What is Histrionic Personality Disorder?

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:

1. Uncomfortable in situations where he or she is not the center of attention.
2. Interactions with others is characterized by inappropriate sexual, seductive and provocative behavior. These individuals are very flirtatious.
3. Displays rapidly shifting and shallow expressions of emotions.
4. Consistently uses physical appearance to draw attention to self.
5. Has a style of speech that is excessively impressionistic and lacking in detail.
6. They show self dramatization, very theatrical.
7. Easily influenced by others and circumstances.
8. 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.

What are 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.

What is the 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.