in both groups. Five variables individually predicted the severity of emptiness in those with BPD. In multivariate models controlling for time, two variables significantly predicted the severity of emptiness over 24 years; a baseline history of PTSD and the number of childhood competencies. Results suggest emptiness is a common but declining symptom of BPD. Severity and course of emptiness in patients with BPD are related to co-occurring PTSD and number of childhood competencies.
边缘型人格障碍（BPD）患者存在多种情感症状，包括空虚感。空虚感受到的关注较少，但会导致严重的痛苦和功能损害。本研究的主要目的是比较290例BPD患者与72例其他人格障碍（OPD）患者在一段时间内空虚感的严重程度，其次要目的是在前瞻性随访的24年中确定空虚感严重程度的临床和社会心理预测因素。符合BPD严格标准或符合OPD的DSM标准的住院患者在基线时进行评估，然后每两年重新评估一次，持续24年。通过自我报告评估空虚感的严重程度。BPD患者在基线时的空虚感严重程度显著高于OPD患者，但两组随时间的下降速度相似。五个变量分别预测了BPD患者空虚感的严重程度。在控制时间的多变量模型中，两个变量显著预测了24年内空虚感的严重程度；创伤后应激障碍（PTSD）的基线病史和童年能力的数量。结果表明，空虚感是BPD常见但呈下降趋势的症状。BPD患者空虚感的严重程度和病程与共病的PTSD和童年能力的数量有关。
