Histrionic Personality Disorder

Overview

  • More common in women than men

  • Variable illness course, with some patients experiencing attenuation of symptoms with age

Notable Features:

High Yield:

Other:

  • Some patients have comorbid mood shifts and dissociation in stressful states

Definition

A pervasive pattern of excessive emotionality and attention-seeking, beginning in early adulthood and present in a variety of contexts.

Criteria (5 or more):

  1. Uncomfortable when he/she is not the center of attention

  2. Uses physical appearance to draw attention to self

  3. Exhibits sexually seductive or provocative behavior

  4. Impressionistic speech

  5. Considers relationships to be more intimate than they actually are

  6. Rapidly shifting and shallow expression of emotions

  7. Self-dramatization, theatricality, and exaggerated expression of emotion

  8. Suggestible (easily influenced by others or circumstances)


1 - 4, attention-seeking5 - 7, exaggerated emotional expression 8, suggestible

Diagnostics


Assessment


Management

Treatment options:

  • Psychodynamic psychotherapy

    • Emphasis on emotional clarification, practical problem-solving, and adherence to structure and detail to counter diffuse cognitive style

  • Low-dose benzos can help transient emotional states

  • Low-dose antipsychotics for dissociation

Sample Cases


Resources