Definition, Causes, Symptoms & Treatment

Definition

The word personality describes deeply ingrained patterns of behavior and the manner in which individuals perceive, relate to, and think about themselves and their world. Personality traits are conspicuous features of personality and are not necessarily pathological, although certain styles of personality may cause interpersonal problems.

Personality disorders, though, are rigid, inflexible and maladaptive, causing impairment in functioning or internal distress. A personality disorder is an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time and leads to distress or impairment.

Individuals with Histrionic Personality Disorder exhibit excessive emotionalism--a tendency to regard things in an emotional manner--and are attention seekers. Behaviors may include constant seeking of approval or attention, self-dramatization, theatricality, and striking self-centeredness or sexual seductiveness in inappropriate situations, including social, occupational and professional relationships beyond what is appropriate for the social context. They may be lively and dramatic and initially charm new acquaintances by their enthusiasm, apparent openness, or flirtatiousness. They commandeer the role of "the life of the party". Personal interests and conversation will be self-focused. They use physical appearance to draw attention to themselves. Their style of speech is excessively impressionistic and lacking in detail. They may do well with jobs that value and require imagination and creativity but will probably have difficulty with tasks that demand logical or analytical thinking. The disorder occurs more frequently in women though that may be because it is more often diagnosed in women.




Symptoms

Constantly seeking reassurance or approval
Excessive dramatics with exaggerated displays of emotion
Excessive sensitivity to criticism or disapproval
Inappropriately seductive appearance or behavior
Overly concerned with physical appearance
Tendency to believe that relationships are more intimate than they actually are
Self-centeredness, uncomfortable when not the center of attention
Low tolerance for frustration or delayed gratification
Rapidly shifting emotional states that appear shallow to others
Opinions are easily influenced by other people, but difficult to back up with details


Causes

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 are less socially acceptable for women than for men. 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. 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.

Diagnostic Evaluation

A diagnosis can be made by knowing the patient's history and by doing a psychological examination.

Individual displays five or more of the following criteria:

Is uncomfortable in situations in which he or she is not the center of attention
Interaction with others is often characterized by inappropriate sexually seductive or provocative behavior
Displays rapidly shifting and shallow expression of emotions
Consistently uses physical appearance to draw attention to self
Has a style of speech that is excessively impressionistic and lacking in detail
Shows self-dramatization, theatricality and exaggerated expression of emotion
Is suggestible, that is, easily influenced by others or circumstances
Considers relationships to be more intimate than they actually are.

Treatment

Patients often seek treatment for depression associated with dissolved romantic relationships. Medication may be helpful with symptoms such as depression. Psychotherapy may also be of benefit.

Medication

Concomitant symptoms, such as depression, may be treated with medication but not for long durations because of the potential for abuse.

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.

This brilliant post was so spot on thought it appropriate to include it here:

Re: Emotional Cheating
by compton
The moral distinction is between what THEY do, which is never cheating, in their minds, and what their partner does - to which they apply the same common-sense standards as society as a whole. If anything, they are MORE conservative than the social norm when it comes to judging the behavior of their partners.

Example:
I once received an email from a married female friend I had not seen in five years, not heard from in a year. (We had never been more than friends anyway.) At the end of this brief email she wrote: I miss you. I sent back an equally brief, small-talky email saying at the end: I miss you too. My HPD later read this exchange and went ballistic. Referred to it in a rage for months afterward, saying it had permanently undermined her trust in me.
All this time, as I later found out, she was skyping, cybering, trolling for guys on craigslist and actually hooking up with many of them. When I called her on that, she was completely unrepentant, even scornful of me for making such a fuss out of something so harmless. ("Just diverting myself. It never led to anything." She saw no hypocrisy in this. When I suggested her behavior had been worse than mine she flew into a rage. A sincere rage.

This crazy-making double-standard is such a prime trait of HPD's that it should really be on the list of main criteria for diagnosis. compton

orion8591 wrote:
Re: Emotional Cheating
by compton
The moral distinction is between what THEY do, which is never cheating, in their minds, and what their partner does - to which they apply the same common-sense standards as society as a whole. If anything, they are MORE conservative than the social norm when it comes to judging the behavior of their partners.

Example:
I once received an email from a married female friend I had not seen in five years, not heard from in a year. (We had never been more than friends anyway.) At the end of this brief email she wrote: I miss you. I sent back an equally brief, small-talky email saying at the end: I miss you too. My HPD later read this exchange and went ballistic. Referred to it in a rage for months afterward, saying it had permanently undermined her trust in me.
All this time, as I later found out, she was skyping, cybering, trolling for guys on craigslist and actually hooking up with many of them. When I called her on that, she was completely unrepentant, even scornful of me for making such a fuss out of something so harmless. ("Just diverting myself. It never led to anything." She saw no hypocrisy in this. When I suggested her behavior had been worse than mine she flew into a rage. A sincere rage.

This crazy-making double-standard is such a prime trait of HPD's that it should really be on the list of main criteria for diagnosis. compton

This post by "Compton" post rang so true for me: an HPD women I knew/lived with always was trying to "loosten me up" and explore the thrills of reckless helmet-less driving. Yet when I would wryly reflect out loud to her on the evening's activities, she would become as cold and indignant as a fundamentalist minister, even though it was only an intimate conversation between us two. She would also talk about her friends (who also were promiscuous or otherwise free-spirited as her), behind their backs, wryling and earnestly commenting on their "weak character traits."

The double standard was so deep she couldn't acknowledge and embrace her own preferred activities, even though I, trying to let the relationship grow, was letting it all slide by joking about it. Talk about splitting; how crazymaking she was!

Shame, or a deep-seated fear of facing her own HPD condition?

as an HPD male I have to agree... there is a bit of a double standard naturally inherent in our thinking, not quite sure it is as bad as it has been made out to be here.

on the flip side of this, HPD's forgive social faux pas comments more quickly (or don't even recognize) the rude things NON's say - and NON's dont realize alot of the things that they do say. I believe this is an issue with ego-development, which is both healthy to have and lacking in the HPD individual. this makes them more sensitive to comments made by a NON..

it just makes me so sad to realize this is what is wrong with my mother. She's 53 and has no idea she has this. It hurts me so badly, and there is nothing I can do. Thanks for the info.

orion8591 wrote:This brilliant post was so spot on thought it appropriate to include it here:

Re: Emotional Cheating
by compton
The moral distinction is between what THEY do, which is never cheating, in their minds, and what their partner does - to which they apply the same common-sense standards as society as a whole. If anything, they are MORE conservative than the social norm when it comes to judging the behavior of their partners.

Example:
I once received an email from a married female friend I had not seen in five years, not heard from in a year. (We had never been more than friends anyway.) At the end of this brief email she wrote: I miss you. I sent back an equally brief, small-talky email saying at the end: I miss you too. My HPD later read this exchange and went ballistic. Referred to it in a rage for months afterward, saying it had permanently undermined her trust in me.
All this time, as I later found out, she was skyping, cybering, trolling for guys on craigslist and actually hooking up with many of them. When I called her on that, she was completely unrepentant, even scornful of me for making such a fuss out of something so harmless. ("Just diverting myself. It never led to anything." She saw no hypocrisy in this. When I suggested her behavior had been worse than mine she flew into a rage. A sincere rage.

This crazy-making double-standard is such a prime trait of HPD's that it should really be on the list of main criteria for diagnosis. compton

Bang on.
This is me to a T.

Ive recently realised i am HPD and now things have started to fall into place.
I am having a hard time dealing with this at the moment, not in any treatment because i refuse to accept that i need it (denial and unwilling to change) and am hoping now i have realised there is a problem, i can address it when i feel it happening.

Your'e post makes perfect sense to me as this is something i do.
I have been with my NHPD bf for 5 years, i am surrounded by males who i thrive on, i have cheated, i have seduced and yet the second my bf mentions another girl (even just a work colleague) i go ballistic.
I then need to know EVERYTHING about this girl, what she looks like, where she lives, who her friends are, where they drink etc. I get obsessive about finding out everything i can, i accuse him of fancying her, wanting to sleep with her and even on occasions, sleeping with her.

Its very much double standards, I am allowed to have as many male friends as i want, spend as much time with them as i want, get as friendly as i want and expect my bf to accept this.
I go out drinking 2 times a week yet if he goes out i scream, yell, cry, strop, threaten its over and usually end up with my own way as he just wants a peaceful life.

He is a diamond. i do not deserve him.

I thought I would put the link to a web site here, that is good source of information related to personality disorders in general.

http://www.mentalhelp.net/poc/center_index.php?id=8&cn=8

Some good material, quoted from “The Hero’s Spouse”

See http://www.midlifecrisismarriageadvocat ... ionic.html

[begin quote]

Histrionic Personality Disorder

The axis of Histrionic Personality is the motivation to conceal a lack of emotional perception and to avoid anxiety through the illusion of excessive emotionality. Based on the core belief that she must impress others in order to survive, a Histrionic is characterized by an addictive need to be the center of attention usually achieved through over dramatizations and provocative seduction with physical displays of affection as are indicated by five or more of the following from DSM IV:

-Is uncomfortable in situations in which he or she is not the center of attention.
-Interaction with others is often characterized by inappropriate sexually seductive or provocative behavior.
-Displays rapidly shifting and shallow expression of emotions.
-Consistently uses physical appearance to draw attention to self.
-Has a style of speech that is excessively impressionistic and lacking in detail.
-Shows self-dramatization, theatricality, and exaggerated expression of emotion.
-Is suggestible, i.e., easily influenced by others or circumstances.
-Considers relationships to be more intimate than they actually are.

The word histrionic originates from the Latin word for actor, histrio, and means dramatic or theatrical. Histrionics are addicted to attention and admiration use overly dramatic behavior to earn attention as well as to distract people from their own lack of emotion. If they act theatrical and move with overt gestures, people will fail to notice that their supposed emotions fail to reach their eyes; displays of affection seem for dramatic effect rather than genuine. Of the Cluster B disorders histrionics are the most sexually overt and provocative.

Sex is their tool, weapon and livelihood and they are highly skilled in its use as a distraction from their deficiencies, but they are an emotionally barren robot.

This is not to say they are not capable of having emotions. A characteristic of HPD is excessive emotionality. At times this is a distractive facade, but histrionics lack the ability to understand feelings and respond with situationally appropriate emotions, their tendency toward shallow emotions and romantic fantasy may be symptomatic of this deficiency.

Though thrill may be in the chase the histrionic cannot handle rejection and will accept the breakdown of a relationship only when she is the initiator. Acceptance and validation of a relationship may cause her to panic and devalue the person of interest, activating abandonment triggers. Histrionics feed their esteem through relationship games, living for the chase, losing interest once they catch their prey, but they are unable to tolerate rejection interpreting moving on as rejection and triggering when a target moves on it triggers a histrionic's feelings of rejection and worthlessness and she must fueling excessive emotionality and a need to re-conquer the person to regain her feelings of worth. This results in a relationship cycle of multiple break-ups and fits well with the high-drama of mid life crisis (MLC).

Histrionics obtain narcissistic supply through sexuality and will unlikely be able to sustain monogamy and may become chronic infidels. They may interpret a jealous romantic partner as evidence that he cares and thus may be motivated to make a partner jealous as a test of devotion; rationalizing that if he likes her he will stay with her, regardless of her betrayals. In a similar rationale a married man who is interested in a histrionic boosts her sense of superiority by risking or leaving his marriage to be with her.

The end goal for a histrionic is not to get the guy and have a relationship; the purpose in all her actions is to bring attention to herself and maintain it.

She evaluates herself competitively against others and requires superior judgment for her to consider herself of value. For this reason she may select friends who she considers beneath her.
The histrionic personality seems like the narcissist or antisocial in that she is bold, initiating communication or contact, but she is like the borderline in her excessive emotionality and need for approval through relationships; she seeks attachment and acceptance, whereas the narcissist or antisocial initiate communication and contact but avoid intimacy in relationships. But a histrionic's excessive emotionality is a cover-up for her lack of understanding of emotions; some histrionics may have diminished empathy or lack it altogether as is the case with NPD.

When ignored or not receiving enough attention, histrionics may obsessively attempt to draw attention to themselves.

This is because they feel they are nothing without attention, not merely that they are unimportant without notice; receiving attention provides them with proof of their existence.

In this attribute and motivation they are like the narcissist, but histrionic seek attention by using their physical attributes whereas narcissists may be either somatic like the histrionic or cerebral.

Because they rely on their physical attributes for narcissistic supply, they are also obsessive-compulsive regarding their physical fitness and appearance. Their self-esteem depends on the approval of others and does not arise from a true feeling of self-worth and the only way they know to gain approval is through their physical attributes.

The difference with narcissist is that though they require notice to prove their existence, they do not require approval; they seek attention in positive or negative form.
[end of quote]

Individuals with Histrionic Personality Disorder exhibit excessive emotionalism--a tendency to regard things in an emotional manner--and are attention seekers. Behaviors may include constant seeking of approval or attention, self-dramatization, theatricality, and striking self-centeredness or sexual seductiveness in inappropriate situations, including social, occupational and professional relationships beyond what is appropriate for the social context. They may be lively and dramatic and initially charm new acquaintances by their enthusiasm, apparent openness, or flirtatiousness. They commandeer the role of "the life of the party". Personal interests and conversation will be self-focused. They use physical appearance to draw attention to themselves. Their style of speech is excessively impressionistic and lacking in detail. They may do well with jobs that value and require imagination and creativity but will probably have difficulty with tasks that demand logical or analytical thinking. The disorder occurs more frequently in women though that may be because it is more often diagnosed in women.
Symptoms Constantly seeking reassurance or approval
Excessive dramatics with exaggerated displays of emotion
Excessive sensitivity to criticism or disapproval
Inappropriately seductive appearance or behavior
Overly concerned with physical appearance
Tendency to believe that relationships are more intimate than they actually are
Self-centeredness, uncomfortable when not the center of attention
Low tolerance for frustration or delayed gratification
Rapidly shifting emotional states that appear shallow to others
Opinions are easily influenced by other people, but difficult to back up with details
Causes 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 are less socially acceptable for women than for men. 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. 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.

When I read a post that describes me literally to the period of the last line written, I am amazed. This is me. It is me through and through, and more. I do get head noise as I call it. My temper is horrible, rage is there. I definitely functioned hi level and now run a business out of the house. I used to be so emotional and quite frankly years ago was Dx BPD. I went to the extreme opposite. As some of you know I also have some Ns traits (So I am told) and the truth is I don't like drama, I like to create it but the aftermath is terrible sometimes. I have been hanging out in the ASPD forum and have learned so much about myself. Right now I'm dealing with constant change in moods. I could go one morning with one, by night another. Has anyone been like that? I'm hoping this will become another forum for me, I have posted several times I hope you will see it. I love the forum I have been a part of but initially posting to a forum is hard, at least for me.