Histrionic Personality Disorder: Causes, Symptoms, Diagnosis, and Treatment

Histrionic personality disorder is a psychological abnormality that occurs in the complex realm of personality and character, referring to specific behaviors and attitudes that individuals adopt to constantly seek attention by comparing their existence with those around them. As a result, individuals act as if they are the main character on stage, constantly striving to attract the attention of others.

1. Characteristics of Histrionic Personality Disorder

Histrionic personality disorder was often referred to by another name, "hysterical personality disorder," and primarily falls under the Cluster B personality disorder category. The main characteristics of this personality disorder are as follows:

(1) Exaggerated Emotional Expression

Individuals with histrionic personality disorder express their emotions in an exaggerated manner and may display strong emotions even for minor events. This can lead others to perceive their reactions as overly dramatic.

(2) Physical Behavior

These individuals often use physical actions to express their emotions. For example, they may engage in dramatic behaviors such as suicide attempts, seeking to gain the attention of those around them through such actions.

(3) Self-Centered Attitude

Individuals with histrionic personality disorder are often self-centered, prioritizing their own desires and needs over those of others. This can lead to interpersonal difficulties.

(4) Excessive Need for Attention

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

(5) Friendly Approach and Seductive Behavior

Individuals with histrionic personality disorder are very friendly towards people they meet for the first time, and they may sometimes exhibit sexually suggestive behavior. This is primarily an effort 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 varied and are complexly explained by the interplay of environmental and genetic factors. While genetic factors require further research, twin studies have shown that this disorder is more common in identical twins. The likelihood also increases if parents or family members have histrionic personality disorder.

Environmental factors may be related to childhood parenting styles. The mother or father's parenting style, home environment, emotional loss, and loss and separation can all have environmental impacts. These environmental factors can contribute to distrust in interpersonal relationships and influence the suppression of 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 commonly observed characteristics.

(1) Excessive Emotional Expression

Individuals exaggerate their emotional expressions and display extreme emotions even for minor events.

(2) Dramatic Language Expression

Individuals' speech is flamboyant and dramatic, and emotional expression can be superficial. The content of their speech may lack substance.

(3) Shifting Attention

Individuals become anxious if they fail to gain attention, and they may shift their attention based on the reactions of others. This can make them feel even more uncomfortable when they fail to attract the attention of others.

4. Diagnosis and Examination

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

● Feels uncomfortable when not the center of attention.

● Interacts with others in an inappropriately seductive or provocative way.

● Displays rapidly shifting and shallow expressions of emotions.

● Has difficulty maintaining consistent relationships.

● Has a tendency to be self-centered and demanding.

5. Treatment and Treatment Options

There are several approaches to treating histrionic personality disorder.

(1) Psychotherapy

Psychotherapy is one of the most effective treatments for these individuals. Through psychotherapy, individuals can become aware of and address their emotional expression and issues related to identity. Various forms of psychotherapy are used, including cognitive behavioral therapy (CBT), interpersonal psychotherapy, interpersonal and social rhythm therapy, and group therapy.

(2) Medication

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

(3) Family Therapy

Family therapy can also be effective along with conversations with family members. Family members can learn how to support and understand the individual.

6. Course and Complications of Histrionic Personality Disorder

The course of histrionic personality disorder varies. Some individuals may experience improvement in symptoms over time, while others may require ongoing treatment and management. If appropriate treatment is not provided, the following complications can arise:

● Interpersonal problems

● Depression and anxiety disorders

● Self-harm or suicide attempts

● Substance abuse

● Academic and occupational problems

7. Prevention and Support Methods

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

(1) Improving Parenting Styles

Parents should provide their children with a sense of stability and security, and demonstrate acceptance and understanding of their emotional expressions.

(2) Mental Health Education

Providing mental health education in schools and homes allows children and adolescents to learn how to manage their emotions properly.

(3) Participating in Support Groups

Individuals and families can help each other by participating in support groups.

8. Conclusion

Histrionic personality disorder is one of the complex personality disorders, with emotional expression and identity issues being key characteristics. With appropriate treatment and support, these individuals can live better lives, and prevention and education are crucial in preventing this disorder.