Hysterical?

TheCastleOf wrote:I don't think I have an answer to your question, dear

From the top of my head though, HPD has been removed from the DSM V, but somatization wasn't listed as HPD criterion in the DSM IV, so overlap is unlikely.

Comorbidity maybe but why with HPD more than with other PDs ? Exaggeration of symptoms isn't the same as somatization I take it, although both could coexist.

Modern psychodynamic theorists have sought to distinguish between the hysterical
character and the histrionic personality as presented in various editions of the DSM.
Most analysts see the two as existing on a spectrum of severity. Kernberg (1992), for example,
places the hysterical personality at a higher level of functioning and the histrionic
personality at a lower, infantile level of functioning. The higher level hysteric, Kernberg
states, is more socially adaptive, with more genuine, authentic, and predictable emotions.
Affective control, he elaborates, is lost only in connection to others with whom
there exist intense sexual or competitive conflicts. Gabbard (1994, pp. 559–560) paints a
similar picture: Histrionics are more florid, more labile, more impulsive, and more sexualized
and seductive; hysterical personalities, in contrast, are more subtle in their exhibitionism
and express sexuality in a more coy or engaging manner. Whereas hysterical
personalities can be successful, even ambitious, at work, Gabbard states, histrionics fail
due to aimlessness, helplessness, and dependence. Finally, hysterical personalities tolerate
separation from love objects, but histrionic patients are overcome with separation
anxiety.

Somatoform Disorders
Historically, the psychodynamic perspective has always considered illness-related
symptoms, especially conversion symptoms, to be part of the hysterical personality.
Today, such symptoms have been separated from their associated personality traits and
classified as part of the Axis I disorders, irrespective of their association to the hysterical
personality. Therefore, we see many other personalities exhibit somatic symptoms,
notably, the dependent personality. Hueston, Mainous, and Schilling (1996) found that
medical care use was highest for subjects at risk for histrionic and dependent personality
disorders as opposed to all other personality disorders, a finding in keeping with our
dancer, Yvonne, who suffered from pain for months with no apparent cause.
For histrionics, hypochondriacal concerns—the fear that you have some serious disease—
and somatization disorder—physical complaints lacking a substantial basis—are used instrumentally to draw attention, comfort, and nurturance from others. Whenever
the histrionic feels empty, isolated, or bored, the secondary gains become more tempting,
so the disorder seems to be exacerbated. Finally, as noted by Benjamin (1996), frequent
complaints of illness have often been associated with the female gender role, as it was
with the patients Freud studied in his seminal investigations. For Benjamin, these somatic
aspects are considered so important that they form a distinct subtype of the histrionic
personality.

mark1958 wrote:Some reading for you EE

Modern psychodynamic theorists have sought to distinguish between the hysterical
character and the histrionic personality as presented in various editions of the DSM.
Most analysts see the two as existing on a spectrum of severity. Kernberg (1992), for example,
places the hysterical personality at a higher level of functioning and the histrionic
personality at a lower, infantile level of functioning. The higher level hysteric, Kernberg
states, is more socially adaptive, with more genuine, authentic, and predictable emotions.
Affective control, he elaborates, is lost only in connection to others with whom
there exist intense sexual or competitive conflicts. Gabbard (1994, pp. 559–560) paints a
similar picture: Histrionics are more florid, more labile, more impulsive, and more sexualized
and seductive; hysterical personalities, in contrast, are more subtle in their exhibitionism
and express sexuality in a more coy or engaging manner. Whereas hysterical
personalities can be successful, even ambitious, at work, Gabbard states, histrionics fail
due to aimlessness, helplessness, and dependence. Finally, hysterical personalities tolerate
separation from love objects, but histrionic patients are overcome with separation
anxiety.

Somatoform Disorders
Historically, the psychodynamic perspective has always considered illness-related
symptoms, especially conversion symptoms, to be part of the hysterical personality.
Today, such symptoms have been separated from their associated personality traits and
classified as part of the Axis I disorders, irrespective of their association to the hysterical
personality. Therefore, we see many other personalities exhibit somatic symptoms,
notably, the dependent personality. Hueston, Mainous, and Schilling (1996) found that
medical care use was highest for subjects at risk for histrionic and dependent personality
disorders as opposed to all other personality disorders, a finding in keeping with our
dancer, Yvonne, who suffered from pain for months with no apparent cause.
For histrionics, hypochondriacal concerns—the fear that you have some serious disease—
and somatization disorder—physical complaints lacking a substantial basis—are used instrumentally to draw attention, comfort, and nurturance from others. Whenever
the histrionic feels empty, isolated, or bored, the secondary gains become more tempting,
so the disorder seems to be exacerbated. Finally, as noted by Benjamin (1996), frequent
complaints of illness have often been associated with the female gender role, as it was
with the patients Freud studied in his seminal investigations. For Benjamin, these somatic
aspects are considered so important that they form a distinct subtype of the histrionic
personality.