SOME INFORMATION ON HISTRIONIC PERSONALITY DISORDER
HISTRIONIC: A related disorder compared to BPD
There is an unfortunate overlap between the criteria on DSM-III for histrionic personality and for the borderline category. These criteria suggest a close relationship between the two in which the borderline group might be considered to be a more dysfunctional variant. Thus both groups tend to be dependent,
manipulative, and affectively expressive.
There is greater stability and better function with this group. The
criteria for both suicidal behavior and psychotic experiences will no
longer be used to characterize the histrionic group. More critically, the
central role of sexuality in the regulation of self-esteem and its overt
interpersonal expressions in seductiveness, erotization, and rivalry with
members of the same sex should become criteria for the histrionic group.
The histrionic patient is not predominantly angry as with the borderline
patient. Moreover, the histrionic patient may experience some periods of
sustained well-being and pleasure.
An excellent review of histrionic personality disorder (HPD) by Horowitz
is found in Synopsis of Treatments of Psychiatric Disorders, edited by
Gabbard & Atkinson, American Psychiatric Press, 1996. Basically, HPD is a
chronic, often life-long pattern of maladaptive behavior, characterized
by excessive emotional expression and attention-seeking behavior.
Individuals with HPD tend to be flirtatious, demanding of attention,
seductive, but emotionally shallow. They are prone to impulsive and
dramatic displays of emotion and are easily influenced by others. HPD
individuals find it difficult to delay gratification, and are often
crushed by what they perceive as rejection; this can lead to serious
depressive bouts and even suicidal gestures. Unfortunately,
well-designed research studies of treatment of HPD are not available;
most of the data consist of case reports. Psychotherapy aimed at helping
the individual develop a more mature sense of self is said to produce
good results (see the chapter by Horowitz), but well-validated success
rates are not available.
HISTRIONIC PERSONALITY DISORDER
These individuals display overly dramatic and attention seeking
behaviours. They are shallow of emotions, self-centered and they can be
inappropriately sexually provocative.
Causes Roughly 2/3 also meet the criteria for antisocial personality
disorder. The two disorders may represent sex-typed alternative
expressions of the same underlying condition. Females exhibit a
histrionic pattern whereas males exhibit an antisocial pattern.
Treatment:
Behaviour therapy has been used to target the attention seeking
behaviours and encouraging more appropriate interpersonal behaviours.
Cognitive Profile:
* Core beliefs include "I am basically unattractive" or "I need other
people to admire me in order to be happy".
* They use dramatics and demonstrativeness in order to bind people
towards them; when they don't get their own way they believe that they
are being treated unfairly and they try to coerce compliance or get even
by throwing temper tantrums.
* The most prominent affect is gaiety and other high spirits; there may
be an undercurrent of anxiety that reflects their fear of rejection.
Here's one version of the criteria
A pervasive pattern of excessive emotionality and attention seeking,
beginning by early adulthood and present in a variety
of contexts, as indicated by five (or more) of the following:
- (1) is uncomfortable in situations in which he or she is not the center of attention
- (2) interaction with others is often characterized by inappropriate sexually seductive or provocative behavior
- (3) displays rapidly shifting and shallow expression of emotions
- (4) consistently uses physical appearance to draw attention to self
- (5) has a style of speech that is excessively impressionistic and lacking in detail
- (6) shows self-dramatization, theatricality, and exaggerated expression of emotion
- (7) is suggestible, i.e., easily influenced by others or circumstances
- (8) considers relationships to be more intimate than they actually are
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How They Appear When Clustered
The DSM-III-R groups the personality disorders into three clusters:
Cluster A: disorders marked by odd
or eccentric behaviors.
paranoid
schizoid
schizotypal
Cluster B: disorders characterized
by dramatic, emotional or erratic behaviors.
antisocial
borderline
histrionic
narcissistic
Cluster C: disorders characterized by anxious
or fearful behaviors.
avoidant
dependent
obsessive compulsive
passive aggressive |
Shmuel (Sam) Vaknin, Ph.D. is probably the most outspoken self proclaimed narcissistic person on the internet. He even has his own discussion group for other narcissistic people.
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This page was created June 27, 1998 Updated 4 JUL 1999
