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Histrionic Personality Disorder

Written by: Editorial Staff.

Histrionic Personality Disorder is considered one of the dramatic personality disorders. Individuals with these dramatic personality disorders have intense, unstable emotions and a distorted self-image. The self-esteem of people with HPD is contingent upon the approval of others and does not arise from a true feeling of self-worth. They have a strong desire to be the center of attention, and often behave dramatically or inappropriately to get it. The word histrionic literally means “dramatic or theatrical.” HPD disorder is diagnosed more in women than in men and is usually evident by early adulthood. Many people with this disorder are able to function well socially and at work. Those with more severe cases may experience significant problems in their daily live and feel the need for treatment.

Causes

Many mental health professionals believe that both environmental and genetic factors play a role in the development of HPD but it is difficult to separate the two. HPD has been recognized as a hereditary disorder. Children of HPD parents might simply be reenacting learned behavior. Positive reinforcement that is given only when a child completes certain approved behaviors and unpredictable attention given to a child all lead to confusion about what types of behavior earn parental approval.

Diagnosis

If signs are present, a medical assessment is suggested to rule out physical illness as being the source of the symptoms. If a medical illness is ruled out the individual may be recommended to visit a psychiatrist or psychologist where if the doctor finds no physical reason for the symptoms, he or she might refer the person to a psychiatrist or psychologist, or other health care professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specifically designed assessment tools and an interview may be used to assess an individual for histrionic personality disorder.

Symptoms

Individuals with histrionic personality disorder usually have good social skills, however they use these skills to manipulate others so that they can be the center of attention.

Symptoms of HPD Include:

  • Become upset unless they are the center of attention
  • Dress provocatively and/or seductively
  • Engage in sexual or flirtatious behavior
  • Rapidly shift emotions
  • Act very dramatically and theatrically as if in front of an audience
  • Exaggerate emotions and expressions, while being insincere
  • Overly concerned with physical appearance
  • Constantly seeking reassurance and approval
  • Easily influenced by others
  • Sensitive to criticism
  • Low tolerance for frustration
  • Easily bored
  • Have trouble starting and finishing projects
  • Impulsive
  • Self-centered and rarely demonstrate concern for others
  • Have fake or shallow relationships
  • Threaten or attempt suicide to get attention

Treatment

People with histrionic personality disorder do not believe they need therapy. They also tend to exaggerate their feelings and to become bored and dislike routine activities, which makes following a treatment plan quite difficult. Sometimes they seek help for depression associated with a loss or a failed relationship or another problem caused by their thinking and behavior causing them distress.

Psychotherapy is the treatment of choice for histrionic personality disorder. The goal of therapy is to assist the individual to uncover the fears associated with his or her thoughts and behavior, to better regulate emotions, and to help the person learn to relate to others in a more positive way. If appropriate, medication might be used to treat depression and anxiety that may co-occur with this disorder.

Complications and Risks

Histrionic personality disorder affects an individual’s social and romantic relationships and how they react to loss and failure. Individuals with this disorder are at high risk to suffering from depression.