Histrionic Personality Disorder

GinaMarie Guarino, LMHC

Histrionic Personality Disorder

Histrionic personality disorder (HPD) is a disorder in which a person consistently acts out. An affected person acts out in an effort to keep attention on themselves. People with HPD crave to be the center of attention. They will engage in different behaviors to gain and retain the attention from the people around them.

When a person with HPD does not feel like they are the center of attention, they can act out in different ways. They do this to try to regain the attention from people around them.

People with HPD tend to be self-centered. They lack the ability to be introspective, and often do not consider the needs of the people around them. People who have HPD tend to have low self-esteem. Because of their low self-esteem, they engage in attention-seeking behavior. This need for attention is in effort to compensate for their own insecurities.

People with HPD are considered to be emotionally sensitive. They are also considered dramatic and irrational. They can be charismatic, and feel most comfortable when they are the center of attention. This often causes them to be extraverted, and are often considered ‘the life of the party’.

People with HPD can be manipulative. They will engage in different behaviors to maintain the attention from others. Such behaviors that are used to be the center of attention include:

  • Acting provocatively
  • Having outbursts of anger or rage
  • Acting out from exaggerated emotional upset
  • Acting seductively or impulsively
  • Being dramatic or theatrical
  • Exaggerating expressions of their emotions
  • Going to extreme lengths to get attention from others

Symptoms of Histrionic Personality Disorder

Symptoms of histrionic personality disorder manifest in the affected person’s behavior. People with HPD will show overly dramatic behaviors. These behaviors are intended to gain the attention of the people around them.

People with HPD have extreme displays of emotion. These displays are typically an exaggeration of how they are really feeling. When a person with HPD acts out, it is in attempt to become the center of attention.

The following are typical symptoms of HPD:

  • Seeking attention from others through performances
  • Seeking attention from others through shock value
  • Feeling very uncomfortable in situations where they are not the center of attention
  • Inappropriate interactions with other people
  • Being significantly influenced by medial and social fads and messages
  • Constantly seeking validation from other people
  • Having low self-esteem
  • Allowing their sense of self-worth to be dependent on validation from other people
  • Investing a great deal of self-worth on the opinion of other people
  • Acting seductively or provocatively for attention
  • Shifting to displays of fleeting and shallow emotions
  • Using their own looks or presentation to draw attention to themselves
  • Needing to be the center of attention in order to feel comfortable
  • Acting or behaving theatrically, dramatically, or with exaggeration
  • Being considered charismatic and manipulative
  • Making threats of self-harm to regain attention from others

Causes of Histrionic Personality Disorder

The central cause of histrionic personality disorder is unknown. There is no evidence that supports a concrete cause of HPD. It is thought to be caused by a combination of factors. Such factors include:

  • Genes
  • Environment
  • Upbringing
  • Parental influence
  • Behavioral modeling in household
  • History of narcissistic personality disorder or HPD in the family
  • Personality type

It is believed that the habits of HPD develop during childhood. Researchers assume that the behaviors of HPD learned during childhood. Histrionic behaviors may be modeled by parents or family members during upbringing, which is the critical point of development.

Children with histrionic or eccentric parents are at higher risk of developing HPD. Ability to handle stress is also considered a factor in the risk of developing HPD. A person’s ability to handle stress, upbringing, personality and temperament are all factors that could lead to the development of HPD.

Histrionic personality disorder is most often diagnosed in women. Both men and women can suffer from the disorder, but women are given the diagnosis at a higher rate than men.

Treatment of Histrionic Personality Disorder

Treatment of histrionic personality disorder takes a great deal of time and commitment to therapy. Many people with the disorder will be in therapy for years. In therapy for HPD, distress tolerance skills and self-exploration are the primary objectives. The goal of therapy for HPD is for the affected person to gain insight on their own behaviors.

Psychotherapy is used to treat people with HPD. In therapy, affected people learn how to be introspective. They are trained to be aware of their own thoughts and behavior. They are taught skills on how to make modifications in order to make more positive decisions.

With successful treatment, people with HPD can recover. The changes they make in therapy significantly affect their self-image. With therapy, self-esteem and distress tolerance skills are improved. All of the changes that result from therapy cause improved relationships. They also build a stronger sense of self-esteem.

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