Many of us desire the admiration of others, but Histrionic personalities have an unhealthy need for constant attention and engage in outrageous behavior to get it.
What is Histrionic Personality Disorder?
To be histrionic is to behave melodramatically—over the top. People with the psychological disorder HPD, have a personality based on histrionic behavior; constantly displaying an excessive level of emotionality.
Histrionics crave the limelight and constantly seek attention and approval. They tend to dominate conversations using grandiose language and frequent interruptions. Those with HPD can be manipulative—negative attention being better than no attention at all (Dobbert 2007, Horowitz 2001).
Diagnosis of HPD
There are currently 10 conditions considered to be personality disorders, some of which have very little in common. Mental health professionals typically group those PDs that share characteristics into one of three clusters. Histrionic is a Cluster B Personality Disorder, a class which also contains Antisocial, Borderline and Narcissistic PD; all three distinguished by dramatic, emotional or erratic behavior.
HPD is only diagnosed when the characteristic behaviors are pervasive and disabling. According to the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders), a patient must fit at least five of the following criteria in order to be diagnosed with Histrionic Personality Disorder:
uncomfortable in situations when not the center of attention
social interactions often characterized by inappropriate sexually provocative behavior
rapidly shifting and shallow expression of emotions
consistently uses physical appearance to draw attention to self
style of speech that lacks detail and is excessively emotional
shows self-dramatization, theatricality, and exaggerated expression of emotion
easily influenced by others or circumstances
considers relationships to be more intimate than they actually are
Prevalence of Histrionic Personality
HPD has been estimated to occur in 2% to 3% of the general population and is more common among women (NESARC 2002).
Cause and Course of HPD
While the exact cause is not yet known, the disorder is exacerbated during increased times of stress and interpersonal difficulties. As is the case with most personality disorders, Histrionic Personality Disorder usually begins in early adulthood, and has a chronic course (Dobbert 2007, Horowitz 2001.
Treatment of Histrionic Disorder
Psychotherapy
Because personality is such an integral part of what defines our identity, PDs are characteristically difficult to treat. Individual psychotherapy, focused on increasing coping mechanisms and interpersonal skills appears to be the most effective course of treatment. Group therapy is generally not recommended for Histrionic patients, since their attention-seeking behavior can monopolize the session.
Suicidal gestures and self-mutilation, as attention-seeking behaviors, are often associated with HPD. Even if death is not the patent’s intention, it may be the result, so any expressed thoughts or plans of suicide should be taken very seriously.
The characteristic emotional neediness of Histrionics can result in an over-reliance on the therapist and reluctant to terminate therapy. Long-term psychotherapy can be financially prohibitive and is unlikely to resolve the deep-rooted issues of personality. The recommended course of treatment is short-term and focused on dealing with immediate stressors and difficulties within the person's life.
HPD and Medication
Psychiatric medications are not typically used to alleviate the personality disorder itself, but may be used to treat associated disorders such as anxiety or depression. Physicians should be cautious when prescribing to those with Histrionic Personality Disorder due to the possibility that the patient may use the medication inappropriately in the commission of self-destructive, harmful behaviors (Dobbert 2007, Horowitz 2001).
This article is a brief summary of the personality disorder HPD. The contents of this article are not meant to be used for diagnosis and are not a substitute for professional help and counseling.
Additional HPD Sources
American Psychiatric Association APA (2000) Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR).
Dobbert, D. (2007) Understanding Personality Disorders: An Introduction. Greenwood Press.
Horowitz, M. J. (2001) Hysterical Personality Style and Histrionic Personality Disorder. Aronson.
National Epidemiologic Survey on Alcohol and Related Conditions - NESARC (2002) Journal of Clinical Psychiatry, 65.
The copyright of the article Histrionic Personality Disorder in Personality Disorders is owned by Tami Port. Permission to republish Histrionic Personality Disorder in print or online must be granted by the author in writing.
CyberSpace Fatal Attraction - a mexican woman contacted me via an internet
dating site. I had been single for 7 years and travelled a lot through out
North American. The mexican woman finally came to Canada to meet me and
then I made several trips from Mexico. Our relationship was basically
honeymoon dating until I told her in August 2004, I no longer wanted a
longdistance relationship, so we either ended the realationship or made a
change. As she had no access to her children and I had my three children
in Canada she decided to come to Canada in September 2004. We married in
October 2004, completed her immigration and she obtained her permanent
residency. Then all the trouble began, discovered her on another dating
site, she began to threaten with divorce, discover she had a depressional
order while adding her to my medical insurance. Our daily life became
filled with threatrics, drama, discussions, financial problems and finally
police intervention. After a 6 month seperation and now an ugly divorce, I
am discovering all the lies and the by contacting the father of her
children, hevis helping me with discover via legal court document she is
prognosed with Narcissism and Histronic Personility Disorder. Added to
this is bulimia. Finally her motives for leaving the country where her
children are, are being revealed: -compulsion to cause police events
at the father of her children's home -financial problems, leaving
allowed her to sell her home -a legal Federal Court order because of a
lawyer she didn't pay The mexican woman lost all parrental rights
after physically and mentally abusing her children. Her story when I met
her, the father had bought the Mexican courts. Recently this crazy mexican
woman threatend to attack my children. In her diary and personal notes she
decribes herself as aggressive and bad with people, she doesn't trust
anyone and continually has to make new friends. In personal letter she
wrote to god, she seems to recognize she is sick, yet seeks miracles in god
and others to bring a miracle to her life. Thank-God I have great family
and kids and friends who know people in high places. I trust my divorce
will come soon and the mexican woman, who falsified her immigration
application and did not disclose her legal and mental problems, will be
sent back to Mexico. A Canadian Father, a son, a brother and man with
really great long time friends. I have gone through tortuous spousal
deceit, emotional and mental manipulation, financial ruin and fear for my
children. Believe me, I know about Histrionic Disorder and its
DRAMA!!!!!!!!!!!! At least I can be proud of being authentique in my
love for her. pb_nich@msn.com
May 10, 2008 10:41 AM
Guest
:
i have been married for 17 years it was up and down but the last few years
were good.My wife decided to sign up for myspace 3 months ago against my
wishes and she seem to have lost control of herself...she was meeting
guys,sending nude pics and has crushed me..she admits she has the problem
but we are not sure how to deal with it...I have two kids and i want to fix
this any suggestions? cfiii@hotmail.com
Jan 30, 2009 12:46 AM
Guest
:
My audlt daughter is Bipolar and has physical and emotional abuse by her
boyfriend and after a year and a half of this treatment by him she is now a
person I don't even know. Now it is being said she has Personality Disorder
with Narcissistic, Histrionic and Absessive Compulsive Features also Panic
Disorder and Posttraumatic Stress Disorder and depressive Disorder and drug
use. She says there is no abuse, But I have seen it. I was just thinking,
Could all this abuse have made her worse? She is my Drama Queen. I would
like to see a study on this. Has there been one? Any comments Please.
Litlbit36@aol.com
May 12, 2009 11:35 AM
Guest
:
What is the suggested approach for dealing with an HPD romantic partner? Is
it better to try to "be understanding", "let them work
through it", or is it better to confront the HPD partner with their
behavior? So far, I have found a few sites that discuss the HPD condition
and treatment aspects, but not good advice on how those in the relationship
should cope with the HPD partner. The only advice I've seen on sites is
from those who've been burned by their HPD partner and they basically
suggest to "run", to "give up" on the relationship as
it will "never get better". Any professional or educated
guidance would be much appreciated.
Jun 24, 2009 4:38 AM
Guest
:
I too have recently found out that my partner has HPD it has been a roller
coaster! I agree there is no information for a spouse with HPD what do we
do? everything I read tells me to run! are there any proffesionals out
there that can give me advice? is there a possability that my partner and I
can have a relationship in the future? are there any statistics? any
couples out there that can speak and say its working? how do you just walk
away? this person I care for deeply and planning to spend the rest of my
life with has a mental illness what is the advice for us? please help