Histrionic Personality Disorder

Histrionic Personality Disorder

Histrionic Personality Disorder

Histrionic personality disorder (HPD) is characterized by a persistent pattern of emotional expression and excessive dramatic, attention-seeking behaviors in multiple situations and settings.

Prevalence

The onset of HPD is in early adulthood, and the male to female ratio is 1:4, although it is suspected that many men are undiagnosed. HPD affects approximately less than 2% of the general population; however, rates can be as high as 15% in mental health settings.

Symptoms of Histrionic Personality Disorder:

Associated traits of HPD include:

  • Constant seeking of approval, appreciation, and reassurance, often acting loudly and inappropriately to get it
  • Sexually seductive behaviors, flirty
  • Persistent manipulative behavior to achieve one’s own needs
  • Self-indulgent, self-centered, likes the attention to be on them, large ego, does not appear to care about others
  • Easily influenced
  • Inability to accept responsibility for any flaws or failures, very sensitive to criticism or disapproval
  • Easily frustrated
  • Prone to changing moods quickly, thus appearing shallow

People with HPD can initially be fun to be around because they seem happier and more “alive,” but relationships can become difficult once their excitement in the newness of it all wears off.

Diagnosing Histrionic Personality Disorder:

Once a physical exam has ruled out the possibility of any medical issues, according to the DSM-5, at least five of the following symptoms must be present for a diagnosis of HPD:

  • Is uncomfortable in situations in which he or she is not the center of attention.
  • Interaction with others is often characterized by inappropriate sexually seductive or
  • Provocative behavior.
  • Displays rapidly shifting and shallow expression of emotions.
  • Consistently uses physical appearance to draw attention to self.
  • Has a style of speech that is excessively impressionistic and lacking in detail.
  • Shows self-dramatization, theatricality, and exaggerated expression of emotion.
  • Is suggestible (i.e., easily influenced by others or circumstances).
  • Considers relationships to be more intimate than they actually are.

People with HPD are often high-functioning, both socially and occupationally. They usually possess good communication skills, although they tend to use them to manipulate others to make themselves the center of attention.

Risk factors for Histrionic Personality Disorder:

People with HPD crave excitement, novelty, and stimulation, and this can often lead them into risky situations. It can also cause them to impulsively quit jobs, friendships, and relationships without thinking of the long-term results such as depression or eviction.

Causes of Histrionic Personality Disorder:

The exact cause of HPD remains unknown; however, brain chemistry, genetic traits, unconscious mental processes, and environmental factors have all been implicated in the development of this condition.

Environmental factors – It has been suggested that parenting styles that lead to confusion about what types of behavior are acceptable — such as unpredictable punishment given to a child by his or her parent(s), or approval only being given for performance — contribute to the development of HPD in adulthood.

HPD often coexists with other mood, personality, eating, and substance use disorders, but particularly antisocial, narcissistic, and borderline personality disorder.

Treatment for Histrionic Personality Disorder:

A person’s HPD symptoms can improve with a combination of talk therapy and medication for any coexisting mental health disorders.

Because of the person with HPD’s constant need for change and their being prone to exaggeration, long-term therapy can be difficult, so therapy should be focused on solutions and support for change.


  • Psychotherapy – such as talk therapy can be used for the treatment of HPD. The goal of treatment is to help the individual uncover the subconscious motivations and fears associated with his or her thoughts and behaviors, and to help them learn to relate to others in a more positive and healthy way.

    • Psychodynamic therapy – helps address associated fears and the reasons for conflict and teaches helpful communication skills to address them. This improves understanding of self and strengthens relationships. The behaviors chosen in response to fearful thoughts are also examined, and healthier ways of validating one’s self worth are adopted.
  • Medications – are ineffective at reducing the symptoms of HPD, but they can be used to treat coexisting conditions such as major depressive disorder or generalized anxiety disorder.
 

Symptoms of Histrionic Personality Disorder:

Associated traits of HPD include:

  • Constant seeking of approval, appreciation, and reassurance, often acting loudly and inappropriately to get it
  • Sexually seductive behaviors, flirty
  • Persistent manipulative behavior to achieve one’s own needs
  • Self-indulgent, self-centered, likes the attention to be on them, large ego, does not appear to care about others
  • Easily influenced
  • Inability to accept responsibility for any flaws or failures, very sensitive to criticism or disapproval
  • Easily frustrated
  • Prone to changing moods quickly, thus appearing shallow

People with HPD can initially be fun to be around because they seem happier and more “alive,” but relationships can become difficult once their excitement in the newness of it all wears off.

 

Diagnosing Histrionic Personality Disorder:

Once a physical exam has ruled out the possibility of any medical issues, according to the DSM-5, at least five of the following symptoms must be present for a diagnosis of HPD:

  • Is uncomfortable in situations in which he or she is not the center of attention.
  • Interaction with others is often characterized by inappropriate sexually seductive or
  • Provocative behavior.
  • Displays rapidly shifting and shallow expression of emotions.
  • Consistently uses physical appearance to draw attention to self.
  • Has a style of speech that is excessively impressionistic and lacking in detail.
  • Shows self-dramatization, theatricality, and exaggerated expression of emotion.
  • Is suggestible (i.e., easily influenced by others or circumstances).
  • Considers relationships to be more intimate than they actually are.

People with HPD are often high-functioning, both socially and occupationally. They usually possess good communication skills, although they tend to use them to manipulate others to make themselves the center of attention.

 

Risk factors for Histrionic Personality Disorder:

People with HPD crave excitement, novelty, and stimulation, and this can often lead them into risky situations. It can also cause them to impulsively quit jobs, friendships, and relationships without thinking of the long-term results such as depression or eviction.

 

Causes of Histrionic Personality Disorder:

The exact cause of HPD remains unknown; however, brain chemistry, genetic traits, unconscious mental processes, and environmental factors have all been implicated in the development of this condition.

Environmental factors – It has been suggested that parenting styles that lead to confusion about what types of behavior are acceptable — such as unpredictable punishment given to a child by his or her parent(s), or approval only being given for performance — contribute to the development of HPD in adulthood.

HPD often coexists with other mood, personality, eating, and substance use disorders, but particularly antisocial, narcissistic, and borderline personality disorder.

 

Treatment for Histrionic Personality Disorder:

A person’s HPD symptoms can improve with a combination of talk therapy and medication for any coexisting mental health disorders.

Because of the person with HPD’s constant need for change and their being prone to exaggeration, long-term therapy can be difficult, so therapy should be focused on solutions and support for change.


  • Psychotherapy – such as talk therapy can be used for the treatment of HPD. The goal of treatment is to help the individual uncover the subconscious motivations and fears associated with his or her thoughts and behaviors, and to help them learn to relate to others in a more positive and healthy way.

    • Psychodynamic therapy – helps address associated fears and the reasons for conflict and teaches helpful communication skills to address them. This improves understanding of self and strengthens relationships. The behaviors chosen in response to fearful thoughts are also examined, and healthier ways of validating one’s self worth are adopted.
  • Medications – are ineffective at reducing the symptoms of HPD, but they can be used to treat coexisting conditions such as major depressive disorder or generalized anxiety disorder.
Sources WEB MD – What Is Psychotherapy | PSYCHOLOGY TODAY – Histrionic Personality Disorder Symptoms, Causes & Treatment | PENN STATE HERSHEY – Histrionic Personality Disorder Causes, Symptoms, Treatment, Complications