Histrionic personality disorder is a psychological condition characterized by erratic and emotionally charged behavior, typically driven by a desire for attention and a distorted self-image.
While histrionic personality disorder or HPD is not considered a severe mental health problem, it can be disruptive to social, occupational or academic functioning. The causes of HPD are unclear, and the disorder remains a challenge to diagnose or treat.
This article will discuss HPD characteristics and how they can be identified and managed.
Fast facts on histrionic personality disorder:
- HPD is a Cluster B disorder, which also includes antisocial, borderline, and narcissistic personality disorders.
- The causes are unknown, as very little research has been conducted in this field.
- Psychotherapy is most commonly used to treat HPD.
A personality refers to the combination of traits that produce thought and behavioral patterns that are unique to an individual.
As personalities vary greatly between people, it is difficult to determine what constitutes a “normal” personality.
However, some individuals exhibit certain combinations of traits that may be considered maladaptive or dysfunctional in everyday life. This is known as a personality disorder.
The vast number of traits that make up a personality means there are several different types of recognized personality disorders.
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, is used to help define personalities.
The DSM-5 recognizes 10 different categories of personality disorders that are grouped into three clusters:
- Cluster A: The odd, eccentric cluster.
- Cluster B: The dramatic, emotional and erratic cluster.
- Cluster C: The anxious, fearful cluster.
HPD is associated with a distorted self-image and remains the only personality disorder to be explicitly related to physical appearance.
As its classification suggests, individuals with HPD display behaviors that are:
- dramatic
- emotional
- erratic
- compulsively desiring to seek attention and approval from others
For example, an individual may go to extreme lengths to exaggerate something they have achieved to gain the approval of others.
HPD typically develops during adolescence and can have a negative impact on the capacity to function in social, occupational or academic settings. As a result, individuals with HPD may have problems excelling at school or maintaining employment in later life.
HPD may be caused by a combination of genetic, social, and developmental factors. For example, experiencing a childhood trauma could contribute to the development of HPD in an individual whose genetic makeup predisposes them to anxiety.
The disorder is thought to be more common in females than it is in males. However, it is possible that females are more likely to report symptoms than males.
HPD symptoms are predominantly psychological and may be long-lasting. They can include:
- compulsive desire for attention
- dramatic and provocative behaviors
- discomfort at a lack of attention
- obsession with self-image
- flirtatious or inappropriate sexual behavior
- emotional instability
- excessive use of physical appearance to seek attention
- high suggestibility
- impulsivity
Individuals with HPD may also develop depression or anxiety disorders.
Individuals with HPD are usually skilled at manipulating social situations to place themselves at the center of attention. They may display dramatic and irrational behavior should attention be directed elsewhere.
Inappropriate attention-seeking behaviors and emotional volatility mean that individuals with HPD often develop unstable and superficial relationships with others.
Diagnosing a personality disorder is challenging, as symptoms can sometimes relate to a more severe, underlying mental or physical health condition.
For this reason, a doctor will first assess a person’s medical and psychiatric history and may do a physical examination.
If a personality disorder is suspected, a person will be referred to a mental health professional, such as a psychiatrist or psychologist. Using diagnostic questions and guidance outlined in the DSM-5, a mental health professional will determine if a person has HPD.
However, there is a high degree of overlap between different personality disorders, making it difficult to determine exactly which disorder an individual may have.
Several amendments to the diagnostic procedure were proposed for the DSM-5 to address the difficulty in diagnosing such conditions. The intention was to provide a more sophisticated approach to diagnosis.
The new model was included, as a supplement, to encourage further research and development of the approach.
A therapist will seek to identify underlying anxieties or motivations that might be responsible for a person’s behavior.
They will help them recognize different ways to frame their thought patterns and behavior to improve their social, occupational, or academic functioning.
However, people with HPD do not always feel that they need treatment for their personality disorder.
In such cases, they may instead seek treatment for related mental health conditions, such as depression. This could involve antidepressant or anxiolytic treatment.
HPD is often a life-long condition. This is due to the difficulties in diagnosing or treating HPD, as well as people’s reluctance to seek help for the disorder. It can be disruptive to daily functioning, particularly in social and occupational settings.
While this can trigger more serious mental health complications, individuals with HPD are often able to live relatively normal lives. Only a minority of individuals with HPD experience significant disruptions to their lives as a direct result of the disorder.