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Histrionic Personality Disorder

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In-depth look at Histrionic Personality Disorder - signs and symptoms, diagnosis, causes, and treatment.

Histrionic Personality Disorder (HPD) is the only personality disorder explicitly connected to a patient's physical appearance. Researchers have found that HPD appears primarily in men and women with above-average physical appearances.

In-depth look at Histrionic Personality Disorder - signs and symptoms, diagnosis, causes, and treatment.Individuals with Histrionic Personality Disorder exhibit excessive emotionalism--a tendency to regard things in an emotional manner--and are attention seekers. Behaviors may include constant seeking of approval or attention, self-dramatization, theatricality, and striking self-centeredness or sexual seductiveness in inappropriate situations, including social, occupational and professional relationships beyond what is appropriate for the social context. They may be lively and dramatic and initially charm new acquaintances by their enthusiasm, apparent openness, or flirtatiousness. They commandeer the role of "the life of the party". Personal interests and conversation will be self-focused. They use physical appearance to draw attention to themselves. Their style of speech is excessively impressionistic and lacking in detail. They may do well with jobs that value and require imagination and creativity but will probably have difficulty with tasks that demand logical or analytical thinking. The disorder occurs more frequently in women though that may be because it is more often diagnosed in women.

What are the signs and symptoms of Histrionic Personality Disorder?

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In many cases, people with histrionic personality disorder have good social skills; however, they tend to use these skills to manipulate others so 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 or flirtatious behavior

  • Shift emotions rapidly

  • Act very dramatically -as though performing before an audience- with exaggerated emotions and expressions, yet appears to lack sincerity

  • 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 from one 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 or shallow in their dealings with others

  • Threaten or attempt suicide to get attention

DSM IV Criteria for Histrionic Personality Disorder

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, i.e., easily influenced by others or circumstances

  • considers relationships to be more intimate than they actually are

What causes someone to develop Histrionic Personality Disorder?

The cause of this disorder is unknown, but childhood events and genetics may both be involved. For example, the tendency for histrionic personality disorder to run in families suggests that a genetic susceptibility for the disorder might be inherited. However, the child of a parent with this disorder might simply be repeating learned behavior. Other environmental factors that might be involved include a lack of criticism or punishment as a child, positive reinforcement that is given only when a child completes certain approved behaviors, and unpredictable attention given to a child by his or her parent(s), all leading to confusion about what types of behavior earn parental approval.