Histrionic

Personality

Disorder Francis O. Timothy

Histrionic Personality Disorder

a personality disorder characterized by a pattern of

excessive emotions and attention-seeking, including

inappropriately seductive behavior and an excessive need

for approval, usually beginning in early adulthood.

People affected by HPD are lively, dramatic, vivacious,

enthusiastic, and flirtatious.

HPD affects four times as many women as men.

It has a prevalance of 2–3% in the general population, and

10–15% in inpatient and outpatient mental health

institutions.

Characteristics

People with HPD are usually high-functioning, both socially and professionally.

They usually have good social skills, despite tending to use them to manipulate others into making them the center of attention.

HPD may also affect a person's social and/or romantic relationships, as well as their ability to cope with losses or failures. They may seek treatment for clinical depression when romantic (or other close personal) relationships end.

Individuals with HPD often fail to see their own personal situation realistically, instead dramatizing and exaggerating their difficulties.

They may go through frequent job changes, as they become easily bored and may prefer withdrawing from frustration (instead of facing it).

They tend to crave novelty and excitement, they may place themselves in risky situations. All of these factors may lead to greater risk of developing clinical depression.

Characteristics

Mnemonic can be used to remember the

characteristics of histrionic personality disorder is

"PRAISE ME"

◦ Provocative (or seductive) behavior

◦ Relationships are considered more intimate than they actually

are

◦ Attention-seeking

◦ Influenced easily

◦ Speech (style) wants to impress; lacks detail

◦ Emotional liability

◦ Make-up; physical appearance is used to draw attention to self

◦ Exaggerated emotions; theatrical

Subtypes of HPD

Theodore Millon identified six subtypes of histrionic personality disorder. Any individual histrionic may exhibit none or one of the following

Appeasing

Vivacious

Tempestuous

Disingenuous

Theatrical

Infantile

1. Appeasing

Appeasing: Including dependent

and compulsive features

Personality traits: Seeks to placate, mend, patch up,

smooth over troubles; knack for settling differences,

moderating tempers by yielding, compromising,

conceding; sacrifices self for commendation.

2. Vivacious

Vivacious: The seductiveness of the histrionic mixed

with the energy typical of hypomania. Some

narcissistic features can also be present

Personality traits: Vigorous, charming, bubbly, brisk,

spirited, flippant, impulsive; seeks momentary

cheerfulness and playful adventures; animated,

energetic, ebullient.

3. Tempestuous

Including negativistic features

Personality traits: Impulsive, out of control; moody

complaints, sulking; precipitous emotion, stormy,

impassioned, easily wrought-up, periodically

inflamed, turbulent

4. Disingenuous

Including antisocial features

Personality trait: Underhanded, double-dealing,

scheming, contriving, plotting, crafty, false-hearted;

egocentric, insincere, deceitful, calculating, guileful.

5. Theatrical

Variant of “pure” pattern

Personality traits: Affected, mannered, put-on;

postures are striking, eyecatching, graphic; markets

self-appearance; is synthesized, stagy; simulates

desirable/dramatic poses.

6. Infantile

Including boderline features

Personality Traits: Labile, high-strung, volatile

emotions; childlike hysteria and nascent pouting;

demanding, overwrought; fastens and clutches to

another; is overly attached, hangs on, stays fused to

and clinging.

Causes

Unknown, but childhood events such as deaths or

illnesses in the immediate family (which present

constant anxiety), divorce of parents, and genetics

may be involved.

HPD is more often diagnosed in women than men;

men with some similar symptoms are often

diagnosed with narcissistic personality disorder.

Co-morbidity

Most histrionics also have other mental disorders.

Comorbid conditions include: antisocial, dependent,

borderline, narcissistic personality disorders,

depression, bipolar disorder, anxiety disorders,

panic disorder, somatoform disorders, anorexia

nervosa, substance use disorder and attachment

disorders.

Diagnosis

The person's appearance, behavior, and history,

along with a psychological evaluation are usually

sufficient to establish a diagnosis.

There is no test to confirm this diagnosis because

the criteria are subjective, some people may be

wrongly diagnosed

Treatment

Treatment is often prompted by depression

associated with dissolved romantic relationships.

Medication does little to affect the personality

disorder, but may be helpful with symptoms such as

depression.

Treatment for HPD itself involves

psychotherapy, cognitive therapy.

Epidemiology

Approximately 1–3% of the general population may

be diagnosed with HPD.

Major character traits may be inherited, while other

traits may be due to a combination of genetics and

environment, including childhood experiences.

This personality is seen more often in women than

in men. It has typically been found that at least two

thirds of persons with HPD are female.

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