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Histrionic personality disorder is one of a group of conditions called”Cluster B” or “dramatic” personality disorders. People with thesedisorders have intense, unstable emotions and distorted self-images.For people with histrionic personality disorder, their self-esteemdepends on the approval of others and does not arise from a truefeeling of self-worth. They have an overwhelming desire to be noticed,and often behave dramatically or inappropriately to get attention. Theword histrionic means “dramatic or theatrical.” This disorder is more common in women than in men and usually isevident by adolescence or early adulthood.
What Are the Symptoms of Histrionic PersonalityDisorder?
In many cases, people with histrionic personality disorder have goodsocial skills; however, they tend to use these skills to manipulate othersso that they can be the center of attention.
A person with this disorder might also:
- Be uncomfortable unless he or she is the center of attention
- Dress provocatively and/or exhibit inappropriately seductive orflirtatious behavior
- Shift emotions rapidly
- Act very dramatically, as though performing before an audience,with exaggerated emotions and expressions, yet appears to lacksincerity
- Be overly concerned with physical appearance
- Constantly seek reassurance or approval
- Be gullible and easily influenced by others
- Be excessively sensitive to criticism or disapproval
- Have a low tolerance for frustration and be easily bored by routine,often beginning projects without finishing them or skipping fromone event to another
- Not think before acting
- Make rash decisions
- Be self-centered and rarely show concern for others
- Have difficulty maintaining relationships, often seeming fake orshallow in their dealings with others
- Threaten or attempt suicide to get attention
What Causes Histrionic Personality Disorder?
The exact cause of histrionic personality disorder is not known, butmany mental health professionals believe that both learned andinherited factors play a role in its development. For example, thetendency for histrionic personality disorder to run in families suggeststhat a genetic susceptibility for the disorder might be inherited.However, the child of a parent with this disorder might simply berepeating learned behavior. Other environmental factors that might beinvolved include a lack of criticism or punishment as a child, positivereinforcement that is given only when a child completes certainapproved behaviors, and unpredictable attention given to a child by hisor her parent(s), all leading to confusion about what types of behaviorearn parental approval. Personality disorders also usually develop inrelation to individual temperament and psychological styles and wayspeople learn to cope with stress while growing up.
How Is Histrionic Personality Disorder Diagnosed?
If signs of this personality disorder are present, the doctor will begin an evaluation by performing a complete medical and psychiatric history. If physical symptoms are present, a physical exam and laboratory tests (such as neuroimaging studies or blood tests) may also be recommended to assure that a physical illness is not causing any symptoms that may be present.
If the doctor finds no physical reason for the symptoms, he or she might refer the person to a psychiatrist or psychologist, health care professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a personality disorder.
How Is Histrionic Personality Disorder Treated?
In general, people with histrionic personality disorder do not believe they need therapy. They also tend to exaggerate their feelings and to dislike routine, which makes following a treatment plan difficult. However, they might seek help if depression — possibly associated with a loss or a failed relationship — or another problem caused by their actions causes them distress. Psychotherapy (a type of counseling) is generally the treatment of choice for histrionic personality disorder. The goal of treatment is to help the individual uncover the motivations and fears associated with his or her thoughts and behavior, and to help the person learn to relate to others in a more positive way. Medication might sometimes be used as supplemental treatment for distressing symptoms that might occur with this disorder, such asdepression and anxiety.