It appears to be linked to emotional dysregulation, which has been shown to be a significant predictor of identity disturbance in psychiatric patients even when controlling for borderline personality disorder diagnosis, depression, and anxiety.Neacsiu, A. D., Herr N. R., Fang C. M., Rodriguez M. A., Rosenthal M. Z. (2015). Identity disturbance and problems with emotion regulation are related constructs across diagnoses. Journal of Clinical Psychology, 71(4), 346-361. Although some researchers posit that it is the lack of consistent goals, values, world views, and relationships that lead to a sense of emptiness,Westen, D., Cohen, R.P. (1994). The self in borderline personality disorder: A psychodynamic perspective. In Z. V. Segal, & S. J. Blatt (Eds.), The self in emotional distress: Cognitive and psychodynamic perspectives (pp. 334-368). New York: Guilford Press. it is not entirely clear whether the link between emotional dysregulation and identity disturbance is because a disturbed identity creates a negative affect that is hard to regulate, because emotional dysregulation disturbs identity, because a third variable causes both (confounding), or some combination of the above.
