What is histrionic personality disorder?
Histrionic personality disorder is one of a group of conditions called dramatic personality disorders. People with these disorders have intense, unstable emotions and distorted self-images. For people with histrionic personality disorder, their self-esteem depends on the approval of others and does not arise from a true feeling of self-worth. They have an overwhelming desire to be noticed, and often behave dramatically or inappropriately to get attention. The word histrionic means "dramatic or theatrical."

This disorder is more common in women than in men and usually is evident by early adulthood.

What are the symptoms of histrionic personality disorder?
In many cases, people with histrionic personality disorder have good social skills; however, they tend to use these skills to manipulate others so that they can be the center of attention.

A person with this disorder might also:

• Be uncomfortable unless he or she is the center of attention
• Dress provocatively and/or exhibit inappropriately seductive or flirtatious behavior
• Shift emotions rapidly
• Act very dramatically—as though performing before an audience—with exaggerated emotions and expressions, yet appears to lack sincerity
• Be overly concerned with physical appearance
• Constantly seek reassurance or approval
• Be gullible and easily influenced by others
• Be excessively sensitive to criticism or disapproval
• Have a low tolerance for frustration and be easily bored by routine, often beginning projects without finishing them or skipping from one event to another
• Not think before acting
• Make rash decisions
• Be self-centered and rarely show concern for others
• Have difficulty maintaining relationships, often seeming fake or shallow in their dealings with others
• Threaten or attempt suicide to get attention

What causes histrionic personality disorder?
The exact cause of histrionic personality disorder is not known, but many mental health professionals believe that both learned and inherited factors play a role in its development. For example, the tendency for histrionic personality disorder to run in families suggests that a genetic susceptibility for the disorder might be inherited. However, the child of a parent with this disorder might simply be repeating learned behavior. Other environmental factors that might be involved include a lack of criticism or punishment as a child, positive reinforcement that is given only when a child completes certain approved behaviors, and unpredictable attention given to a child by his or her parent(s), all leading to confusion about what types of behavior earn parental approval.

How is histrionic personality disorder diagnosed?
If symptoms are present, the doctor will begin an evaluation by performing a complete medical history and physical examination. Although there are no laboratory tests to specifically diagnose personality disorders, the doctor might use various diagnostic tests to rule out physical illness as the cause of the symptoms.

If the doctor finds no physical reason for the symptoms, he or she might refer the person to a psychiatrist or psychologist, health care professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a personality disorder.

How is histrionic personality disorder treated?
In general, people with histrionic personality disorder do not believe they need therapy. They also tend to exaggerate their feelings and to dislike routine, which makes following a treatment plan difficult. However, they might seek help if depression—possibly associated with a loss or a failed relationship—or another problem caused by their thinking and behavior causes them distress.

Psychotherapy (a type of counseling) is generally the treatment of choice for histrionic personality disorder. The goal of treatment is to help the individual uncover the motivations and fears associated with his or her thoughts and behavior, and to help the person learn to relate to others in a more positive way.

Medication might be used to treat the distressing symptoms—such as depression and anxiety—that might co-occur with this disorder.

What are the complications of histrionic personality disorder?
Histrionic personality disorder can affect a person’s social or romantic relationships and how a person reacts to losses or failures. People with this disorder are also at higher risk than the general population to suffer from depression.

What is the outlook for people with histrionic personality disorder?
Many people with this disorder are able to function well socially and at work. Those with severe cases, however, might experience significant problems in their daily lives.

Can histrionic personality disorder be prevented?
Although prevention of the disorder might not be possible, treatment can allow a person who is prone to this disorder to learn more productive ways of dealing with situations.

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