Histrionic personality disorder is in a group of conditions referred to as dramatic personality disorders, known in the medical community as Cluster B disorders. People with these disorders may have intense, unstable emotions and inaccurate self-images. The self-esteem of people with histrionic personality disorder may depend on the approval of other people and has nothing to do with the true feeling of self-worth. If someone has histrionic personality disorder, they may have an overwhelming desire for other people to notice them and often behave dramatically or inappropriately, to get attention.

What is Histrionic Personality Disorder?

The word histrionic means dramatic or theatrical. People with histrionic personality disorder may exaggerate their emotions and may be drawn to situations with an emotional or attention-grabbing theme.

People with this disorder may feel uncomfortable or even underappreciated when they are not the center of attention. Behaviors that exist among these individuals may include constant approval-seeking, self-dramatization, “showy” behavior and remarkable self-centeredness or sexual seductiveness in inappropriate situations (including social, occupational and professional relationships).

These individuals may embarrass their friends and family with their excessive public displays of emotion, possibly sobbing uncontrollably over minor issues or having temper tantrums. People with struggling with histrionic personality disorder may go above and beyond to get attention.

Symptoms of Histrionic Personality Disorder

Living with histrionic personality disorder does not hinder someone’s ability to manage a “normal” life. In fact, they may be able to function at a high level and can function well in social and occupational environments. They may be unaware of any personality issue they may have and may seek treatment for other problems in their life that are being caused by personality disorder. Patients with histrionic personality disorder may seek treatment for depression when a romantic relationship ends.

Histrionic personality disorder patients may fail to see the reality of their condition. Someone with histrionic personality disorder may rarely accept responsibility for failure or disappointment. They may place blame on other people.

People with this disorder may have fairly good social skills. They may use these skills to manipulate other people to be the center of attention.

Persistent patterns of excessive attention seeking characterize histrionic personality disorder.  Some symptoms of histrionic personality disorder can include:

  • Self-centeredness
  • Constantly seeking reassurance or approval
  • Inappropriate seductive appearance or behavior
  • Rapidly shifting emotional states
  • Using physical appearance to draw attention to self
  • Excessive dramatics with exaggerated emotions
  • Believing relationships are more serious than they are
  • Easily influenced

Mental health professionals may wait to diagnose a patient with a personality disorder because they require long-term patterns of behavior. It is uncommon to diagnose personality disorders in childhood or adolescence because of the constant development and personality changes throughout childhood.

Causes of Histrionic Personality Disorder

Mental health professionals believe that both learned and inherited factors play a role in the development of the disorder. Like other personality disorders, there is no definitive cause for histrionic personality disorder, though it has connections to both genetic and environmental factors. Personality disorders may also develop with an individual’s temperament and emotional flairs as well as the ways individuals learn to cope with stress early in life.

Environmental Factors

There is always the chance that when a parent has a personality disorder, the child may also be repeating the learned behavior. Children learn behavior from people who they spend the most time with during development. Their personality can be formed and may mimic people with extreme behaviors.

Additional environmental factors that might be involved in histrionic personality disorder include a lack of criticism or punishment as a child and unpredictable attention is given to a child by his or her parents. These factors may lead to confusion about what types of behavior earn parental approval, causing the child to act in a manner that receives the most attention, good or bad.

Genetic Factors

The tendency for histrionic personality disorder to run in families suggests that a genetic predisposition for the disorder might exist. If someone has histrionic personality disorder, research suggests that there is a slightly increased risk for this disorder to be passed on to their children.

How is Histrionic Personality Disorder Diagnosed?

Mental health professionals, like a psychologist or psychiatrist, typically diagnose personality disorders. While most patients initially consult a general physician about their problem, the family physicians may refer a patient exhibiting symptoms of a personality disorder to a trained professional who is well-equipped to make this type of psychological diagnosis. There are no lab or blood tests used to diagnose histrionic personality disorder.

Many people with histrionic personality disorder do not seek treatment. Just like other personality disorders, individuals may only seek out treatment when the disorder starts to interfere or otherwise impact their life. This situation may occur when coping becomes unbearable for the patient and the stress takes over their lives.

A diagnosis can be made by knowing the patient’s history and by doing a psychological examination or a histrionic personality disorder test. The criteria for diagnosis include:

  • The individual is uncomfortable in situations in which they are not the center of attention
  • Interaction with people characterized by inappropriate sexually provocative behavior
  • The individual displays swiftly changing emotions or a lack of expression of emotions
  • They consistently use physical appearance to draw attention to themselves
  • Has a style of speech that is excessively allusive and lacking in detail
  • Shows self-dramatization, showy behavior and exaggerated expression of emotion
  • The individual has a high degree of vulnerability, and people or circumstances easily influence them
  • The individual often considers relationships to be more intimate than they are.

Who Is at Risk for Histrionic Personality Disorder?

Mental health experts believe that personality disorders like histrionic disorder may develop most often in people who experience stress, anxiety and trauma during their childhood. Neglected or abused children must rely on their limited coping skills to deal with undesirable memories and the feelings of shame or inadequacy. The personality disorder may develop as a form of compensation for the needs that were not met as a child.

Overindulgent or inconsistent parenting can lead to the development of histrionic personality disorder later in life. A structure-less parenting style doesn’t set firm boundaries and can interfere with a child’s healthy emotional development.

If there is a family history of personality disorders or other mental health conditions, the individual may be at risk for developing histrionic personality disorder. The disorder also occurs more frequently in females than in males.

Histrionic Personality Disorder Statistics

Histrionic personality disorder occurs in about 1.8 percent of the general population. Like most personality disorders, histrionic personality disorder typically decreases in intensity as the patient ages. Most patients experience the more extreme symptoms at around age 40 or 50 years old.

Histrionic personality disorder is one of the least common personality disorders, but about four million people have been diagnosed with the disorder.

If you are or a loved one is struggling with a substance use and co-occurring disorder like histrionic personality disorder, The Recovery Village can help. A team of professionals provides a continuum of care for substance use and co-occurring disorder treatment. Call and speak with a representative to learn more about which treatment program could work for you.

Histrionic Personality Disorder
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