Histrionic personality disorder (HPD) is earmarked by attention seeking and overly dramatic behavior. The individual feels the need to be the center of attention in any social setting. It is not uncommon for this individual to use seductive behavior to get what they want. HPD is the “only personality disorder explicitly connected to a patient’s physical appearance” (Encyclopedia of Mental Disorders, 2010). If needs of this individual are not met, then a dramatic display of emotions could soon emerge.
While the exact cause of HPD is not known, it is thought to be biopsychosocial, meaning that the disorder is caused by biological and genetic factors, social factors, and psychological factors (PsychCental, 2010). It had been discovered that individuals with HPD have “highly responsive noradrenergic systems, the mechanisms surrounding the release of a neurotransmitter called norepinephrine” (Encyclopedia of Mental Disorders, 2010). The impulsive behavior that is so prevalent in those with HPD may be caused by a malfunction in these neurotransmitters.
Environmental factors may 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” (Cleveland Clinic, 2009). Thus, the individual with HPD learns that the only way to get attention to perform and does not weigh out the consequences of such theatrics. They will do anything to fulfill the need they have for attention.
The following list is derived from the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR).
- Center of attention: Patients with HPD experience discomfort when they are not the center of attention.
- Sexually seductive: Patients with HPD displays inappropriate sexually seductive or provocative behaviors towards others.
- Shifting emotions: The expression of emotions of patients with HPD tends to be shallow and to shift rapidly.
- Physical appearance: Individuals with HPD consistently employ physical appearance to gain attention for themselves.
- Speech style: The speech style of patients with HPD lacks detail. Individuals with HPD tend to generalize, and when these individuals speak, they aim to please and impress.
- Dramatic behaviors: Patients with HPD display self-dramatization and exaggerate their emotions.
- Suggestibility: Other individuals or circumstances can easily influence patients with HPD.
- Overestimation of intimacy: Patients with HPD overestimate the level of intimacy in a relationship.
In addition to the above symptoms, a person with HPD may also be naïve, gullible, restless, anxious, and may also become depressed if their needs are not met. In extreme cases, the threat of suicide could surface.
Diagnosis is typically made by a trained mental health care provider since a common practitioner is not trained in this area. The DSM has provided the medical community with certain criterion to make diagnosis more recognizable. The healthcare provider will interview the individual and pay close attention to their history. This interview is specially designed to make the assessment accurate. Unfortunately, those with HPD may not seek help, as they feel there is nothing wrong with them.
Therapy can be greatly beneficial to an individual with HPD. Psychodynamic therapy will focus on the root of the disorder, often digging into the patient’s childhood to reveal this root. Cognitive therapy will focus on the behaviors and how to control them. Group therapy is thought to very helpful in teaching the patient how to interact with others in a healthy way, while fostering interpersonal relationships. While medication is not typically used in treatment for HPD, the use of antidepressants may be used if the patient suffers from severe anxiety and/or depression.
PsychCentral (2010). Histrionic personality disorder. Retrieved June 16, 2010, from http://psychcentral.com/disorders/sx17.htm
Encyclopedia of Mental Disorders (2010). Histrionic personality disorder. Retrieved June 16, 2010, from http://www.minddisorders.com/Flu-Inv/Histrionic-personality-disorder.html