What is Histrionic Personality Disorder?
Histrionic Personality Disorder is a personality disorder characterized by a pattern of extreme, intense emotions as well as attention-seeking behavior. A person who has Histrionic Personality Disorder needs to be the center of attention in a group - any group - and when they are not, they become upset and uncomfortable.
Those with Histrionic Personality Disorder need novelty and thrills, which may lead them to become bored with the usual routines. This may lead to frustration when gratification is delayed, as they want immediate satisfaction. Interest in jobs, friendships, and relationships may quickly dwindle in favor of the shiny newness of other relationships.
Someone with Histrionic Personality Disorder is usually effervescent, lively, and interesting (sometimes appearing shallow), but cannot handle it when the attention is not focused entirely upon him or her. In order to direct attention back to themselves, they may begin sexually suggestive or seductive behavior.
Despite being highly sexual, people with Histrionic Personality Disorder often have problems with emotional intimacy in sexual or romantic relationships. Whether or not they are aware, they often choose a role (victim, princess) within their relationships. People with Histrionic Personality Disorder may try to control their partner through seductiveness or emotional manipulation while displaying a strong dependency on their partners on another level. Because people with Histrionic Personality Disorder crave excitement and newness, longer-term relationships are difficult for them to maintain.
It's hard for those with Histrionic Personality Disorder to maintain same-sex friendships because their sexually-charged style may come across as a threat to their friends' romantic relationships. In addition, people with Histrionic Personality Disorder can alienate friends through their demands for constant attention, and their depression when that attention is not provided.
Causes For Histrionic Personality Disorder:
As with many other mental illnesses, researchers do not know what causes Histrionic Personality Disorder. Many different theories exist, but the most widely accepted theory is what's called a "biopsychosocial model of causation"; in other words the cause of Histrionic Personality Disorder is likely due to genetic and biological factors, social factors, and psychological factors. This means that no single cause is to blame for the development of Histrionic Personality Disorder.
Symptoms of Histrionic Personality Disorder:
While people with Histrionic Personality Disorder are able to function at a high-level and be socially successful, they often use these skills to manipulate others and become the center of attention.
Some basic symptoms of Histrionic Personality Disorder can include: constant approval-seeking; constant reassurance-seeking; extreme sensitivity to criticism; grossly exaggerated displays of emotions; and exhibitionism-type behavior.
Other symptoms can be unwillingness to change; suggestion of change viewed as a threat; inappropriately seductive behavior; inappropriately sexy clothing; and a low tolerance for frustration.
Individuals with Histrionic Personality Disorder may also feel a need to be center of attention; use somatic symptoms to get attention; display rapidly shifting emotional states; make rash decisions; and believe that their relationships are more intimate than they are.
DSM-IV Diagnostic Criteria for Histrionic Personality Disorder:
According to the DSM-IV, Histrionic Personality Disorder is diagnosed by:
A pervasive pattern of excessive emotionality and attention-seeking, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
- 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, easily influenced by others or circumstances
- Considers relationships to be more intimate than they actually are.
Diagnosis of Histrionic Personality Disorder:
A person must be at least 18 years old in order to be diagnosed with any personality disorder. Symptoms will generally increase in intensity with age, with the peak level of symptoms displayed in their 40's or 50's.
Many people with Histrionic Personality Disorder do not seek out treatment, unless the disorder begins to impact their lives. This usually happens only if life becomes too stressful and they are unable to cope with it.
Unlike other mental illnesses, it's extremely difficult for a general practitioner to diagnose Histrionic Personality Disorder, therefore a diagnosis must be made by a trained mental health professional.
A diagnosis of Histrionic Personality Disorder occurs through a thorough examination by a psychiatrist or psychologist by reviewing symptoms and taking a detailed health history. If the symptoms meet the diagnostic criteria, a diagnosis of Histrionic Personality Disorder is made.
Treatment of Histrionic Personality Disorder:
Those who suffer Histrionic Personality Disorder are generally hard to treat for many reasons. People with Histrionic Personality Disorder often only seek treatment when their symptoms have become too much for them to handle. Once in treatment, however, these people often exaggerate their symptoms and lack of ability to function. They also have a hard time, as they are emotionally needy, terminating therapy.
Psychotherapy is the treatment of choice for those with Histrionic Personality Disorder. Family or group therapy is not recommended, as the person often spends the time drawing attention to themselves. Individual psychotherapy with a solution-based approach is often followed, as the person with Histrionic Personality Disorder may develop boundary issues with the therapist. It also allows for treatment of specific problems, rather than a long-term approach, as few people with Histrionic Personality Disorder can afford to cure this disorder.
Medications are not indicated for treatment of Histrionic Personality Disorder.
Self-help groups are not effective for treatment of Histrionic Personality Disorder.
Additional Resources for Histrionic Personality Disorder:
Out of the Fog - an information site and support group offering help to family members and loved-ones of people who suffer from personality disorders.