*Note to Mods: I did not know where to put this thread... so I have put it in this section. Please move it to a more appropriate section if there is one.Histrionic personality disorder
From Wikipedia, the free encyclopedia
This article may conflate the histrionic Personality Type, which is not clinical, with the histrionic personality disorder, which is. More, and clearer, explanations and sources from exclusively psychiatrically-verifiable origins, should be provided by editors to this page, to lessen and/or eliminate this alleged conflation.
Histrionic personality disorder (HPD) is defined by the American Psychiatric Association as a personality disorder characterized by a pattern of excessive emotionality and attention-seeking, including an excessive need for approval and inappropriately seductive behavior, usually beginning in early adulthood. These individuals are lively, dramatic, vivacious, enthusiastic, and flirtatious.
They may be inappropriately sexually provocative, express strong emotions with an impressionistic style, and be easily influenced by others. Associated features may include egocentrism, self-indulgence, continuous longing for appreciation, and persistent manipulative behavior to achieve their own needs.Characteristics
People with this disorder are usually able to function at a high level and can be successful socially and professionally. People with histrionic personality disorder usually have good social skills, but they tend to use these skills to manipulate other people and become the center of attention. Furthermore, histrionic personality disorder may affect a person's social or romantic relationships or their ability to cope with losses or failures. They may seek treatment for depression when romantic relationships end, although this is by no means a feature exclusive to this disorder.
They often fail to see their own personal situation realistically, instead tending to dramatize and exaggerate their difficulties. They may go through frequent job changes, as they become easily bored and have trouble dealing with frustration. Because 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 depression.
Additional symptoms may include:
Constant seeking of reassurance or approval.
Excessive dramatics with exaggerated displays of emotions, such as hugging someone they have just met or crying uncontrollably during a sad movie (Svrakie & Cloninger, 2005).
Excessive sensitivity to criticism or disapproval.
Proud of own personality, unwillingness to change and any change is viewed as a threat.
Inappropriately seductive appearance or behavior.
Somatic symptoms, and using these symptoms as a means of garnering attention.
A need to be the center of attention.
Low tolerance for frustration or delayed gratification.
Rapidly shifting emotional states that may appear superficial or exaggerated to others.
Tendency to believe that relationships are more intimate than they actually are.
Making rash decisions.Causes
The cause of this disorder is unknown, but childhood events such as deaths in the immediate family, illnesses within the immediate family which present constant anxiety, divorce of parents and genetics may be involved. Histrionic Personality Disorder is more often diagnosed in women than men; men with some quite similar symptoms are often diagnosed with narcissistic personality disorder.
Little research has been conducted to determine the biological sources, if any, of this disorder. Psychoanalytic theories incriminate authoritarian or distant attitudes by one (mainly mother) or both of the parents of these patients, or love based on expectations from the child that can never be fully met.Diagnosis
The person's appearance, behavior, and history, along with a psychological evaluation, are usually sufficient to establish the diagnosis. There is no test to confirm this diagnosis. Because the criteria are subjective, some people may be wrongly diagnosed as having the disorder while others with the disorder may not be diagnosed. Treatment is often prompted by depression associated with dissolved romantic relationships. Medication does little to affect this personality disorder, but may be helpful with symptoms such as depression. Psychotherapy may also be of benefit.
 DSM-IV-TR 301.50
The Diagnostic and Statistical Manual of Mental Disorders fourth edition, DSM IV-TR, a widely used manual for diagnosing mental disorders, defines histrionic personality disorder (in Axis II Cluster B) as:
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.
It is a requirement of DSM-IV that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria.ICD-10
The World Health Organization's ICD-10 lists histrionic personality disorder as (F60.4) Histrionic personality disorder.
It is characterized by at least 3 of the following:
self-dramatization, theatricality, exaggerated expression of emotions;
suggestibility, easily influenced by others or by circumstances;
shallow and labile affectivity;
continual seeking for excitement and activities in which the patient is the center of attention;
inappropriate seductiveness in appearance or behavior;
over-concern with physical attractiveness.
It is a requirement of ICD-10 that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria. Millon's subtypes
Theodore Millon identified six subtypes of histrionic. Any individual histrionic may exhibit none or one of the following:
Theatrical histrionic - especially dramatic, romantic and attention seeking.
Infantile histrionic - including borderline features.
Vivacious histrionic - synthesizes the seductiveness of the histrionic with the energy level typical of hypomania.
Appeasing histrionic - including dependent and compulsive features.
Tempestuous histrionic - including negativistic (passive-aggressive) features.
Disingenuous histrionic - antisocial features.Mnemonic
A mnemonic that can be used to remember the criteria for histrionic personality disorder is PRAISE ME:
P - provocative (or seductive) behavior
R - relationships, considered more intimate than they are
A - attention, must be at center of
I - influenced easily
S - speech (style) - wants to impress, lacks detail
E - emotional lability, shallowness
M - make-up - physical appearance used to draw attention to self
E - exaggerated emotions - theatricalDifferential diagnosis
Because of the lack of research support for work on personality disorders and long-term treatment with psychotherapy, the empirical findings on the treatment of these disorders remain based on the case report method and not on clinical trials. On the basis of case presentations, the treatment of choice is psychotherapy and/or cognitive-behavioral therapy, aimed at self-development through resolution of conflict and advancement of inhibited developmental lines. Group therapy can assist individuals with HPD to learn to decrease the display of excessively dramatic behaviors, but must be closely monitored because it may provide the person with an audience to play to (perform for), thus giving opportunity to perpetuate histrionic behavior.
Cognitive behavioral therapy Epidemiology
This section requires expansion.
Major character traits may be inherited. Other character traits due to a phenotypical combination of genetics and environment, including childhood experiencesHistory
This section needs attention from an expert on the subject. See the talk page for details. WikiProject Psychology or the Psychology Portal may be able to help recruit an expert. (October 2009)
This section contains information which may be of unclear or questionable importance or relevance to the article's subject matter. Please help improve this article by clarifying or removing superfluous information. (October 2009)
Histrionic personality disorder shares a divergent history with conversion disorder and somatization disorder. Historically, they are linked to the ancient notion of hysteria, or "wandering womb." (Note, however, that according to the Online Etymology Dictionary, the word "histrionic" derives not from the Greek hystera, but from the Latin histrionicus, "pertaining to an actor.") Ancient Greeks thought that excessive emotionality in women was caused by a displaced uterus and sexual discontent.
"Hysteria" differentiated into conversion hysteria (later to become conversion disorder) and hysterical personality (later to become histrionic personality disorder) in the psychoanalytic literature as well as with the writings of Kraepelin, Schneider, and others. Sigmund Freud wrote primarily about conversion hysteria. Wilhelm Reich wrote about hysteria as a set of personality characteristics and differentiated conversion hysteria as a transient disorder from hysterical character. These early conceptualizations of both kinds of hysteria carried notions of women's deficiency due to penis envy and feelings of castration. Paul Chodoff has written about the ways in which these diagnoses paralleled the misogynistic sentiment of the times.
The concept of hysterical personality was well developed by the mid-20th century and strongly resembled the current definition of histrionic personality disorder. The first DSM featured a symptom-based category, "hysteria" (conversion) and a personality-based category, "emotionally unstable personality." DSM-II distinguished between hysterical neurosis (conversion reaction and dissociative reaction) and hysterical (histrionic) personality.
In DSM-III, the term hysterical personality changed to histrionic personality disorder to emphasize the histrionic (derived from the Latin word histrio, or actor) behavior pattern and to reduce the confusion caused by the historical links of hysteria to conversion symptoms. The landmark case of Ruth E. helped to fully define and emphasize the characteristics of the current DSM-IV diagnostic. DSM-III-R attempted to reduce the overlap between Histrionic Personality Disorder and borderline personality disorder by dropping three overlapping criteria and adding two criteria that emphasized histrionicity. DSM-IV dropped two more criteria that did not appear to contribute to the consistency of the diagnosis, according to research done by Bruce Pfohl.See also
Making a mountain out of a molehill References
^ a b "Histrionic Personality Disorder". Histrionic Personality Disorder. The Cleveland Clinic. Retrieved 2011-11-23.
^ Seligman, Martin E.P (1984). "11". Abnormal Psychology. W. W. Norton & Company. ISBN 039394459X.
^ "Histrionic Personality Disorder". Personality Disorders. WebMD. 2006. Retrieved 2007-01-10.
^ Psych Central: Histrionic Personality Disorder Treatment
^ Histrionic personality disorder - Diagnostic and Statistical Manual of Mental Disorders Fourth edition Text Revision (DSM-IV-TR) American Psychiatric Association (2000)
^ Histrionic personality disorder - International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10)
^ Millon, Theodore, Personality Disorders in Modern Life, 2004
^ Millon, Theodore - Personality Subtypes
^ Pinkofsky HB. Mnemonics for DSM-IV personality disorders. Psychiatr Serv. 1997 Sep;48(9):1197-8. PMID 9285984.
^ Personality Disorders. www.personalityresearch.org
. URL: http://www.personalityresearch.org/pd.html
. Accessed May 2, 2006.
^ "Histrionic Personality Disorder". Histrionic Personality Disorder - Choice of Treatment. Armenian Medical Network. 2006. Retrieved 2007-01-10.
^ "Histrionic Personality Disorder". Histrionic Personality Disorder - Choice of Treatment. Encyclopedia of Mental Disorders - Thomson Gale, a part of the Thomson Corporation. Retrieved 2007-01-10.
^ "Histrionic Personality Disorder". Histrionic Personality Disorder: Description, Incidence, Prevalence, Risk Factors, Causes, Associated Conditions, Diagnosis, Signs and symptoms and treatment. Armenian Medical Network. 2006. Retrieved 2007-01-10.
^ Prochaska, J. & Norcross, J. (2007). Systems of Psychotherapy: A Transtheoretical Analysis.Belmont, CA: Thomson Brooks/Cole.External links
Histrionic personality disorder - Causes, Diagnosis, Demographics, Treatment - well-referenced.
Taken from this site: http://my.clevelandclinic.org/disorders/personality_disorders/hic_histrionic_personality_disorder.aspxHistrionic Personality Disorder
What is histrionic personality disorder?
Histrionic personality disorder is one of a group of conditions called dramatic personality disorders. People with these disorders have intense, unstable emotions and distorted self-images. For people with histrionic personality disorder, their self-esteem depends on the approval of others and does not arise from a true feeling of self-worth. They have an overwhelming desire to be noticed, and often behave dramatically or inappropriately to get attention. The word histrionic means “dramatic or theatrical.”
This disorder is more common in women than in men and usually is evident by early adulthood.What are the symptoms of histrionic personality disorder?
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 attentionWhat causes histrionic personality disorder?
The exact cause of histrionic personality disorder is not known, but many mental health professionals believe that both learned and inherited factors play a role in its development. 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.How is histrionic personality disorder diagnosed?
If symptoms are present, the doctor will begin an evaluation by performing a complete medical history and physical examination. Although there are no laboratory tests to specifically diagnose personality disorders, the doctor might use various diagnostic tests to rule out physical illness as the cause of the symptoms.
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 thinking and behavior 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 be used to treat the distressing symptoms, such as depression and anxiety, that might co-occur with this disorder.What are the complications of histrionic personality disorder?
Histrionic personality disorder can affect a person's social or romantic relationships and how a person reacts to losses or failures. People with this disorder are also at higher risk than the general population to suffer from depression.What is the outlook for people with histrionic personality disorder?
Many people with this disorder are able to function well socially and at work. Those with severe cases, however, might experience significant problems in their daily lives.Can histrionic personality disorder be prevented?
Although prevention of the disorder might not be possible, treatment can allow a person who is prone to this disorder to learn more productive ways of dealing with situations.
© Copyright 1995-2009 The Cleveland Clinic Foundation. All rights reserved.
Can't find the health information you’re looking for?
Ask a Health Educator, Live!
Know someone who could use this information?...send them this link.
This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 4/19/2005…#9743
Find a Doctor that treats this disease
Institutes, Departments and Centers
Department of Psychiatry and Psychology