Histrionic personality disorder is a psychological disorder that arises in the complex realm of personality and character, characterized by the patient's persistent need to compare themselves to their surroundings and adopt specific behaviors and attitudes to attract attention. This causes the patient to act like a protagonist on stage, constantly striving to capture the attention of others.

1. Characteristics of Histrionic Personality Disorder

Histrionic personality disorder, often referred to as "hysterical personality disorder," is primarily classified under cluster B personality disorders. The key characteristics of this personality disorder include:

(1) Exaggerated Emotional Expression

Individuals with histrionic personality disorder tend to express their emotions in an exaggerated manner, reacting strongly even to minor events. This can lead others to perceive their responses as overly dramatic.

(2) Physical Behavior

These patients often employ physical behaviors to express their emotions. For instance, they might engage in dramatic actions like suicide attempts, seeking to gain attention from those around them through such behaviors.

(3) Self-Centered Attitude

Individuals with histrionic personality disorder are often self-centered, prioritizing their desires and needs above those of others. This can cause interpersonal problems.

(4) Excessive Need for Attention

These individuals constantly seek attention and recognition from those around them. However, if they fail to receive attention, they become anxious and may demand more attention.

(5) Familiar Approach and Seductive Behavior

Individuals with histrionic personality disorder are often extremely friendly towards those they meet for the first time, sometimes displaying sexually suggestive behavior. This is primarily an attempt to gain attention.

Cluster B personality disorders

Antisocial personality disorder
Borderline personality disorder
Histrionic personality disorder
Narcissistic personality disorder

2. Causes and Genetic Factors

The causes of histrionic personality disorder are multifaceted and complex, resulting from an interplay of environmental and genetic factors. While further research is needed regarding genetic factors, twin studies have shown that this disorder is more common among identical twins. The likelihood also increases if parents or family members have histrionic personality disorder.

Environmental factors may be linked to parenting styles during childhood. Mother or father's parenting approaches, home environment, emotional loss, loss and separation, among others, can influence environmental factors. These environmental factors can foster distrust in the patient's interpersonal relationships and inhibit emotional expression.

3. Symptoms of Histrionic Personality Disorder

The primary symptoms of histrionic personality disorder are diverse and can vary from individual to individual, but the following are common characteristics:

(1) Excessive Emotional Expression

Patients express their emotions in an exaggerated manner, exhibiting intense emotions even for minor events.

(2) Dramatic Language

The patient's speech is flamboyant and dramatic, their emotional expression can be superficial. Their words may lack substantial content.

(3) Attention Shifting

If patients fail to receive attention, they become anxious and may shift their focus to gain attention from others. This can make them unpleasant if they don't get the attention they desire.

4. Diagnosis and Testing

Diagnosing histrionic personality disorder requires professional assistance. Mental health professionals diagnose the disorder through interviews and assessments, primarily based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the American Psychiatric Association. According to this manual, diagnosis is possible when five or more of the following criteria are met:

● They feel uncomfortable in situations where they are not the center of attention.

● They engage in inappropriate sexually seductive or provocative behavior with others.

● Their emotional expression is shallow and shifting rapidly.

● They have difficulty identifying with their own sense of self.

● They exhibit a self-centered and demanding attitude.

5. Treatment and Treatment Options

Several approaches exist for treating histrionic personality disorder.

(1) Psychotherapy

Psychotherapy is one of the most effective treatments for these patients. Through psychotherapy, patients can gain insight into their emotional expression and self-identity issues and learn to manage them. Various forms of psychotherapy, such as cognitive- behavioral therapy (CBT), interpersonal psychotherapy, interpersonal behavioral therapy, and group therapy, are employed.

(2) Medication

Medication can be used to manage accompanying symptoms such as depression and anxiety.

(3) Family Therapy

Family therapy can also be effective, involving communication with the family. Family members can learn how to support and understand the patient.

6. Course and Complications of Histrionic Personality Disorder

The course of histrionic personality disorder varies. Some patients experience symptom improvement over time, while others require ongoing treatment and management. If proper treatment is not provided, the following complications may arise:

● Interpersonal problems

● Depression and anxiety disorders

● Self-harm or suicide attempts

● Substance abuse

● Academic and occupational difficulties

7. Prevention and Support Methods

Several strategies can be considered to prevent and support histrionic personality disorder.

(1) Improved Parenting Style

Parents should provide their children with a sense of security and safety, demonstrating acceptance and understanding of emotional expression.

(2) Mental Health Education

Providing mental health education in schools and homes can help children and adolescents learn how to manage their emotions appropriately.

(3) Participation in Support Groups

Patients and families can join support groups to provide mutual support.

8. Conclusion

Histrionic personality disorder is a complex personality disorder characterized by emotional expression and self-identity issues. With proper treatment and support, these patients can lead better lives. Prevention and education are crucial to preventing this disorder.