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Histrionic personality disorder

In psychiatry, histrionic personality disorder involves a pattern of excessive emotional expression and attention-seeking, including an excessive need for approval and inappropriate seductiveness, that usually begins in early adulthood.

The essential feature of the histrionic personality disorder is a pervasive and excessive pattern of emotionality and attention-seeking behavior. These individuals are lively, dramatic, enthusiastic, and flirtatious. They may be inappropriately sexually provocative, express strong emotions with an impressionistic style, and be easily influenced by others.

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.

The symptoms include:

  • 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.

The person's appearance, behavior, and history, and a psychological evaluation are usually sufficient to establish the diagnosis. There is no test to confirm this diagnosis. Because the criteria are subjective, some people may be wrongly diagnosed as having the disorder while others with the disorder may not be diagnosed. Treatment is often prompted by depression associated with dissolved romantic relationships. Medication does little to affect this personality disorder, but may be helpful with symptoms such as depression. Psychotherapy may also be of benefit.

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. 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.

This text, or a previous version of it, is from the US National Library of Medicine (http://www.nlm.nih.gov).

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