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@previous (J)
Histrionic personality disorder
From Wikipedia, the free encyclopedia
Histrionic personality disorder
Classification and external resources
Specialty Psychiatry
ICD-10 F60.4
ICD-9-CM 301.50
MedlinePlus 001531
MeSH D006677
Personality disorders
Cluster A (odd)
Paranoid Schizoid Schizotypal
Cluster B (dramatic)
Antisocial Borderline Histrionic Narcissistic
Cluster C (anxious)
Avoidant Dependent Obsessive–compulsive
Not specified
Depressive Passive-aggressive Sadistic Self-defeating Psychopathic
v t e
Histrionic personality disorder (HPD) is defined by the American Psychiatric Association as a personality disorder characterized by a pattern of excessive attention-seeking emotions, usually beginning in early adulthood, including inappropriately seductive behavior and an excessive need for approval. Histrionic people are lively, dramatic, vivacious, enthusiastic, and flirtatious. HPD affects four times as many women as men.[1] It has a prevalence of 2–3% in the general population and 10–15% in inpatient and outpatient mental health institutions.[2]
HPD lies in the dramatic cluster of personality disorders.[3] People with HPD have a high need for attention, make loud and inappropriate appearances, exaggerate their behaviors and emotions, and crave stimulation.[3] They may exhibit sexually provocative behavior, express strong emotions with an impressionistic style, and can be easily influenced by others. Associated features include egocentrism, self-indulgence, continuous longing for appreciation, and persistent manipulative behavior to achieve their own needs.
Contents [hide]
1 Characteristics
1.1 Mnemonic
2 Causes
2.1 Psychoanalytic theory
2.2 HPD and antisocial personality disorder
3 Diagnosis
3.1 DSM-IV-TR
3.2 ICD-10
3.3 Comorbidity
3.4 Millon's subtypes
4 Treatment
4.1 Interviews and self-report methods
4.2 Functional analytic psychotherapy
4.3 Coding client and therapist behaviors
5 Epidemiology
6 History
6.1 Ancient times
6.2 Middle Ages
6.3 Renaissance
6.4 Contemporary age
6.5 Social implications
7 See also
8 References
9 External links
Characteristics[edit]
People with HPD are usually high-functioning, both socially and professionally. They usually have good social skills, despite tending to use them to manipulate others into making them the center of attention.[4] HPD may also affect a person's social and/or romantic relationships, as well as their ability to cope with losses or failures. They may seek treatment for clinical depression when romantic (or other close personal) relationships end.
Individuals with HPD often fail to see their own personal situation realistically, instead dramatizing and exaggerating their difficulties. They may go through frequent job changes, as they become easily bored and may prefer withdrawing from frustration (instead of facing it). 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 clinical depression.[5]
Additional characteristics may include:
Exhibitionist behavior
Constant seeking of reassurance or approval
Excessive sensitivity to criticism or disapproval
Pride of own personality and unwillingness to change, viewing any change as a threat
Inappropriately seductive appearance or behavior of a sexual nature
Using somatic symptoms (of physical illness) to garner 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[4]
Blaming personal failures or disappointments on others
Being easily influenced by others, especially those who treat them approvingly
Being overly dramatic and emotional[6]
Some histrionics change their seduction technique into a more maternal or paternal style as they age.[7]
Mnemonic[edit]
A mnemonic that can be used to remember the characteristics of histrionic personality disorder is shortened as "PRAISE ME":[8][9]
Provocative (or seductive) behavior
Relationships are considered more intimate than they actually are
Attention-seeking
Influenced easily
Speech (style) wants to impress; lacks detail
Emotional lability; shallowness
Make-up; physical appearance is used to draw attention to self
Exaggerated emotions; theatrical
Causes[edit]
Little research has been done to find evidence as to what causes histrionic personality disorder and where it stems from. There are a few theories, however, that relate to the lineage of its diagnosis. Traits such as extravagance, vanity, and seductiveness of hysteria have similar qualities to women diagnosed with HPD.[10] An example of over-zealousness could be compared to the famous grande hystérie, a well-known demonstration of hypnotism by Jean-Martin Charcot by using his best-known subject, Blanche Wittmann. Wittmann was known for her attractiveness and ability to make herself the center of attention from her hysteria and lavish performance.[11]
Psychoanalytic theory[edit]
Psychoanalytic theories incriminate authoritarian or distant attitudes by one (mainly the mother) or both parents, along with conditional love based on expectations the child can never fully meet.[3] Using psychoanalysis Freud believed the lustfulness was a projection of the patient's lack of ability to love unconditionally and develop cognitively to maturity, and that such patients were overall emotionally shallow.[12] He believed the reason of not being able to love could have been from a traumatic death experience from a close relative during childhood or divorce between parents, which gave the wrong impression of committed relationships. Exposure to one or multiple traumatic occurrences of a close friend or family member leaving (abandonment or fate of mortality) would make the person unable to form true and affectionate attachments towards people.[13]
HPD and antisocial personality disorder[edit]
Another theory suggests that histrionic personality disorder and antisocial personality disorder could have a possible relationship to one another. Research has found two-thirds of patients diagnosed with histrionic personality disorder also meet criteria similar to that of the antisocial personality disorder.[10] This suggests that both disorders based towards sex-type expressions may have the same underlying problem. Women are hyper-sexualized in the media consistently, engraining thoughts that the only way women are to gain attention is by exploiting themselves, and when seductiveness isn't enough, theatricals are the next step in achieving attention.[14] Men can just as well be flirtatious towards multiple women yet feel no empathy or sense of compassion towards them.[10] They may also be the center of attention by exhibiting the "Don Juan" macho figure as a role-play.[14] Some family history studies have found that histrionic personality disorder, as well as borderline and antisocial personality disorders tends to run in families, but it is not clear if this is due to genetic or environmental factors.[15] Both examples suggest that predisposition could be a factor as to why certain people are diagnosed with histrionic personality disorder, however little is known whether or not the disorder is influenced by any biological compound or genetically inheritable.[15] Little research has been conducted to determine the biological sources, if any, of this disorder.
Diagnosis[edit]
The person's appearance, behavior, and history, along with a psychological evaluation, are usually sufficient to establish a diagnosis. There is no test to confirm this diagnosis. Because the criteria are subjective, some people may be wrongly diagnosed.[16]
DSM-IV-TR[edit]
The previous edition of the Diagnostic and Statistical Manual of Mental Disorders, DSM IV-TR, defines histrionic personality disorder (in Cluster B) as:[2]
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
The DSM-IV requires that a diagnosis for any specific personality disorder also satisfies a set of general personality disorder criteria.
ICD-10[edit]
The World Health Organization's ICD-10 lists histrionic personality disorder as:[17]
A personality disorder characterized by:
shallow and labile affectivity,
self-dramatization,
theatricality,
exaggerated expression of emotions,
suggestibility,
egocentricity,
self-indulgence,
lack of consideration for others,
easily hurt feelings, and
continuous seeking for appreciation, excitement and attention.
It is a requirement of ICD-10 that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria.
Comorbidity[edit]
Most histrionics also have other mental disorders. Comorbid conditions include: antisocial, dependent, borderline, and narcissistic personality disorders,[18] as well as depression, anxiety disorders, panic disorder, somatoform disorders, anorexia nervosa, substance use disorder[19] and attachment disorders, including reactive attachment disorder.[citation needed]
Millon's subtypes[edit]
Theodore Millon identified six subtypes of histrionic personality disorder. Any individual histrionic may exhibit none or one of the following:[20]
Subtype Description Personality Traits
Appeasing Including dependent and compulsive features Seeks to placate, mend, patch up, smooth over troubles; knack for settling differences, moderating tempers by yielding, compromising, conceding; sacrifices self for commendation; fruitlessly placates the unplacatable.
Vivacious The seductiveness of the histrionic mixed with the energy typical of hypomania. Some narcissistic features can also be present Vigorous, charming, bubbly, brisk, spirited, flippant, impulsive; seeks momentary cheerfulness and playful adventures; animated, energetic, ebullient.
Tempestuous Including negativistic features Impulsive, out of control; moody complaints, sulking; precipitous emotion, stormy, impassioned, easily wrought-up, periodically inflamed, turbulent.
Disingenuous Including antisocial features Underhanded, double-dealing, scheming, contriving, plotting, crafty, false-hearted; egocentric, insincere, deceitful, calculating, guileful.
Theatrical Variant of “pure” pattern Affected, mannered, put-on; postures are striking, eyecatching, graphic; markets self-appearance; is synthesized, stagy; simulates desirable/dramatic poses.
Infantile Including borderline features Labile, high-strung, volatile emotions; childlike hysteria and nascent pouting; demanding, overwrought; fastens and clutches to another; is overly attached, hangs on, stays fused to and clinging.
Treatment[edit]
Treatment is often prompted by depression associated with dissolved romantic relationships. Medication does little to affect the personality disorder, but may be helpful with symptoms such as depression.[16] Treatment for HPD itself involves psychotherapy, including cognitive therapy.[3]
I used to drink...then I wised up..