Histrionic personality disorder

Definition 
Histrionic personality disorder involves a pattern of excessive emotional expression and attention-seeking, including an excessive need for approval and inappropriate seductiveness. It usually begins in early adulthood.

Causes, incidence, and risk factors 

The cause of this disorder is unknown, but childhood events and genetics may both be involved. It occurs more frequently in women than in men, although some feel it is simply more often diagnosed in women because attention-seeking and sexual forwardness is less socially acceptible for women.

People with this disorder are usually able to function at a high level and can be successful socially and at work. They may seek treatment for depression when romantic relationships end.

They often fail to see their own situation realistically, instead tending to overdramatize and exaggerate. Responsibility for failure or disappointment is usually blamed on others.

Symptoms 

     
  • Constant seeking of reassurance or approval  
  • Excessive dramatics with exaggerated displays of emotions  
  • Excessive sensitivity to criticism or disapproval  
  • Inappropriately seductive appearance or behavior  
  • Excessive concern with physical appearance  
  • A need to be the center of attention (self-centeredness)  
  • Low tolerance for frustration or delayed gratification  
  • Rapidly shifting emotional states that may appear shallow to others  
  • Opinions are easily influenced by other people, but difficult to back up with details  
  • Tendency to believe that relationships are more intimate than they actually are

Signs and tests 

The person’s overall appearance, behavior, and history, and a psychological evaluation are usually sufficient to establish the diagnosis. There is no formal test to confirm the diagnosis.

Treatment 

Treatment is often prompted by depression associated with dissolved romantic relationships. Medication may be helpful with symptoms such as depression. Psychotherapy may also be of benefit.

Expectations (prognosis) 

Histrionic personality disorder does not usually affect the person’s ability to function adequately in a superficial work or social environment. However, problems often arise in more intimate relationships, where deeper involvements are required.

Complications 

Histrionic personality disorder may affect a person’s social or romantic relationships or their ability to cope with losses or failures. They may go through frequent job changes, as they become easily bored and have trouble dealing with frustration.

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 depression.

Calling your health care provider 

Call your health care provider if you think you may have symptoms of histrionic personality disorder, particularly if it is affecting your sense of well-being, your relationships with others, or your ability to maintain a job.

Prevention 

Mental health intervention may allow people who are prone to this condition to learn more effective ways of understanding and dealing with their needs.

Johns Hopkins patient information

Last revised: December 3, 2012
by Levon Ter-Markosyan, D.M.D.

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