{"id":1719,"date":"2020-09-09T16:28:54","date_gmt":"2020-09-09T16:28:54","guid":{"rendered":"https:\/\/courses.lumenlearning.com\/abnormalpsych\/?post_type=chapter&#038;p=1719"},"modified":"2022-07-26T20:07:01","modified_gmt":"2022-07-26T20:07:01","slug":"histrionic-personality-disorder","status":"publish","type":"chapter","link":"https:\/\/courses.lumenlearning.com\/wm-abnormalpsych\/chapter\/histrionic-personality-disorder\/","title":{"raw":"Histrionic Personality Disorder","rendered":"Histrionic Personality Disorder"},"content":{"raw":"<div class=\"textbox learning-objectives\">\r\n<h3>Learning Objectives<\/h3>\r\n<ul>\r\n \t<li>Describe the characteristics and diagnosis of histrionic personality disorder<\/li>\r\n<\/ul>\r\n<\/div>\r\nCluster B personality disorders include those related to impulsive, dramatic, emotional, or erratic behavior. These include antisocial personality disorder (ASPD), borderline\u00a0personality disorder (BPD), histrionic\u00a0personality disorder (HPD), and narcissistic\u00a0personality disorder (NPD). We will review histrionic personality disorder on this page.\r\n<table summary=\"A table provides basic descriptions of the DSM-5 personality disorders and their associated clusters. Cluster A includes Paranoid (harbors a pervasive and unjustifiable suspiciousness and mistrust of others; reluctant to confide in or become close to others; reads hidden demeaning or threatening meaning into benign remarks or events; takes offense easily and bears grudges; not due to schizophrenia or other psychotic disorders), Schizoid (lacks interest and desire to form relationships with others; aloof and shows emotional coldness and detachment; indifferent to approval or criticism of others; lacks close friends or confidants; not due to schizophrenia or other psychotic disorders, not an autism spectrum disorder), and Schizotypal (exhibits eccentricities in thought, perception, emotion, speech, and behavior; shows suspiciousness or paranoia; has unusual perceptual experiences; speech is often idiosyncratic; displays inappropriate emotions; lacks friends or confidants; not due to schizophrenia or other psychotic disorder, or to autism spectrum disorder). Cluster B includes Antisocial (continuously violates the rights of others; history of antisocial tendencies prior to age 15; often lies, fights, and has problems with the law; impulsive and fails to think ahead; can be deceitful and manipulative in order to gain profit or pleasure; irresponsible and often fails to hold down a job or pay financial debts; lacks feelings for others and remorse over misdeeds), Histrionic (excessively overdramatic, emotional, and theatrical; feels uncomfortable when not the center of others\u2019 attention; behavior is often inappropriately seductive or provocative; speech is highly emotional but often vague and diffuse; emotions are shallow and often shift rapidly; may alienate friends with demands for constant attention), Narcissistic (overinflated and unjustified sense of self-importance and preoccupied with fantasies of success; believes he is entitled to special treatment from others; shows arrogant attitudes and behaviors; takes advantage of others; lacks empathy), and Borderline (unstable in self-image, mood, and behavior; cannot tolerate being alone and experiences chronic feelings of emptiness; unstable and intense relationships with others; behavior is impulsive, unpredictable, and sometimes self-damaging; shows inappropriate and intense anger; makes suicidal gestures). Cluster C includes Avoidant (socially inhibited and oversensitive to negative evaluation; avoids occupations that involve interpersonal contact because of fears of criticism or rejection; avoids relationships with others unless guaranteed to be accepted unconditionally; feels inadequate and views self as socially inept and unappealing; unwilling to take risks or engage in new activities if they may prove embarrassing), Dependent (allows others to take over and run her life; is submissive, clingy, and fears separation; cannot make decisions without advice and reassurance from others; lacks self-confidence; cannot do things on her own; feels uncomfortable or helpless when alone), and Obsessive-Compulsive (pervasive need for perfectionism that interferes with the ability to complete tasks; preoccupied with details, rules, order, and schedules; excessively devoted to work at the expense of leisure and friendships; rigid, inflexible, and stubborn; insists things be done his way; miserly with money).\"><caption>Table 1. DSM-5 Personality Disorders<\/caption>\r\n<thead><\/thead>\r\n<tbody>\r\n<tr>\r\n<td>Antisocial<\/td>\r\n<td>continuously violates the rights of others; history of antisocial tendencies prior to age 15; often lies, fights, and has problems with the law; impulsive and fails to think ahead; can be deceitful and manipulative in order to gain profit or pleasure; irresponsible and often fails to hold down a job or pay financial debts; lacks feelings for others and remorse over misdeeds<\/td>\r\n<td>B<\/td>\r\n<\/tr>\r\n<tr>\r\n<td><strong>Histrionic<\/strong><\/td>\r\n<td>excessively overdramatic, emotional, and theatrical; feels uncomfortable when not the center of others\u2019 attention; behavior is often inappropriately seductive or provocative; speech is highly emotional but often vague and diffuse; emotions are shallow and often shift rapidly; may alienate friends with demands for constant attention<\/td>\r\n<td>B<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Narcissistic<\/td>\r\n<td>overinflated and unjustified sense of self-importance and preoccupied with fantasies of success; feels entitled to special treatment from others; shows arrogant attitudes and behaviors; takes advantage of others; lacks empathy<\/td>\r\n<td>B<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Borderline<\/td>\r\n<td>unstable in self-image, mood, and behavior; cannot tolerate being alone and experiences chronic feelings of emptiness; unstable and intense relationships with others; behavior is impulsive, unpredictable, and sometimes self-damaging; shows inappropriate and intense anger; makes suicidal gestures<\/td>\r\n<td>B<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<h2>Histrionic Personality Disorder<\/h2>\r\nHistrionic personality disorder (HPD) is a\u00a0personality disorder\u00a0characterized by a pattern of excessive\u00a0attention-seeking\u00a0behaviors, usually beginning in early childhood, including inappropriate\u00a0seduction\u00a0and an excessive need for approval. People diagnosed with the disorder are said to be lively, dramatic, vivacious, enthusiastic, and\u00a0flirtatious.\r\n\r\nPeople with a histrionic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0(HPD) may feel underappreciated or disregarded when they are not the center of attention. People with this\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0are typically \u201cthe life of the party\u201d and have a \u201clarger than life\u201d presence. People with\u00a0histrionic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0(HPD) have a high need for attention, make loud and inappropriate appearances,\u00a0exaggerate\u00a0their behaviors and emotions, and crave stimulation.\u00a0<sup id=\"cite_ref-WebMD_3-1\" class=\"reference\"><\/sup>They may exhibit sexually provocative behavior, express strong emotions with an impressionistic style, and can be easily influenced by others.\r\n<h2>Diagnostic Criteria<\/h2>\r\nThe DSM-5 defines histrionic personality disorder\u00a0as a<span style=\"font-size: 1rem; text-align: initial;\">\u00a0pervasive pattern of excessive\u00a0<\/span>emotionality<span style=\"font-size: 1rem; text-align: initial;\">\u00a0and attention-seeking, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following characteristics:<\/span>\r\n<ul>\r\n \t<li>is uncomfortable in situations in which they are not the center of attention\r\n\r\n[caption id=\"attachment_4311\" align=\"alignright\" width=\"309\"]<img class=\"wp-image-4311\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/5351\/2020\/09\/12060949\/3558210146_d238315603_o-300x200.jpg\" alt=\"A person posing and being photographed by paparazzi. \" width=\"309\" height=\"206\" \/> <strong>Figure 1.<\/strong> Individuals with histrionic personality disorder crave stimulation and need to be the center of attention.[\/caption]<\/li>\r\n \t<li>interaction with others is often characterized by inappropriate sexually seductive or provocative behavior<\/li>\r\n \t<li>displays rapidly shifting and shallow expression of emotions<\/li>\r\n \t<li>consistently uses physical appearance to draw attention to self<\/li>\r\n \t<li>has a style of speech that is excessively impressionistic and lacking in detail<\/li>\r\n \t<li>shows self-dramatization, theatricality, and\u00a0exaggerated\u00a0expression of emotion<\/li>\r\n \t<li>is suggestible, i.e., easily influenced by others or circumstances<\/li>\r\n \t<li>considers relationships to be more intimate than they actually are<\/li>\r\n<\/ul>\r\n<h3>Differential Diagnosis<\/h3>\r\nThe <strong>differential diagnosis<\/strong> (unique attributes that differentiate a disorder from others with similar features) for histrionic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0includes narcissistic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>, borderline\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>, dependent\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>, somatic symptom\u00a0<span class=\"term-highlight\">disorder<\/span>, and illness anxiety\u00a0<span class=\"term-highlight\">disorder<\/span>.\r\n<ul>\r\n \t<li>Like histrionic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>, patients with narcissistic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0prefer to be the center of attention.\u00a0However, patients with narcissistic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0want attention, which results from admiration or veneration, whereas people with histrionic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0are not particular about what type of attention they garner.<\/li>\r\n \t<li>Patients with histrionic\u00a0<span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">personality<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">disorder<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0are similar to those with borderline\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">personality<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0because both demographics of patients experience intense emotions; however, patients with borderline\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">personality<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">disorder<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0usually dislike themselves.<\/span><\/li>\r\n \t<li>Dependent\u00a0<span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">personality<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">disorder<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0should be considered in the differential diagnosis for histrionic\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">personality<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">disorder<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0as with both\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">personality<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0disorders; the patient will prefer to be around others.<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0However, patients with dependent\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">personality<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">disorder<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0tend to be more submissive, and their behavior is more inhibited as they are preoccupied with fears of rejection.<\/span><\/li>\r\n \t<li>Somatic symptom\u00a0<span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">disorder<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0and illness anxiety\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">disorder<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0are also included in the differential for histrionic\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">personality<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">disorder<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0as patients with a histrionic\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">personality<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">disorder<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0may use physical symptoms and complaints to gain attention from others.<\/span><\/li>\r\n<\/ul>\r\n<h3>Comorbidity<\/h3>\r\nMost people with histrionic personality disorder also have other mental disorders. Comorbid conditions include antisocial,\u00a0dependent,\u00a0borderline, and\u00a0narcissistic personality disorders as well as\u00a0depression,\u00a0anxiety disorders,\u00a0panic disorder,\u00a0somatoform disorders,\u00a0anorexia nervosa,\u00a0substance use disorder,\u00a0and\u00a0attachment disorders.\r\n<div class=\"textbox examples\">\r\n<h3>Watch It<\/h3>\r\nWatch this clip to see how histrionic personality disorder may be demonstrated.\r\n\r\n<iframe src=\"\/\/plugin.3playmedia.com\/show?mf=5576210&amp;p3sdk_version=1.10.1&amp;p=20361&amp;pt=375&amp;video_id=VOPjir_94fQ&amp;video_target=tpm-plugin-vwxd1ryd-VOPjir_94fQ\" width=\"800px\" height=\"450px\" frameborder=\"0\" marginwidth=\"0px\" marginheight=\"0px\"><\/iframe>\r\n\r\nYou can view the <a href=\"https:\/\/course-building.s3-us-west-2.amazonaws.com\/Abnormal+Psychology\/transcripts\/DSM5HistrionicPersonalityDisorderCriteriaExample_transcript.txt\" target=\"_blank\" rel=\"noopener\">transcript for \"DSM 5 Histrionic Personality Disorder Criteria Example, Symptoms Video\" here (opens in new window)<\/a>.\r\n\r\n<\/div>\r\n<h2>Epidemiology<\/h2>\r\nThe prevalence of histrionic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0in the general population runs about 2%-3%. It is possible for people to have more than one\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>. Women are four times more likely to be diagnosed with histrionic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0than men.\u00a0However, research suggests that women may be overly diagnosed with this\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0when compared to men due to sexual-forwardness being less socially acceptable for women.\u00a0Furthermore, men may be less likely to report their symptoms and thereby be under-diagnosed.\u00a0Histrionic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0tends to be ego-syntonic, meaning people with this\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0typically consider their behavior to be normal and struggle to identify a problem.\r\n<h2>Etiology<\/h2>\r\nHistrionic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0probably develops as a combination of both learned and inherited factors. One hypothesis is that histrionic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0may develop as a result of trauma experienced during childhood. Children may endure their trauma by coping with their environment in ways that may ultimately lead to a\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>.\u00a0<span class=\"term-highlight\">Personality<\/span>\u00a0disorders in childhood may originate as an adaptation to cope with a traumatic situation or traumatic environment.\r\n\r\nParenting styles may also influence the likelihood of developing a histrionic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>. Parenting that lacks boundaries is over-indulgent, or inconsistent may predispose children to develop a histrionic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>. Because histrionic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0tends to run in families, there is some consideration that there is genetic susceptibility for this\u00a0<span class=\"term-highlight\">disorder that<\/span>\u00a0may be inherited. As with all psychiatric disorders, having a family history of\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0disorders, psychiatric illness, or substance use disorders is a risk factor for histrionic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>.\r\n<h2>Treatment<\/h2>\r\nSupportive psychotherapy is a recommended modality of treatment for patients with histrionic personality disorder, as this approach is found to be encouraging, reassuring, and non-threatening. Supportive psychotherapy aims to reduce emotional distress, improve self-esteem, and to enhance the patient\u2019s coping skills, all through attentive and sympathetic listening.\r\n\r\nPsychodynamic psychotherapy (also called insight-oriented therapy) has also proven to be a successful approach in treating patients with histrionic personality disorder. The goal of this therapy is to alter an aspect of a patient\u2019s dysfunctional personality by integrating crucial developmental milestones a patient may have missed during previous stages of emotional maturation. Psychodynamic psychotherapy aims to resolve underlying, unconscious conflicts in an effort for patients to understand themselves and their behaviors better. The patients are encouraged to substitute excessively dramatic speech for a more adaptive action or behavior, to promote better communication with others. Through psychodynamic psychotherapy, patients learn to recognize that hyper-sexual, attention-seeking behaviors are maladaptive, and discover new, healthier ways to develop self-esteem.\r\n\r\nWhile the gold standard for treating personality disorders is psychotherapy, patients with histrionic personality disorder may be profoundly symptomatic. Patients may experience affective dysregulation, where they frequently endure mood swings, anger, tearfulness, anxiety, and depression. While there are no FDA-approved medications for the treatment of histrionic personality disorder, affective dysregulation may be treated with antidepressants, mood stabilizers, and antipsychotics. Antidepressants that have proven to be effective include desipramine, fluoxetine, amitriptyline, and fluvoxamine. The mood stabilizers with proven therapeutic benefits include lamotrigine, carbamazepine, topiramate, valproate, and lithium. Research has demonstrated that antipsychotics such as risperidone, aripiprazole, olanzapine, and haloperidol have been useful in treating affective dysregulation. Patients with histrionic personality disorder may struggle with impulse control and regulation of their behaviors. Clinical trials have demonstrated that mood stabilizers specifically can target these symptoms.\r\n<div class=\"textbox key-takeaways\">\r\n<h3>Key Takeaways:\u00a0Histrionic Personality Disorder<\/h3>\r\n<iframe title=\"55. Histrionic\u00a0personality disorder\" src=\"https:\/\/lumenlearning.h5p.com\/content\/1291235956777381558\/embed\" width=\"1088\" height=\"603\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><script src=\"https:\/\/lumenlearning.h5p.com\/js\/h5p-resizer.js\" charset=\"UTF-8\"><\/script>\r\n\r\n<\/div>\r\n<div class=\"textbox exercises\">\r\n<h3>Think it Over: Michael Scott's Diagnosis<\/h3>\r\nMany of you are familiar with the fictional character Michael Scott from the hit TV show <em>The Office<\/em>. Scott is a 46-year-old, Caucasian male from Scranton, Pennsylvania, and the regional manager at Dunder Mifflin Inc., a local paper and printer distribution company. Michael Scott's outward appearance is well put together, as he presents as a business professional, and there are no obvious health concerns. Despite his seemingly composed demeanor, Scott displays exaggerated emotions and reactions. In addition to these exaggerations, romantic relationships have proven turbulent for Scott throughout his life, as he goes from one relationship to the next with the other person usually being the one to end the relationship. He has few close friends or relatives and tends to perceive new friendships as closer than they actually are. Scott believes his subordinates to be his family, and oftentimes gets involved in their personal lives without their consent. His parents divorced when he was young (age unknown), and he displays clear resentment towards his stepfather and sister, whom he once didn\u2019t talk to for fifteen years. Scott has a very close relationship with his mother now, though this was not the case when he was a child. Though Scott seems to be lacking in managerial style, responsibility, and delegation, he demonstrates above-average sales abilities due to his personable qualities. Scott does not have a history of drug or alcohol abuse, though he will drink in social situations and when pressured to do so by coworkers.\r\n\r\nSome of Michael Scott's behaviors fit with the description of histrionic personality disorder, namely that he likes to be the center of attention, uses impressionistic speech, considers relationships to be more intimate than they actually are, and even shows self-dramatization at times. These things still do not meet all five criteria for the diagnosis, however. <a href=\"https:\/\/courses.lumenlearning.com\/abnormalpsych\/chapter\/introduction-to-opioid-and-hallucinogen-related-disorders\/\" target=\"_blank\" rel=\"noopener\">This video by Dr. Grande goes through each of the criteria for histrionic personality disorder (start at the 14:54 mark)<\/a>, then goes on to explain why Michael Scott may better fit the description for narcissistic personality disorder, which we'll examine on the next page.\r\n\r\nBecause of the overlap in some of the criteria and frequent comorbidity of histrionic personality disorder with other personality disorders, some scholars have recommended removing the histrionic diagnosis altogether.\r\n<p class=\"mb15\">Bakkevig and Karterud (2010), in a study carried out with a sample of patients attending psychiatric day hospital, concluded that the prevalence of HPD was very low (0.4%) and comorbidity was high, especially with borderline, narcissistic, and dependent personality disorders. They suggested that the HPD category should be deleted from the DSM system, excepting that clinical phenomena of exhibitionism and attention-seeking, which are the dominant personality features of HPD, should be preserved in an exhibitionistic subtype of narcissism.[footnote]Novais F, Ara\u00fajo A and Godinho P (2015) Historical roots of histrionic personality disorder. <em>Front. Psychol<\/em>. 6:1463. doi: 10.3389\/fpsyg.2015.01463[\/footnote]<\/p>\r\n\r\n<\/div>\r\n<section>\r\n<div class=\"textbox tryit\">\r\n<h3>Try It<\/h3>\r\nhttps:\/\/assess.lumenlearning.com\/practice\/485bd630-fc1b-426d-9833-bf13673a6eb0\r\n\r\n<\/div>\r\n<\/section>\r\n<div class=\"textbox learning-objectives\">\r\n<h3>Glossary<\/h3>\r\n<strong>histrionic personality disorder:\u00a0<\/strong>characterized by a pattern of excessive\u00a0attention-seeking\u00a0behaviors, usually beginning in early childhood, including inappropriate\u00a0seduction\u00a0and an excessive need for approval\r\n\r\n<strong>personality disorder:\u00a0<\/strong>group of DSM-5 disorders characterized by an inflexible and pervasive personality style that differs markedly from the expectations of one\u2019s culture and causes distress and impairment\r\n\r\n<\/div>","rendered":"<div class=\"textbox learning-objectives\">\n<h3>Learning Objectives<\/h3>\n<ul>\n<li>Describe the characteristics and diagnosis of histrionic personality disorder<\/li>\n<\/ul>\n<\/div>\n<p>Cluster B personality disorders include those related to impulsive, dramatic, emotional, or erratic behavior. These include antisocial personality disorder (ASPD), borderline\u00a0personality disorder (BPD), histrionic\u00a0personality disorder (HPD), and narcissistic\u00a0personality disorder (NPD). We will review histrionic personality disorder on this page.<\/p>\n<table summary=\"A table provides basic descriptions of the DSM-5 personality disorders and their associated clusters. Cluster A includes Paranoid (harbors a pervasive and unjustifiable suspiciousness and mistrust of others; reluctant to confide in or become close to others; reads hidden demeaning or threatening meaning into benign remarks or events; takes offense easily and bears grudges; not due to schizophrenia or other psychotic disorders), Schizoid (lacks interest and desire to form relationships with others; aloof and shows emotional coldness and detachment; indifferent to approval or criticism of others; lacks close friends or confidants; not due to schizophrenia or other psychotic disorders, not an autism spectrum disorder), and Schizotypal (exhibits eccentricities in thought, perception, emotion, speech, and behavior; shows suspiciousness or paranoia; has unusual perceptual experiences; speech is often idiosyncratic; displays inappropriate emotions; lacks friends or confidants; not due to schizophrenia or other psychotic disorder, or to autism spectrum disorder). Cluster B includes Antisocial (continuously violates the rights of others; history of antisocial tendencies prior to age 15; often lies, fights, and has problems with the law; impulsive and fails to think ahead; can be deceitful and manipulative in order to gain profit or pleasure; irresponsible and often fails to hold down a job or pay financial debts; lacks feelings for others and remorse over misdeeds), Histrionic (excessively overdramatic, emotional, and theatrical; feels uncomfortable when not the center of others\u2019 attention; behavior is often inappropriately seductive or provocative; speech is highly emotional but often vague and diffuse; emotions are shallow and often shift rapidly; may alienate friends with demands for constant attention), Narcissistic (overinflated and unjustified sense of self-importance and preoccupied with fantasies of success; believes he is entitled to special treatment from others; shows arrogant attitudes and behaviors; takes advantage of others; lacks empathy), and Borderline (unstable in self-image, mood, and behavior; cannot tolerate being alone and experiences chronic feelings of emptiness; unstable and intense relationships with others; behavior is impulsive, unpredictable, and sometimes self-damaging; shows inappropriate and intense anger; makes suicidal gestures). Cluster C includes Avoidant (socially inhibited and oversensitive to negative evaluation; avoids occupations that involve interpersonal contact because of fears of criticism or rejection; avoids relationships with others unless guaranteed to be accepted unconditionally; feels inadequate and views self as socially inept and unappealing; unwilling to take risks or engage in new activities if they may prove embarrassing), Dependent (allows others to take over and run her life; is submissive, clingy, and fears separation; cannot make decisions without advice and reassurance from others; lacks self-confidence; cannot do things on her own; feels uncomfortable or helpless when alone), and Obsessive-Compulsive (pervasive need for perfectionism that interferes with the ability to complete tasks; preoccupied with details, rules, order, and schedules; excessively devoted to work at the expense of leisure and friendships; rigid, inflexible, and stubborn; insists things be done his way; miserly with money).\">\n<caption>Table 1. DSM-5 Personality Disorders<\/caption>\n<thead><\/thead>\n<tbody>\n<tr>\n<td>Antisocial<\/td>\n<td>continuously violates the rights of others; history of antisocial tendencies prior to age 15; often lies, fights, and has problems with the law; impulsive and fails to think ahead; can be deceitful and manipulative in order to gain profit or pleasure; irresponsible and often fails to hold down a job or pay financial debts; lacks feelings for others and remorse over misdeeds<\/td>\n<td>B<\/td>\n<\/tr>\n<tr>\n<td><strong>Histrionic<\/strong><\/td>\n<td>excessively overdramatic, emotional, and theatrical; feels uncomfortable when not the center of others\u2019 attention; behavior is often inappropriately seductive or provocative; speech is highly emotional but often vague and diffuse; emotions are shallow and often shift rapidly; may alienate friends with demands for constant attention<\/td>\n<td>B<\/td>\n<\/tr>\n<tr>\n<td>Narcissistic<\/td>\n<td>overinflated and unjustified sense of self-importance and preoccupied with fantasies of success; feels entitled to special treatment from others; shows arrogant attitudes and behaviors; takes advantage of others; lacks empathy<\/td>\n<td>B<\/td>\n<\/tr>\n<tr>\n<td>Borderline<\/td>\n<td>unstable in self-image, mood, and behavior; cannot tolerate being alone and experiences chronic feelings of emptiness; unstable and intense relationships with others; behavior is impulsive, unpredictable, and sometimes self-damaging; shows inappropriate and intense anger; makes suicidal gestures<\/td>\n<td>B<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2>Histrionic Personality Disorder<\/h2>\n<p>Histrionic personality disorder (HPD) is a\u00a0personality disorder\u00a0characterized by a pattern of excessive\u00a0attention-seeking\u00a0behaviors, usually beginning in early childhood, including inappropriate\u00a0seduction\u00a0and an excessive need for approval. People diagnosed with the disorder are said to be lively, dramatic, vivacious, enthusiastic, and\u00a0flirtatious.<\/p>\n<p>People with a histrionic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0(HPD) may feel underappreciated or disregarded when they are not the center of attention. People with this\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0are typically \u201cthe life of the party\u201d and have a \u201clarger than life\u201d presence. People with\u00a0histrionic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0(HPD) have a high need for attention, make loud and inappropriate appearances,\u00a0exaggerate\u00a0their behaviors and emotions, and crave stimulation.\u00a0<sup id=\"cite_ref-WebMD_3-1\" class=\"reference\"><\/sup>They may exhibit sexually provocative behavior, express strong emotions with an impressionistic style, and can be easily influenced by others.<\/p>\n<h2>Diagnostic Criteria<\/h2>\n<p>The DSM-5 defines histrionic personality disorder\u00a0as a<span style=\"font-size: 1rem; text-align: initial;\">\u00a0pervasive pattern of excessive\u00a0<\/span>emotionality<span style=\"font-size: 1rem; text-align: initial;\">\u00a0and attention-seeking, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following characteristics:<\/span><\/p>\n<ul>\n<li>is uncomfortable in situations in which they are not the center of attention\n<div id=\"attachment_4311\" style=\"width: 319px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-4311\" class=\"wp-image-4311\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/5351\/2020\/09\/12060949\/3558210146_d238315603_o-300x200.jpg\" alt=\"A person posing and being photographed by paparazzi.\" width=\"309\" height=\"206\" \/><\/p>\n<p id=\"caption-attachment-4311\" class=\"wp-caption-text\"><strong>Figure 1.<\/strong> Individuals with histrionic personality disorder crave stimulation and need to be the center of attention.<\/p>\n<\/div>\n<\/li>\n<li>interaction with others is often characterized by inappropriate sexually seductive or provocative behavior<\/li>\n<li>displays rapidly shifting and shallow expression of emotions<\/li>\n<li>consistently uses physical appearance to draw attention to self<\/li>\n<li>has a style of speech that is excessively impressionistic and lacking in detail<\/li>\n<li>shows self-dramatization, theatricality, and\u00a0exaggerated\u00a0expression of emotion<\/li>\n<li>is suggestible, i.e., easily influenced by others or circumstances<\/li>\n<li>considers relationships to be more intimate than they actually are<\/li>\n<\/ul>\n<h3>Differential Diagnosis<\/h3>\n<p>The <strong>differential diagnosis<\/strong> (unique attributes that differentiate a disorder from others with similar features) for histrionic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0includes narcissistic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>, borderline\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>, dependent\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>, somatic symptom\u00a0<span class=\"term-highlight\">disorder<\/span>, and illness anxiety\u00a0<span class=\"term-highlight\">disorder<\/span>.<\/p>\n<ul>\n<li>Like histrionic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>, patients with narcissistic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0prefer to be the center of attention.\u00a0However, patients with narcissistic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0want attention, which results from admiration or veneration, whereas people with histrionic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0are not particular about what type of attention they garner.<\/li>\n<li>Patients with histrionic\u00a0<span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">personality<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">disorder<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0are similar to those with borderline\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">personality<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0because both demographics of patients experience intense emotions; however, patients with borderline\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">personality<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">disorder<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0usually dislike themselves.<\/span><\/li>\n<li>Dependent\u00a0<span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">personality<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">disorder<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0should be considered in the differential diagnosis for histrionic\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">personality<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">disorder<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0as with both\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">personality<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0disorders; the patient will prefer to be around others.<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0However, patients with dependent\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">personality<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">disorder<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0tend to be more submissive, and their behavior is more inhibited as they are preoccupied with fears of rejection.<\/span><\/li>\n<li>Somatic symptom\u00a0<span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">disorder<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0and illness anxiety\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">disorder<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0are also included in the differential for histrionic\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">personality<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">disorder<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0as patients with a histrionic\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">personality<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0<\/span><span class=\"term-highlight\" style=\"font-size: 1rem; text-align: initial;\">disorder<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0may use physical symptoms and complaints to gain attention from others.<\/span><\/li>\n<\/ul>\n<h3>Comorbidity<\/h3>\n<p>Most people with histrionic personality disorder also have other mental disorders. Comorbid conditions include antisocial,\u00a0dependent,\u00a0borderline, and\u00a0narcissistic personality disorders as well as\u00a0depression,\u00a0anxiety disorders,\u00a0panic disorder,\u00a0somatoform disorders,\u00a0anorexia nervosa,\u00a0substance use disorder,\u00a0and\u00a0attachment disorders.<\/p>\n<div class=\"textbox examples\">\n<h3>Watch It<\/h3>\n<p>Watch this clip to see how histrionic personality disorder may be demonstrated.<\/p>\n<p><iframe loading=\"lazy\" src=\"\/\/plugin.3playmedia.com\/show?mf=5576210&amp;p3sdk_version=1.10.1&amp;p=20361&amp;pt=375&amp;video_id=VOPjir_94fQ&amp;video_target=tpm-plugin-vwxd1ryd-VOPjir_94fQ\" width=\"800px\" height=\"450px\" frameborder=\"0\" marginwidth=\"0px\" marginheight=\"0px\"><\/iframe><\/p>\n<p>You can view the <a href=\"https:\/\/course-building.s3-us-west-2.amazonaws.com\/Abnormal+Psychology\/transcripts\/DSM5HistrionicPersonalityDisorderCriteriaExample_transcript.txt\" target=\"_blank\" rel=\"noopener\">transcript for &#8220;DSM 5 Histrionic Personality Disorder Criteria Example, Symptoms Video&#8221; here (opens in new window)<\/a>.<\/p>\n<\/div>\n<h2>Epidemiology<\/h2>\n<p>The prevalence of histrionic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0in the general population runs about 2%-3%. It is possible for people to have more than one\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>. Women are four times more likely to be diagnosed with histrionic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0than men.\u00a0However, research suggests that women may be overly diagnosed with this\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0when compared to men due to sexual-forwardness being less socially acceptable for women.\u00a0Furthermore, men may be less likely to report their symptoms and thereby be under-diagnosed.\u00a0Histrionic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0tends to be ego-syntonic, meaning people with this\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0typically consider their behavior to be normal and struggle to identify a problem.<\/p>\n<h2>Etiology<\/h2>\n<p>Histrionic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0probably develops as a combination of both learned and inherited factors. One hypothesis is that histrionic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0may develop as a result of trauma experienced during childhood. Children may endure their trauma by coping with their environment in ways that may ultimately lead to a\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>.\u00a0<span class=\"term-highlight\">Personality<\/span>\u00a0disorders in childhood may originate as an adaptation to cope with a traumatic situation or traumatic environment.<\/p>\n<p>Parenting styles may also influence the likelihood of developing a histrionic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>. Parenting that lacks boundaries is over-indulgent, or inconsistent may predispose children to develop a histrionic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>. Because histrionic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>\u00a0tends to run in families, there is some consideration that there is genetic susceptibility for this\u00a0<span class=\"term-highlight\">disorder that<\/span>\u00a0may be inherited. As with all psychiatric disorders, having a family history of\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0disorders, psychiatric illness, or substance use disorders is a risk factor for histrionic\u00a0<span class=\"term-highlight\">personality<\/span>\u00a0<span class=\"term-highlight\">disorder<\/span>.<\/p>\n<h2>Treatment<\/h2>\n<p>Supportive psychotherapy is a recommended modality of treatment for patients with histrionic personality disorder, as this approach is found to be encouraging, reassuring, and non-threatening. Supportive psychotherapy aims to reduce emotional distress, improve self-esteem, and to enhance the patient\u2019s coping skills, all through attentive and sympathetic listening.<\/p>\n<p>Psychodynamic psychotherapy (also called insight-oriented therapy) has also proven to be a successful approach in treating patients with histrionic personality disorder. The goal of this therapy is to alter an aspect of a patient\u2019s dysfunctional personality by integrating crucial developmental milestones a patient may have missed during previous stages of emotional maturation. Psychodynamic psychotherapy aims to resolve underlying, unconscious conflicts in an effort for patients to understand themselves and their behaviors better. The patients are encouraged to substitute excessively dramatic speech for a more adaptive action or behavior, to promote better communication with others. Through psychodynamic psychotherapy, patients learn to recognize that hyper-sexual, attention-seeking behaviors are maladaptive, and discover new, healthier ways to develop self-esteem.<\/p>\n<p>While the gold standard for treating personality disorders is psychotherapy, patients with histrionic personality disorder may be profoundly symptomatic. Patients may experience affective dysregulation, where they frequently endure mood swings, anger, tearfulness, anxiety, and depression. While there are no FDA-approved medications for the treatment of histrionic personality disorder, affective dysregulation may be treated with antidepressants, mood stabilizers, and antipsychotics. Antidepressants that have proven to be effective include desipramine, fluoxetine, amitriptyline, and fluvoxamine. The mood stabilizers with proven therapeutic benefits include lamotrigine, carbamazepine, topiramate, valproate, and lithium. Research has demonstrated that antipsychotics such as risperidone, aripiprazole, olanzapine, and haloperidol have been useful in treating affective dysregulation. Patients with histrionic personality disorder may struggle with impulse control and regulation of their behaviors. Clinical trials have demonstrated that mood stabilizers specifically can target these symptoms.<\/p>\n<div class=\"textbox key-takeaways\">\n<h3>Key Takeaways:\u00a0Histrionic Personality Disorder<\/h3>\n<p><iframe loading=\"lazy\" title=\"55. Histrionic\u00a0personality disorder\" src=\"https:\/\/lumenlearning.h5p.com\/content\/1291235956777381558\/embed\" width=\"1088\" height=\"603\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><script src=\"https:\/\/lumenlearning.h5p.com\/js\/h5p-resizer.js\" charset=\"UTF-8\"><\/script><\/p>\n<\/div>\n<div class=\"textbox exercises\">\n<h3>Think it Over: Michael Scott&#8217;s Diagnosis<\/h3>\n<p>Many of you are familiar with the fictional character Michael Scott from the hit TV show <em>The Office<\/em>. Scott is a 46-year-old, Caucasian male from Scranton, Pennsylvania, and the regional manager at Dunder Mifflin Inc., a local paper and printer distribution company. Michael Scott&#8217;s outward appearance is well put together, as he presents as a business professional, and there are no obvious health concerns. Despite his seemingly composed demeanor, Scott displays exaggerated emotions and reactions. In addition to these exaggerations, romantic relationships have proven turbulent for Scott throughout his life, as he goes from one relationship to the next with the other person usually being the one to end the relationship. He has few close friends or relatives and tends to perceive new friendships as closer than they actually are. Scott believes his subordinates to be his family, and oftentimes gets involved in their personal lives without their consent. His parents divorced when he was young (age unknown), and he displays clear resentment towards his stepfather and sister, whom he once didn\u2019t talk to for fifteen years. Scott has a very close relationship with his mother now, though this was not the case when he was a child. Though Scott seems to be lacking in managerial style, responsibility, and delegation, he demonstrates above-average sales abilities due to his personable qualities. Scott does not have a history of drug or alcohol abuse, though he will drink in social situations and when pressured to do so by coworkers.<\/p>\n<p>Some of Michael Scott&#8217;s behaviors fit with the description of histrionic personality disorder, namely that he likes to be the center of attention, uses impressionistic speech, considers relationships to be more intimate than they actually are, and even shows self-dramatization at times. These things still do not meet all five criteria for the diagnosis, however. <a href=\"https:\/\/courses.lumenlearning.com\/abnormalpsych\/chapter\/introduction-to-opioid-and-hallucinogen-related-disorders\/\" target=\"_blank\" rel=\"noopener\">This video by Dr. Grande goes through each of the criteria for histrionic personality disorder (start at the 14:54 mark)<\/a>, then goes on to explain why Michael Scott may better fit the description for narcissistic personality disorder, which we&#8217;ll examine on the next page.<\/p>\n<p>Because of the overlap in some of the criteria and frequent comorbidity of histrionic personality disorder with other personality disorders, some scholars have recommended removing the histrionic diagnosis altogether.<\/p>\n<p class=\"mb15\">Bakkevig and Karterud (2010), in a study carried out with a sample of patients attending psychiatric day hospital, concluded that the prevalence of HPD was very low (0.4%) and comorbidity was high, especially with borderline, narcissistic, and dependent personality disorders. They suggested that the HPD category should be deleted from the DSM system, excepting that clinical phenomena of exhibitionism and attention-seeking, which are the dominant personality features of HPD, should be preserved in an exhibitionistic subtype of narcissism.<a class=\"footnote\" title=\"Novais F, Ara\u00fajo A and Godinho P (2015) Historical roots of histrionic personality disorder. Front. Psychol. 6:1463. doi: 10.3389\/fpsyg.2015.01463\" id=\"return-footnote-1719-1\" href=\"#footnote-1719-1\" aria-label=\"Footnote 1\"><sup class=\"footnote\">[1]<\/sup><\/a><\/p>\n<\/div>\n<section>\n<div class=\"textbox tryit\">\n<h3>Try It<\/h3>\n<p>\t<iframe id=\"assessment_practice_485bd630-fc1b-426d-9833-bf13673a6eb0\" class=\"resizable\" src=\"https:\/\/assess.lumenlearning.com\/practice\/485bd630-fc1b-426d-9833-bf13673a6eb0?iframe_resize_id=assessment_practice_id_485bd630-fc1b-426d-9833-bf13673a6eb0\" frameborder=\"0\" style=\"border:none;width:100%;height:100%;min-height:300px;\"><br \/>\n\t<\/iframe><\/p>\n<\/div>\n<\/section>\n<div class=\"textbox learning-objectives\">\n<h3>Glossary<\/h3>\n<p><strong>histrionic personality disorder:\u00a0<\/strong>characterized by a pattern of excessive\u00a0attention-seeking\u00a0behaviors, usually beginning in early childhood, including inappropriate\u00a0seduction\u00a0and an excessive need for approval<\/p>\n<p><strong>personality disorder:\u00a0<\/strong>group of DSM-5 disorders characterized by an inflexible and pervasive personality style that differs markedly from the expectations of one\u2019s culture and causes distress and impairment<\/p>\n<\/div>\n\n\t\t\t <section class=\"citations-section\" role=\"contentinfo\">\n\t\t\t <h3>Candela Citations<\/h3>\n\t\t\t\t\t <div>\n\t\t\t\t\t\t <div id=\"citation-list-1719\">\n\t\t\t\t\t\t\t <div class=\"licensing\"><div class=\"license-attribution-dropdown-subheading\">CC licensed content, Original<\/div><ul class=\"citation-list\"><li>Modification, adaptation, and original content. <strong>Authored by<\/strong>: Julie Manley for Lumen Learning. <strong>Provided by<\/strong>: Lumen Learning. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><\/ul><div class=\"license-attribution-dropdown-subheading\">CC licensed content, Shared previously<\/div><ul class=\"citation-list\"><li>Textbook of Psychiatry. <strong>Authored by<\/strong>: Wikibooks. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikibooks.org\/wiki\/Textbook_of_Psychiatry\/Print_version#Cluster_B\">https:\/\/en.wikibooks.org\/wiki\/Textbook_of_Psychiatry\/Print_version#Cluster_B<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Personality Disorder. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Personality_disorder\">https:\/\/en.wikipedia.org\/wiki\/Personality_disorder<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Histrionic Personality Disorder. <strong>Authored by<\/strong>: Jennifer H. French and Sangam Shrestha. <strong>Provided by<\/strong>: Stat Pearls. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK542325\/#\">https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK542325\/#<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\">CC BY: Attribution<\/a><\/em><\/li><li>Histrionic Personality Disorder case study. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/courses.lumenlearning.com\/abnormalpsychology\/chapter\/histrionic-personality-disorder\/\">https:\/\/courses.lumenlearning.com\/abnormalpsychology\/chapter\/histrionic-personality-disorder\/<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/\">CC BY-NC-SA: Attribution-NonCommercial-ShareAlike<\/a><\/em><\/li><li>Historical roots of histrionic personality disorder. <strong>Authored by<\/strong>: Filipa Novais, Andreia Arau00fajo, and Paula Godinho. <strong>Provided by<\/strong>: Frontiers in Psychology. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2015.01463\/full\">https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2015.01463\/full<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><\/ul><div class=\"license-attribution-dropdown-subheading\">All rights reserved content<\/div><ul class=\"citation-list\"><li>DSM 5 Histrionic Personality Disorder Criteria Example, Symptoms Video. <strong>Provided by<\/strong>: Symptom Media. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/youtu.be\/VOPjir_94fQ?t=32\">https:\/\/youtu.be\/VOPjir_94fQ?t=32<\/a>. <strong>License<\/strong>: <em>Other<\/em>. <strong>License Terms<\/strong>: Standard YouTube License<\/li><\/ul><\/div>\n\t\t\t\t\t\t <\/div>\n\t\t\t\t\t <\/div>\n\t\t\t <\/section><hr class=\"before-footnotes clear\" \/><div class=\"footnotes\"><ol><li id=\"footnote-1719-1\">Novais F, Ara\u00fajo A and Godinho P (2015) Historical roots of histrionic personality disorder. <em>Front. Psychol<\/em>. 6:1463. doi: 10.3389\/fpsyg.2015.01463 <a href=\"#return-footnote-1719-1\" class=\"return-footnote\" aria-label=\"Return to footnote 1\">&crarr;<\/a><\/li><\/ol><\/div>","protected":false},"author":29,"menu_order":9,"template":"","meta":{"_candela_citation":"[{\"type\":\"cc\",\"description\":\"Textbook of Psychiatry\",\"author\":\"Wikibooks\",\"organization\":\"\",\"url\":\"https:\/\/en.wikibooks.org\/wiki\/Textbook_of_Psychiatry\/Print_version#Cluster_B\",\"project\":\"\",\"license\":\"cc-by-sa\",\"license_terms\":\"\"},{\"type\":\"cc\",\"description\":\"Personality Disorder\",\"author\":\"\",\"organization\":\"Wikipedia\",\"url\":\"https:\/\/en.wikipedia.org\/wiki\/Personality_disorder\",\"project\":\"\",\"license\":\"cc-by-sa\",\"license_terms\":\"\"},{\"type\":\"copyrighted_video\",\"description\":\"DSM 5 Histrionic Personality Disorder Criteria Example, Symptoms Video\",\"author\":\"\",\"organization\":\"Symptom Media\",\"url\":\"https:\/\/youtu.be\/VOPjir_94fQ?t=32\",\"project\":\"\",\"license\":\"other\",\"license_terms\":\"Standard YouTube License\"},{\"type\":\"original\",\"description\":\"Modification, adaptation, and original content\",\"author\":\"Julie Manley for Lumen Learning\",\"organization\":\"Lumen Learning\",\"url\":\"\",\"project\":\"\",\"license\":\"cc-by-sa\",\"license_terms\":\"\"},{\"type\":\"cc\",\"description\":\"Histrionic Personality Disorder\",\"author\":\"Jennifer H. 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