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According to the DSM IV, histrionic personality disorder is defined
as a continuous pattern of excessive emotionality and attention
seeking behavior. It usually begins in early adulthood and presents
in a variety of contexts. According to the DSM IV, a person needs
to meet five of the following criteria before a diagnosis is made:
- Uncomfortable in situations where he or she is not the center
of attention.
- Interactions with others is characterized by inappropriate
sexual, seductive and provocative behavior. These individuals
are very flirtatious.
- Displays rapidly shifting and shallow expressions of emotions.
- Consistently uses physical appearance to draw attention to
self.
- Has a style of speech that is excessively impressionistic and
lacking in detail.
- They show self dramatization, very theatrical.
- Easily influenced by others and circumstances.
- Consider relationships to be more intimate than they actually
are.
Individuals are very reactionary. In group settings, they will
clearly set up situations where they will pout, or leave the situation
if they are not the center of attention. They have difficulty blending.
They will only blend if they can be in the limelight. They can be
very destructive to other relationships, and can be a clear source
of marital discord since these individuals are very flirtatious
and have very poor boundaries. They frequently are misdiagnosed
and at times confused with borderline personality disorders.
Causes of Histrionic Personality Disorder
There has been evidence and research clearly indicating past history
of sexual abuse and/or being alienated by parents as a child. This
alienation usually takes the form of emotional alienation, and that
love is really not there for them. These children grow up seeking
and desperately needing attention at all costs. Clearly many different
factors have to take place before a full-blown histrionic disorder
can develop. However the above has consistently been found in full-blown
histrionics.
Treatment of Histrionic Personality Disorder
Treatment remains very difficult, as with all personality disorders.
Treatment is a minimum of one year, if the individual consistently
comes to the sessions. If confrontation in therapy begins too soon,
these individuals will drop out of therapy. These individuals do
not want to address or deal with their issues because their issues
have provided them some secondary gain. It is very difficult to
stop maladaptive behavior when it does reward or give the individual
something back. Their relationships are very shallow, and they don’t
have meaningful relationships. Subsequently, this is an avenue in
therapy. Medication is generally not prescribed and is of minimal
benefit.
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