Histrionic personality disorder: Difference between revisions

Histrionic personality disorder
Histrionic personality disorder
	Dramatic behavior is a key marker of Histrionic personality disorder
Specialty	Clinical Psychology, Psychiatry
Symptoms	Persistent attention seeking, dramatic behavior, rapidly shifting and shallow emotions, sexually provocative behavior, undetailed style of speech, and a tendency to consider relationships more intimate than they actually are.
Usual onset	Symptoms typically do not fully develop until the age of 15
Duration	Lifelong
Causes	Highly responsive noradrenergic systems, genetics, authoritarian parenting
Diagnostic method	Based on symptoms
Differential diagnosis	Other personality disorders, Substance abuse disorders, and Personality change due to another medical condition
Treatment	Functional analytic psychotherapy, Functional ideographic assessment template, and coding client and therapist behaviors

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Histrionic personality disorder (HPD) is defined by the American Psychiatric Association as a personality disorder characterized by a pattern of excessive attention-seeking behaviors, usually beginning in early childhood, including inappropriate seduction and an excessive desire for approval. People diagnosed with the disorder are said to be lively, dramatic, vivacious, enthusiastic, extroverted and flirtatious.

HPD lies in the dramatic cluster of personality disorders.^[1] People with HPD have a high desire for attention, make loud and inappropriate appearances, exaggerate their behaviors and emotions, and crave stimulation.^[1] They may exhibit sexually provocative behavior, express strong emotions with an impressionistic style, and can be easily influenced by others. Associated features include egocentrism, self-indulgence, continuous longing for appreciation, and persistent manipulative behavior to achieve their own wants.

Signs and symptoms

People diagnosed with HPD may be dramatic.^[2]^[3]^[4] They often fail to see their own personal situation realistically, instead dramatizing and exaggerating their difficulties. Patients with this disorder can have rapidly shifting emotions and a decreased ability to recognize other's emotions.^[5] Their emotions may appear superficial or exaggerated to others. This disorder is associated with extraversion,^[6] a lower tolerance for frustration or delayed gratification,^[7] and openness to new experiences. People with HPD may have little self-doubt and often appear egocentric.^[8]

Research has also shown those with histrionic personality have a greater desire for social approval and reassurance and will constantly seek it out, making those with HPD more vulnerable to social media addiction.^[9] People with this disorder often display excessive sensitivity to criticism or disapproval.^[10] They will work hard to get others to pay attention to them,^[11] possibly as a method of testing the stability of relationships.^[12] They may enjoy situations in which they can be the center of attention, and may feel uncomfortable when people are not paying attention to them.^[6] It is common for people with this disorder to flamboyant clothing, try body modifications,^[13] and fake medical conditions in an attempt to draw other's attention.^[6]^[14] They may display inappropriately sexually provocative,^[15]^[16] flirtatious,^[6]^[17]^[18] or exploitative behavior.^[19] Sexting and exhibitionist behavior are also behaviors people with this condition sometimes exhibit.^[20] Some people with histrionic traits or personality disorder change their seduction technique into a more maternal or paternal style as they age.^[21] When their desire for attention is not met, it can heighten the severity of their symptoms.^[22] They tend to be impressionable and easily manipulatable, especially by those they respect.^[6]^[23]^[24]

Patients with HPD are usually high-functioning, both socially and professionally. They usually have good social skills, despite tending to use them to make themselves the center of attention.^[6] HPD may also affect a person's social and romantic relationships, as well as their ability to cope with losses or failures. People with HPD tend to consider relationships closer than they usually are.^[25]^[26]^[27] They may seek treatment for clinical depression when romantic (or other close personal) relationships end.^[26] Substance disorders,^[28]^[29] such as Alcohol Use Disorder or Opioid use disorder,^[30]^[31] are all common in patients with Histrionic Personality Disorder.^[32]^[33] They are also at higher risks of suicide,^[34]^[35] body dysmorphia,^[36]^[37] and divorce.^[38] They may go through frequent job changes, as they become easily bored and may prefer withdrawing from frustration (instead of facing it). Because they tend to crave novelty and excitement, they may place themselves in risky situations. All of these factors may lead to greater risk of developing clinical depression.^[4] People with this condition can have an impressionistic and undetailed style of speech.^[39]

Despite these traits they can be prideful of their own personality, and may be unwilling to change, viewing any change as a threat. They may even blame their personal failures or disappointments on others.^[21]

Causes

Little research has been done to find evidence of what causes histrionic personality disorder. Although direct causes are inconclusive, various theories and studies suggest multiple possible causes, of a neurochemical, genetic, psychoanalytic, or environmental nature. Traits such as extravagance, vanity, and seductiveness of hysteria have similar qualities to women diagnosed with HPD.^[40] HPD symptoms typically do not fully develop until the age of 15, while the onset of treatment only occurs, on average, at approximately 40 years of age.^[41]^[42]

Neurochemical/physiological

Studies have shown that there is a strong correlation between the function of neurotransmitters and the Cluster B personality disorders such as HPD. Individuals diagnosed with HPD have a highly responsive noradrenergic system, which is responsible for the synthesis, storage, and release of the neurotransmitter norepinephrine. High levels of norepinephrine lead to anxiety-proneness, dependency, and high sociability.^[41]^{[medical citation needed]}

Genetic

Twin studies have aided in breaking down the genetic vs. environment debate. A twin study conducted by the Department of Psychology at Oslo University attempted to establish a correlation between genetics and Cluster B personality disorders. With a test sample of 221 twins, 92 monozygotic and 129 dizygotic, researchers interviewed the subjects using the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II) and concluded that there was a correlation of 0.67 that histrionic personality disorder is hereditary.^[32]

Psychoanalytic theory

Though criticised as being unsupported by scientific evidence, psychoanalytic theories incriminate authoritarian or distant attitudes by one (mainly the mother) or both parents, along with conditional love based on expectations the child can never fully meet.^[1] Using psychoanalysis, Freud believed that lustfulness was a projection of the patient's lack of ability to love unconditionally and develop cognitively to maturity, and that such patients were overall emotionally shallow.^[43] He believed the reason for being unable to love could have resulted from a traumatic experience, such as the death of a close relative during childhood or divorce of one's parents, which gave the wrong impression of committed relationships. Exposure to one or multiple traumatic occurrences of a close friend or family member's leaving (via abandonment or mortality) would make the person unable to form true and affectionate attachments towards other people.^[44]

HPD and antisocial personality disorder

Another theory suggests a possible relationship between histrionic personality disorder and antisocial personality disorder. Research has found 2/3 of patients diagnosed with histrionic personality disorder also meet criteria similar to those of the antisocial personality disorder,^[40] which suggests both disorders based towards sex-type expressions may have the same underlying cause.

Some family history studies have found that histrionic personality disorder, as well as borderline and antisocial personality disorders, tend to run in families, but it is unclear how much is due to genetic versus environmental factors.^[45] Both examples suggest that predisposition could be a factor as to why certain people are diagnosed with histrionic personality disorder, however little is known about whether or not the disorder is influenced by any biological compound or is genetically inheritable.^[45] Little research has been conducted to determine the biological sources, if any, of this disorder.

Diagnosis

The person's appearance, behavior and history, along with a psychological evaluation, are usually sufficient to establish a diagnosis. There is no test to confirm this diagnosis. Because the criteria are subjective, some people may be wrongly diagnosed.^[46]^{[medical citation needed]}

DSM 5

The current edition of the Diagnostic and Statistical Manual of Mental Disorders, DSM 5, defines histrionic personality disorder (in Cluster B) as:^[47]

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:
is uncomfortable in situations in which he or she is not the center of attention

interaction with others is often characterized by inappropriate sexually seductive or provocative behavior

displays rapidly shifting and shallow expression of emotions

consistently uses physical appearance to draw attention to self

has a style of speech that is excessively impressionistic and lacking in detail

shows self-dramatization, theatricality, and exaggerated expression of emotion

is suggestible, i.e., easily influenced by others or circumstances

considers relationships to be more intimate than they actually are

The DSM 5 requires that a diagnosis for any specific personality disorder also satisfies a set of general personality disorder criteria.

ICD-10

The World Health Organization's ICD-10 lists histrionic personality disorder as:^[48]

A personality disorder characterized by:
shallow and labile affectivity,

self-dramatization,

theatricality,

exaggerated expression of emotions,

suggestibility,

egocentricity,

self-indulgence,

lack of consideration for others,

easily hurt feelings, and

continuous seeking for appreciation, excitement and attention.

It is a requirement of ICD-10 that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria.

Comorbidity

Most histrionics also have other mental disorders. Comorbid conditions include: antisocial, dependent, borderline, and narcissistic personality disorders,^[49] as well as depression,^[50] anxiety disorders, panic disorder, somatoform disorders, anorexia nervosa, substance use disorder^[51] and attachment disorders, including reactive attachment disorder.^{[citation needed]}

Millon's subtypes

Theodore Millon identified six subtypes of histrionic personality disorder. Any individual histrionic may exhibit one or more of the following:^[52]

Subtype	Personality Traits
Appeasing histrionic (Including dependent and compulsive features)	Seeks to placate, mend, patch up, smooth over troubles; knack for settling differences, moderating tempers by yielding, compromising, conceding; sacrifices self for commendation; fruitlessly placates the unplacatable.
Vivacious histrionic (including hypomanic features, and possibly narcissistic features)	Vigorous, charming, bubbly, brisk, spirited, flippant, impulsive; seeks momentary cheerfulness and playful adventures; animated, energetic, ebullient.
Tempestuous histrionic (Including negativistic features)	Impulsive, out of control; moody complaints, sulking; precipitous emotion, stormy, impassioned, easily wrought-up, periodically inflamed, turbulent.
Disingenuous histrionic (Including antisocial features)	Underhanded, double-dealing, scheming, contriving, plotting, crafty, false-hearted; egocentric, insincere, deceitful, calculating, guileful.
Theatrical histrionic (Variant of “pure” pattern)	Affected, mannered, put-on; postures are striking, eyecatching, graphic; markets self-appearance; is synthesized, stagy; simulates desirable/dramatic poses.
Infantile histrionic (Including borderline features)	Labile, high-strung, volatile emotions; childlike hysteria and nascent pouting; demanding, overwrought; fastens and clutches to another; is excessively attached, hangs on, stays fused to and clinging.

Treatment

Treatment is often prompted by depression associated with dissolved romantic relationships. Medication does little to affect the personality disorder, but may be helpful with symptoms such as depression.^[46]^{[failed verification]} Treatment for HPD itself involves psychotherapy, including cognitive therapy.^[1]

Interviews and self-report methods

In general clinical practice with assessment of personality disorders, one form of interview is the most popular: an unstructured interview.^[53] The actual preferred method is a semi-structured interview but there is reluctance to use this type of interview because they can seem impractical or superficial.^[53] The reason that a semi-structured interview is preferred over an unstructured interview is that semi-structured interviews tend to be more objective, systematic, replicable, and comprehensive.^[53] Unstructured interviews, despite their popularity, tend to have problems with unreliability and are susceptible to errors leading to false assumptions of the patient.^[53]

One of the single most successful methods for assessing personality disorders by researchers of normal personality functioning is the self-report inventory following up with a semi-structured interview.^[53] There are some disadvantages with the self-report inventory method that with histrionic personality disorder there is a distortion in character, self-presentation, and self-image.^[53] This cannot be assessed simply by asking most clients if they match the criteria for the disorder.^[53] Most projective testing depend less on the ability or willingness of the person to provide an accurate description of the self, but there is currently limited empirical evidence on projective testing to assess histrionic personality disorder.^[53]

Functional analytic psychotherapy

Another way to treat histrionic personality disorder after identification is through functional analytic psychotherapy.^[54] The job of a Functional Analytic Psychotherapist is to identify the interpersonal problems with the patient as they happen in session or out of session.^[54] Initial goals of functional analytic psychotherapy are set by the therapist and include behaviors that fit the client's needs for improvement.^[54] Functional analytic psychotherapy differs from the traditional psychotherapy due to the fact that the therapist directly addresses the patterns of behavior as they occur in-session.^[54]

The in-session behaviors of the patient or client are considered to be examples of their patterns of poor interpersonal communication and to adjust their neurotic defenses.^[54] To do this, the therapist must act on the client's behavior as it happens in real time and give feedback on how the client's behavior is affecting their relationship during therapy.^[54] The therapist also helps the client with histrionic personality disorder by denoting behaviors that happen outside of treatment; these behaviors are termed "Outside Problems" and "Outside Improvements".^[54] This allows the therapist to assist in problems and improvements outside of session and to verbally support the client and condition optimal patterns of behavior".^[54] This then can reflect on how they are advancing in-session and outside of session by generalizing their behaviors over time for changes or improvement".^[54]

Coding client and therapist behaviors

In these sessions there is a certain set of dialogue or script that can be forced by the therapist for the client to give insight on their behaviors and reasoning".^[54] Here is an example from"^[54] the conversation is hypothetical. T = therapist C = Client This coded dialogue can be transcribed as:

ECRB – Evoking clinically relevant behavior
- T: Tell me how you feel coming in here today (CRB2) C: Well, to be honest, I was nervous. Sometimes I feel worried about how things will go, but I am really glad I am here.
CRB1 – In-session problems
- C: Whatever, you always say that. (becomes quiet). I don't know what I am doing talking so much.
CRB2 – In-session improvements
TCRB1 – Clinically relevant response to client problems
- T: Now you seem to be withdrawing from me. That makes it hard for me to give you what you might need from me right now. What do you think you want from me as we are talking right now?".
TCRB2 – Responses to client improvement
- T: That's great. I am glad you're here, too. I look forward to talking to you.^[54]

Functional ideographic assessment template

Another example of treatment besides coding is functional ideographic assessment template.^[54] The functional ideographic assessment template, also known as FIAT, was used as a way to generalize the clinical processes of functional analytic psychotherapy.^[54] The template was made by a combined effort of therapists and can be used to represent the behaviors that are a focus for this treatment.^[54] Using the FIAT therapists can create a common language to get stable and accurate communication results through functional analytic psychotherapy at the ease of the client; as well as the therapist.^[54]

Epidemiology

The survey data from the National epidemiological survey from 2001 to 2002 suggests a prevalence of HPD of 1.84 percent.^[55]^{[medical citation needed]} Major character traits may be inherited, while other traits may be due to a combination of genetics and environment, including childhood experiences.^[21] This personality is seen more often in women than in men.^[56] Approximately 65% of HPD diagnoses are women while 35% are men. In Marcie Kaplan's A Women's View of DSM-III, she argues that women are overdiagnosed due to potential biases and expresses that even healthy women are often automatically diagnosed with HPD.^[19] It has also been argued due to diagnostic bias that prevalence rates are equal among women and men.^[57]

Many symptoms representing HPD in the DSM are exaggerations of traditional feminine behaviors. In a peer and self-review study, it showed that femininity was correlated with histrionic, dependent and narcissistic personality disorders.^[15] Although two thirds of HPD diagnoses are female, there have been a few exceptions.^[58] Whether or not the rate will be significantly higher than the rate of women within a particular clinical setting depends upon many factors that are mostly independent of the differential sex prevalence for HPD.^[39] Those with HPD are more likely to look for multiple people for attention, which leads to marital problems due to jealousy and lack of trust from the other party. This makes them more likely to become divorced or separated once married.^[59] With few studies done to find direct causations between HPD and culture, cultural and social aspects play a role in inhibiting and exhibiting HPD behaviors.

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^ ^a ^b ^c ^d ^e ^f ^g ^h Sutker, P.B. (2002). Histrionic, Narcissistic, and Dependent Personality Disorders. Comprehensive handbook of psychopathology (3rd ed., pp. 513–514). New York: Kluwer Academic.
^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k ^l ^m ⁿ ^o ^p Callaghan G.M.; Summers C.J.; Weidman M. (2003). "The treatment of histrionic and narcissistic personality disorder behaviors: A single-subject demonstration of clinical improvement using functional analytic psychotherapy". Journal of Contemporary Psychotherapy. 33 (4): 321–339. doi:10.1023/b:jocp.0000004502.55597.81. S2CID 42066477.
^ Grant, Bridget F.; Hasin, Deborah S.; Stinson, Frederick S.; Dawson, Deborah A.; Chou, S. Patricia; Ruan, W. June; Pickering, Roger P. (2004-07-15). "Prevalence, Correlates, and Disability of Personality Disorders in the United States". The Journal of Clinical Psychiatry. 65 (7): 948–958. doi:10.4088/jcp.v65n0711. ISSN 0160-6689. PMID 15291684.
^ Suinn, Richard M. (1984). Fundamentals of abnormal psychology (Updated ed.). Chicago: Nelson-Hall. pp. 335–336. ISBN 978-0-8304-1071-2.
^ Sprock, June (2 February 2000). "Gender-Typed Behavioral Examples of Histrionic Personality Disorder". Journal of Psychopathology and Behavioral Assessment. 22 (2): 107–122. doi:10.1023/A:1007514522708. S2CID 141244223.
^ Corbitt, E., Widiger, T. (1995). "Sex differences among the personality disorders: An exploration of the data". Clinical Psychology: Science and Practice. 2 (3): 225–238. doi:10.1111/j.1468-2850.1995.tb00041.x.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^ Disney, K.L., Weinstein, Y., & Oltmanns, T.F. (2012). "Personality disorder symptoms are differentially related to divorce frequency". Journal of Family Psychology. 26 (6): 959–965. doi:10.1037/a0030446. PMC 3569846. PMID 23244459.{{cite journal}}: CS1 maint: multiple names: authors list (link)

External links

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[3] French, J.; Shrestha, S. (2020). "Histrionic Personality Disorder". Definitions. doi:10.32388/lqk9fy. S2CID 212809271.

[ADAM2-4] "Histrionic personality disorder". A.D.A.M. Medical Encyclopedia. PubMed Health. Archived from the original on 2012-08-29. Retrieved 17 June 2012.

[5] Ritzl, A.; Csukly, G.; Balázs, K.; Égerházi, A. (2018). "Facial emotion recognition deficits and alexithymia in borderline, narcissistic, and histrionic personality disorders". Psychiatry Research. 270: 154–159. doi:10.1016/j.psychres.2018.09.017. PMID 30248486. S2CID 52876012.

[Cleveland2-6] ^ ^a ^b ^c ^d ^e ^f "Histrionic Personality Disorder". The Cleveland Clinic. Archived from the original on 2011-10-03. Retrieved 23 November 2011.

[7] First, Michael B.; Tasman, Allan (2010-02-08). Clinical Guide to the Diagnosis and Treatment of Mental Disorders. John Wiley & Sons. p. 503. ISBN 978-0-470-74520-5.

[8] Furnham, A. (2014). "A bright side, facet analysis of histrionic personality disorder: The relationship between the HDS Colourful factor and the NEO-PI-R facets in a large adult sample". The Journal of Social Psychology. 154 (6): 527–536. doi:10.1080/00224545.2014.953026. PMID 25280168. S2CID 7592361.

[9] Savci, Mustafa; Turan, Mehmet Emin; Griffiths, Mark D.; Ercengiz, Mustafa (2021). "Histrionic Personality, Narcissistic Personality, and Problematic Social Media Use: Testing of a New Hypothetical Model". International Journal of Mental Health and Addiction. 19 (4): 986–1004. doi:10.1007/s11469-019-00139-5. ISSN 1557-1874. S2CID 204887310.

[10] Sperry, Len (2013-05-13). Handbook of Diagnosis and Treatment of DSM-IV Personality Disorders. Routledge. p. 135. ISBN 978-1-135-95083-5.

[11] "Histrionic Personality Disorder (HPD) - Psychiatric Disorders". MSD Manual Professional Edition. Retrieved 2022-07-25.

[12] Babl, Anna; Gómez Penedo, Juan Martín; Berger, Thomas; Schneider, Noemi; Sachse, Rainer; Kramer, Ueli (2022-07-06). "Change processes in psychotherapy for patients presenting with histrionic personality disorder". Clinical Psychology & Psychotherapy: cpp.2769. doi:10.1002/cpp.2769. ISSN 1063-3995. PMID 35776063. S2CID 250174275.

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[Callaghan2-54] ^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k ^l ^m ⁿ ^o ^p Callaghan G.M.; Summers C.J.; Weidman M. (2003). "The treatment of histrionic and narcissistic personality disorder behaviors: A single-subject demonstration of clinical improvement using functional analytic psychotherapy". Journal of Contemporary Psychotherapy. 33 (4): 321–339. doi:10.1023/b:jocp.0000004502.55597.81. S2CID 42066477.

[55] Grant, Bridget F.; Hasin, Deborah S.; Stinson, Frederick S.; Dawson, Deborah A.; Chou, S. Patricia; Ruan, W. June; Pickering, Roger P. (2004-07-15). "Prevalence, Correlates, and Disability of Personality Disorders in the United States". The Journal of Clinical Psychiatry. 65 (7): 948–958. doi:10.4088/jcp.v65n0711. ISSN 0160-6689. PMID 15291684.

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[59] Disney, K.L., Weinstein, Y., & Oltmanns, T.F. (2012). "Personality disorder symptoms are differentially related to divorce frequency". Journal of Family Psychology. 26 (6): 959–965. doi:10.1037/a0030446. PMC 3569846. PMID 23244459.{{cite journal}}: CS1 maint: multiple names: authors list (link)

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@@ Line 23: / Line 23: @@
 People diagnosed with HPD may be [[drama]]tic.<ref>{{Cite journal |last1=Kuzman |first1=Martina Rojnic |last2=Jovanovic |first2=Nikolina |last3=Vukelja |first3=Dinko |last4=Medved |first4=Vesna |last5=Hotujac |first5=Ljubomir |date=2008 |title=Psychiatric symptoms in idiopathic intracranial hypertension |url=https://onlinelibrary.wiley.com/doi/10.1111/j.1440-1819.2008.01810.x |journal=Psychiatry and Clinical Neurosciences |language=en |volume=62 |issue=3 |pages=367 |doi=10.1111/j.1440-1819.2008.01810.x |pmid=18588604 |s2cid=38221625 |issn=1323-1316}}</ref><ref>{{Cite journal |last1=French |first1=J. |last2=Shrestha |first2=S. |date=2020 |title=Histrionic Personality Disorder |url=https://www.semanticscholar.org/paper/Histrionic-Personality-Disorder-French-Shrestha/96c1ba36ed67ef927334c758b92b2834d0d16c07 |journal=Definitions |doi=10.32388/lqk9fy|s2cid=212809271 }}</ref><ref name="ADAM2">{{cite encyclopedia |title=Histrionic personality disorder |encyclopedia=A.D.A.M. Medical Encyclopedia |publisher=PubMed Health |url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002498/ |access-date=17 June 2012 |archive-url=https://web.archive.org/web/20120829223434/http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002498/ |archive-date=2012-08-29 |url-status=live}}</ref> They often fail to see their own personal situation realistically, instead dramatizing and exaggerating their difficulties. Patients with this disorder can have rapidly shifting emotions and a decreased ability to recognize other's emotions.<ref>{{cite journal | url=https://pubmed.ncbi.nlm.nih.gov/30248486/ | pmid=30248486 | year=2018 | last1=Ritzl | first1=A. | last2=Csukly | first2=G. | last3=Balázs | first3=K. | last4=Égerházi | first4=A. | title=Facial emotion recognition deficits and alexithymia in borderline, narcissistic, and histrionic personality disorders | journal=Psychiatry Research | volume=270 | pages=154–159 | doi=10.1016/j.psychres.2018.09.017 | s2cid=52876012 }}</ref> Their emotions may appear superficial or exaggerated to others. This disorder is associated with [[Extraversion and introversion|extraversion]],<ref name="Cleveland2">{{cite web |title=Histrionic Personality Disorder |url=http://www.clevelandclinic.org/health/health-info/docs/3700/3795.asp?index=9743 |url-status=dead |archive-url=https://web.archive.org/web/20111003045057/http://www.clevelandclinic.org/health/health-info/docs/3700/3795.asp?index=9743 |archive-date=2011-10-03 |access-date=23 November 2011 |publisher=The Cleveland Clinic}}</ref> a lower tolerance for frustration or [[delayed gratification]],<ref>{{Cite book |last1=First |first1=Michael B. |url=https://books.google.com/books?id=jyXxmyysU7gC&dq=%22Histrionic+personality+disorder%22+%22delayed+gratification%22&pg=PA503 |title=Clinical Guide to the Diagnosis and Treatment of Mental Disorders |last2=Tasman |first2=Allan |date=2010-02-08 |publisher=John Wiley & Sons |isbn=978-0-470-74520-5 |pages=503 |language=en}}</ref> and [[Openness to experience|openness to new experiences]]. People with HPD may have little self-doubt and often appear egocentric.<ref>{{cite journal | url=https://pubmed.ncbi.nlm.nih.gov/25280168/ | pmid=25280168 | year=2014 | last1=Furnham | first1=A. | title=A bright side, facet analysis of histrionic personality disorder: The relationship between the HDS Colourful factor and the NEO-PI-R facets in a large adult sample | journal=The Journal of Social Psychology | volume=154 | issue=6 | pages=527–536 | doi=10.1080/00224545.2014.953026 | s2cid=7592361 }}</ref>
-Research has also shown those with histrionic personality have a greater desire for social approval and reassurance and will constantly seek it out, making those with HPD more vulnerable to social media addiction.<ref>{{Cite journal |last1=Savci |first1=Mustafa |last2=Turan |first2=Mehmet Emin |last3=Griffiths |first3=Mark D. |last4=Ercengiz |first4=Mustafa |date=2021 |title=Histrionic Personality, Narcissistic Personality, and Problematic Social Media Use: Testing of a New Hypothetical Model |url=https://link.springer.com/10.1007/s11469-019-00139-5 |journal=International Journal of Mental Health and Addiction |language=en |volume=19 |issue=4 |pages=986–1004 |doi=10.1007/s11469-019-00139-5 |issn=1557-1874 |s2cid=204887310}}</ref> People with this disorder often display excessive sensitivity to [[criticism]] or disapproval.<ref>{{Cite book |last=Sperry |first=Len |url=https://books.google.com/books?id=VSQ1cDjxsPkC&dq=%22Histrionic+personality+disorder+AND+%22sensitive%22&pg=PA135 |title=Handbook of Diagnosis and Treatment of DSM-IV Personality Disorders |date=2013-05-13 |publisher=Routledge |isbn=978-1-135-95083-5 |pages=135 |language=en}}</ref> They will work hard to get others to pay attention to them,<ref>{{Cite web |title=Histrionic Personality Disorder (HPD) - Psychiatric Disorders |url=https://www.msdmanuals.com/en-gb/professional/psychiatric-disorders/personality-disorders/histrionic-personality-disorder-hpd?ruleredirectid=382 |access-date=2022-07-25 |website=MSD Manual Professional Edition |language=en-GB}}</ref> possibly as a method of testing the stability of relationships.<ref>{{Cite journal |last1=Babl |first1=Anna |last2=Gómez Penedo |first2=Juan Martín |last3=Berger |first3=Thomas |last4=Schneider |first4=Noemi |last5=Sachse |first5=Rainer |last6=Kramer |first6=Ueli |date=2022-07-06 |title=Change processes in psychotherapy for patients presenting with histrionic personality disorder |url=https://onlinelibrary.wiley.com/doi/10.1002/cpp.2769 |journal=Clinical Psychology & Psychotherapy |language=en |pages=cpp.2769 |doi=10.1002/cpp.2769 |pmid=35776063 |s2cid=250174275 |issn=1063-3995}}</ref> They may enjoy situations in which they can be the center of attention, and may feel uncomfortable when people are not paying attention to them.<ref name="Cleveland2" /> It is common for people with this disorder to flamboyant clothing, try [[body modification]]s,<ref>{{Cite journal |last1=Malick |first1=Farah |last2=Howard |first2=Josie |last3=Koo |first3=John |date=2008 |title=Understanding the psychology of the cosmetic patients |url=https://onlinelibrary.wiley.com/doi/10.1111/j.1529-8019.2008.00169.x |journal=Dermatologic Therapy |language=en |volume=21 |issue=1 |pages=47–53 |doi=10.1111/j.1529-8019.2008.00169.x |pmid=18318885 |s2cid=20474746 |issn=1396-0296}}</ref> and [[Factitious disorder imposed on self|fake medical conditions]] in an attempt to draw other's attention.<ref name="Cleveland2" /><ref>{{cite journal | url=https://pubmed.ncbi.nlm.nih.gov/17048160/ | pmid=17048160 | year=2006 | last1=Ritvo | first1=E. C. | last2=Melnick | first2=I. | last3=Marcus | first3=G. R. | last4=Glick | first4=I. D. | title=Psychiatric conditions in cosmetic surgery patients | journal=Facial Plastic Surgery | volume=22 | issue=3 | pages=194–197 | doi=10.1055/s-2006-950177 }}</ref> They may display inappropriately sexually provocative,<ref name=":1">{{Cite journal |last=Klonsky, Jane, Turkheimer, Oltmanns |first=E. David, J. Serrita, Eric, Thomas |year=2002 |title=Gender Role and Personality Disorders |journal=J Pers Disord |volume=16 |issue=5 |pages=464–76 |doi=10.1521/pedi.16.5.464.22121 |pmc=4364134 |pmid=12489312}}</ref><ref>{{Cite book |last1=White |first1=Robert Douglas |url=https://books.google.com/books?id=rHLqtIm71cAC&dq=Histrionic+personality+disorder+%22realistically%22&pg=PA190 |title=Working with Offenders: A Guide to Concepts and Practices |last2=Graham |first2=Hannah |date=2010 |publisher=Routledge |isbn=978-1-84392-794-5 |pages=190 |language=en}}</ref> flirtatious,<ref name="Cleveland2" /><ref>{{cite journal | url=https://pubmed.ncbi.nlm.nih.gov/25868053/ | pmid=25868053 | year=2015 | last1=Gazzillo | first1=F. | last2=Lingiardi | first2=V. | last3=Del Corno | first3=F. | last4=Genova | first4=F. | last5=Bornstein | first5=R. F. | last6=Gordon | first6=R. M. | last7=McWilliams | first7=N. | title=Clinicians' emotional responses and Psychodynamic Diagnostic Manual adult personality disorders: A clinically relevant empirical investigation | journal=Psychotherapy | volume=52 | issue=2 | pages=238–246 | doi=10.1037/a0038799 }}</ref><ref>Busch AM, Kanter JW, Callaghan GM, Baruch DE, Weeks CE, Berlin KS. [https://pubmed.ncbi.nlm.nih.gov/19647529/ A micro-process analysis of Functional Analytic Psychotherapy's mechanism of change]. Behav Ther. 2009 Sep;40(3):280-90. doi: 10.1016/j.beth.2008.07.003. Epub 2009 Jan 21. PMID 19647529.</ref> or exploitative behavior.<ref name=":2">{{Cite journal |last=Kaplan |first=Marcie |date=July 1983 |title=A Women's View on DSM-III |url=https://pdfs.semanticscholar.org/74cc/0e0c7579a914c66173bc9e5f05fefc3c09e4.pdf |url-status=dead |journal=American Psychologist |volume=38 |issue=7 |pages=786–792 |doi=10.1037/0003-066x.38.7.786 |pmid=6614624 |archive-url=https://web.archive.org/web/20180316152728/https://pdfs.semanticscholar.org/74cc/0e0c7579a914c66173bc9e5f05fefc3c09e4.pdf |archive-date=2018-03-16 |access-date=2018-03-16 |s2cid=37908061}}</ref> [[Sexting]] and [[exhibitionist]] behavior are also behaviors people with this condition sometimes exhibit.<ref>Ferguson CJ. [https://pubmed.ncbi.nlm.nih.gov/21153441/ Sexting behaviors among young Hispanic women: incidence and association with other high-risk sexual behaviors]. Psychiatr Q. 2011 Sep;82(3):239-43. doi: 10.1007/s11126-010-9165-8. PMID 21153441.</ref> Some people with histrionic traits or personality disorder change their seduction technique into a more maternal or paternal style as they age.<ref name="AMN2">{{cite web |last=Arthur |first=Melissa |year=2006 |title=Histrionic Personality Disorder |url=http://www.health.am/psy/histrionic-personality-disorder/ |url-status=live |archive-url=https://web.archive.org/web/20070212190602/http://www.health.am/psy/histrionic-personality-disorder/ |archive-date=2007-02-12 |access-date=10 January 2007 |work=Histrionic Personality Disorder: Description, Incidence, Prevalence, Risk Factors, Causes, Associated Conditions, Diagnosis, Signs and symptoms and treatment |publisher=Armenian Medical Network}}</ref> When their desire for attention is not met, it can heighten the severity of their symptoms.<ref>{{Cite journal |last1=Duncan* |first1=Cameron |last2=Mellum |first2=Nathanael |last3=Cuneo |first3=Candie |last4=Anukam |first4=Doris |last5=Anderson-Monroe |first5=Cassandra |date=2020-10-13 |title=Understanding Histrionic Personality Disorder: A Guide for APRNs |url=https://www.gavinpublishers.com/article/view/understanding-histrionic-personality-disorder-a-guide-for-aprns |journal=International Journal of Nursing and Health Care Research |language=en |issn=2688-9501}}</ref> They tend to be impressionable and easily manipulatable, especially by those they respect.<ref name="Cleveland2" /><ref>{{Cite web |date=2020-09-08 |title=Cluster B personality disorders: Types and symptoms |url=https://www.medicalnewstoday.com/articles/320508 |access-date=2022-07-22 |website=www.medicalnewstoday.com |language=en}}</ref><ref>{{Cite web |title=Histrionic Personality Disorder {{!}} Psychology Today |url=https://www.psychologytoday.com/us/conditions/histrionic-personality-disorder |access-date=2018-04-24 |website=Psychology Today |language=en}}</ref>
+Research has also shown those with histrionic personality have a greater desire for social approval and reassurance and will constantly seek it out, making those with HPD more vulnerable to social media addiction.<ref>{{Cite journal |last1=Savci |first1=Mustafa |last2=Turan |first2=Mehmet Emin |last3=Griffiths |first3=Mark D. |last4=Ercengiz |first4=Mustafa |date=2021 |title=Histrionic Personality, Narcissistic Personality, and Problematic Social Media Use: Testing of a New Hypothetical Model |url=https://link.springer.com/10.1007/s11469-019-00139-5 |journal=International Journal of Mental Health and Addiction |language=en |volume=19 |issue=4 |pages=986–1004 |doi=10.1007/s11469-019-00139-5 |issn=1557-1874 |s2cid=204887310}}</ref> People with this disorder often display excessive sensitivity to [[criticism]] or disapproval.<ref>{{Cite book |last=Sperry |first=Len |url=https://books.google.com/books?id=VSQ1cDjxsPkC&dq=%22Histrionic+personality+disorder+AND+%22sensitive%22&pg=PA135 |title=Handbook of Diagnosis and Treatment of DSM-IV Personality Disorders |date=2013-05-13 |publisher=Routledge |isbn=978-1-135-95083-5 |pages=135 |language=en}}</ref> They will work hard to get others to pay attention to them,<ref>{{Cite web |title=Histrionic Personality Disorder (HPD) - Psychiatric Disorders |url=https://www.msdmanuals.com/en-gb/professional/psychiatric-disorders/personality-disorders/histrionic-personality-disorder-hpd?ruleredirectid=382 |access-date=2022-07-25 |website=MSD Manual Professional Edition |language=en-GB}}</ref> possibly as a method of testing the stability of relationships.<ref>{{Cite journal |last1=Babl |first1=Anna |last2=Gómez Penedo |first2=Juan Martín |last3=Berger |first3=Thomas |last4=Schneider |first4=Noemi |last5=Sachse |first5=Rainer |last6=Kramer |first6=Ueli |date=2022-07-06 |title=Change processes in psychotherapy for patients presenting with histrionic personality disorder |url=https://onlinelibrary.wiley.com/doi/10.1002/cpp.2769 |journal=Clinical Psychology & Psychotherapy |language=en |pages=cpp.2769 |doi=10.1002/cpp.2769 |pmid=35776063 |s2cid=250174275 |issn=1063-3995}}</ref> They may enjoy situations in which they can be the center of attention, and may feel uncomfortable when people are not paying attention to them.<ref name="Cleveland2" /> It is common for people with this disorder to flamboyant clothing, try [[body modification]]s,<ref>{{Cite journal |last1=Malick |first1=Farah |last2=Howard |first2=Josie |last3=Koo |first3=John |date=2008 |title=Understanding the psychology of the cosmetic patients |url=https://onlinelibrary.wiley.com/doi/10.1111/j.1529-8019.2008.00169.x |journal=Dermatologic Therapy |language=en |volume=21 |issue=1 |pages=47–53 |doi=10.1111/j.1529-8019.2008.00169.x |pmid=18318885 |s2cid=20474746 |issn=1396-0296}}</ref> and [[Factitious disorder imposed on self|fake medical conditions]] in an attempt to draw other's attention.<ref name="Cleveland2" /><ref>{{cite journal | url=https://pubmed.ncbi.nlm.nih.gov/17048160/ | pmid=17048160 | year=2006 | last1=Ritvo | first1=E. C. | last2=Melnick | first2=I. | last3=Marcus | first3=G. R. | last4=Glick | first4=I. D. | title=Psychiatric conditions in cosmetic surgery patients | journal=Facial Plastic Surgery | volume=22 | issue=3 | pages=194–197 | doi=10.1055/s-2006-950177 }}</ref> They may display inappropriately sexually provocative,<ref name=":1">{{Cite journal |last=Klonsky, Jane, Turkheimer, Oltmanns |first=E. David, J. Serrita, Eric, Thomas |year=2002 |title=Gender Role and Personality Disorders |journal=J Pers Disord |volume=16 |issue=5 |pages=464–76 |doi=10.1521/pedi.16.5.464.22121 |pmc=4364134 |pmid=12489312}}</ref><ref>{{Cite book |last1=White |first1=Robert Douglas |url=https://books.google.com/books?id=rHLqtIm71cAC&dq=Histrionic+personality+disorder+%22realistically%22&pg=PA190 |title=Working with Offenders: A Guide to Concepts and Practices |last2=Graham |first2=Hannah |date=2010 |publisher=Routledge |isbn=978-1-84392-794-5 |pages=190 |language=en}}</ref> flirtatious,<ref name="Cleveland2" /><ref>{{cite journal | url=https://pubmed.ncbi.nlm.nih.gov/25868053/ | pmid=25868053 | year=2015 | last1=Gazzillo | first1=F. | last2=Lingiardi | first2=V. | last3=Del Corno | first3=F. | last4=Genova | first4=F. | last5=Bornstein | first5=R. F. | last6=Gordon | first6=R. M. | last7=McWilliams | first7=N. | title=Clinicians' emotional responses and Psychodynamic Diagnostic Manual adult personality disorders: A clinically relevant empirical investigation | journal=Psychotherapy | volume=52 | issue=2 | pages=238–246 | doi=10.1037/a0038799 }}</ref><ref>{{cite journal | url=https://pubmed.ncbi.nlm.nih.gov/19647529/ | pmid=19647529 | year=2009 | last1=Busch | first1=A. M. | last2=Kanter | first2=J. W. | last3=Callaghan | first3=G. M. | last4=Baruch | first4=D. E. | last5=Weeks | first5=C. E. | last6=Berlin | first6=K. S. | title=A micro-process analysis of Functional Analytic Psychotherapy's mechanism of change | journal=Behavior Therapy | volume=40 | issue=3 | pages=280–290 | doi=10.1016/j.beth.2008.07.003 }}</ref> or exploitative behavior.<ref name=":2">{{Cite journal |last=Kaplan |first=Marcie |date=July 1983 |title=A Women's View on DSM-III |url=https://pdfs.semanticscholar.org/74cc/0e0c7579a914c66173bc9e5f05fefc3c09e4.pdf |url-status=dead |journal=American Psychologist |volume=38 |issue=7 |pages=786–792 |doi=10.1037/0003-066x.38.7.786 |pmid=6614624 |archive-url=https://web.archive.org/web/20180316152728/https://pdfs.semanticscholar.org/74cc/0e0c7579a914c66173bc9e5f05fefc3c09e4.pdf |archive-date=2018-03-16 |access-date=2018-03-16 |s2cid=37908061}}</ref> [[Sexting]] and [[exhibitionist]] behavior are also behaviors people with this condition sometimes exhibit.<ref>{{cite journal | url=https://pubmed.ncbi.nlm.nih.gov/21153441/ | pmid=21153441 | year=2011 | last1=Ferguson | first1=C. J. | title=Sexting behaviors among young Hispanic women: Incidence and association with other high-risk sexual behaviors | journal=The Psychiatric Quarterly | volume=82 | issue=3 | pages=239–243 | doi=10.1007/s11126-010-9165-8 | s2cid=29980530 }}</ref> Some people with histrionic traits or personality disorder change their seduction technique into a more maternal or paternal style as they age.<ref name="AMN2">{{cite web |last=Arthur |first=Melissa |year=2006 |title=Histrionic Personality Disorder |url=http://www.health.am/psy/histrionic-personality-disorder/ |url-status=live |archive-url=https://web.archive.org/web/20070212190602/http://www.health.am/psy/histrionic-personality-disorder/ |archive-date=2007-02-12 |access-date=10 January 2007 |work=Histrionic Personality Disorder: Description, Incidence, Prevalence, Risk Factors, Causes, Associated Conditions, Diagnosis, Signs and symptoms and treatment |publisher=Armenian Medical Network}}</ref> When their desire for attention is not met, it can heighten the severity of their symptoms.<ref>{{Cite journal |last1=Duncan* |first1=Cameron |last2=Mellum |first2=Nathanael |last3=Cuneo |first3=Candie |last4=Anukam |first4=Doris |last5=Anderson-Monroe |first5=Cassandra |date=2020-10-13 |title=Understanding Histrionic Personality Disorder: A Guide for APRNs |url=https://www.gavinpublishers.com/article/view/understanding-histrionic-personality-disorder-a-guide-for-aprns |journal=International Journal of Nursing and Health Care Research |language=en |issn=2688-9501}}</ref> They tend to be impressionable and easily manipulatable, especially by those they respect.<ref name="Cleveland2" /><ref>{{Cite web |date=2020-09-08 |title=Cluster B personality disorders: Types and symptoms |url=https://www.medicalnewstoday.com/articles/320508 |access-date=2022-07-22 |website=www.medicalnewstoday.com |language=en}}</ref><ref>{{Cite web |title=Histrionic Personality Disorder {{!}} Psychology Today |url=https://www.psychologytoday.com/us/conditions/histrionic-personality-disorder |access-date=2018-04-24 |website=Psychology Today |language=en}}</ref>
-Patients with HPD are usually high-functioning, both socially and professionally. They usually have good [[social skills]], despite tending to use them to make themselves the center of attention.<ref name="Cleveland2" /> HPD may also affect a person's social and [[Romance (love)|romantic]] relationships, as well as their ability to cope with losses or failures. People with HPD tend to consider relationships closer than they usually are.<ref>Cunliffe T, Gacono CB. [https://pubmed.ncbi.nlm.nih.gov/16260481/ A Rorschach investigation of incarcerated female offenders with antisocial personality disorder]. Int J Offender Ther Comp Criminol. 2005 Oct;49(5):530-46. doi: 10.1177/0306624X04273198. PMID 16260481.</ref><ref name=":3">{{Citation |last1=French |first1=Jennifer H. |title=Histrionic Personality Disorder |date=2022 |url=http://www.ncbi.nlm.nih.gov/books/NBK542325/ |work=StatPearls |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=31194465 |access-date=2022-07-21 |last2=Shrestha |first2=Sangam}}</ref><ref>{{Cite web |title=Histrionic Personality Disorder (HPD) - Psychiatric Disorders |url=https://www.msdmanuals.com/en-gb/professional/psychiatric-disorders/personality-disorders/histrionic-personality-disorder-hpd |access-date=2022-07-25 |website=MSD Manual Professional Edition |language=en-GB}}</ref> They may seek treatment for [[clinical depression]] when romantic (or other close personal) relationships end.<ref name=":3" /> [[Substance use disorder|Substance disorders]],<ref>{{Cite journal |last1=Noorbakhsh |first1=Simasadat |last2=Zeinodini |first2=Zahra |last3=Khanjani |first3=Zeynab |last4=Poorsharifi |first4=Hamid |last5=Rajezi Esfahani |first5=Sepideh |date=2015 |title=Personality Disorders, Narcotics, and Stimulants; Relationship in Iranian Male Substance Dependents Population |journal=Iranian Red Crescent Medical Journal |volume=17 |issue=6 |pages=e23038 |doi=10.5812/ircmj.23038v2 |issn=2074-1804 |pmc=4553170 |pmid=26328064}}</ref><ref>Lorea I, Fernández-Montalvo J, López-Goñi JJ, Landa N. [https://pubmed.ncbi.nlm.nih.gov/19333525/ Adicción a la cocaína y trastornos de personalidad: un estudio con el MCMI-II] [Cocaine addiction and personality disorders: a study with the MCMI-II]. Adicciones. 2009;21(1):57-63. Spanish. PMID 19333525.</ref> such as [[Alcoholism|Alcohol Use Disorder]] or [[Opioid use disorder]],<ref>{{Cite journal |last1=Albein-Urios |first1=Natalia |last2=Verdejo-Román |first2=Juan |last3=Soriano-Mas |first3=Carles |last4=Asensio |first4=Samuel |last5=Martínez-González |first5=José Miguel |last6=Verdejo-García |first6=Antonio |date=2013 |title=Cocaine users with comorbid Cluster B personality disorders show dysfunctional brain activation and connectivity in the emotional regulation networks during negative emotion maintenance and reappraisal |url=https://pubmed.ncbi.nlm.nih.gov/23712090/ |journal=European Neuropsychopharmacology: The Journal of the European College of Neuropsychopharmacology |volume=23 |issue=12 |pages=1698–1707 |doi=10.1016/j.euroneuro.2013.04.012 |issn=1873-7862 |pmid=23712090|s2cid=12081832 }}</ref><ref>{{Cite journal |last1=González |first1=Ester |last2=Arias |first2=Francisco |last3=Szerman |first3=Nestor |last4=Vega |first4=Pablo |last5=Mesias |first5=Beatriz |last6=Basurte |first6=Ignacio |date=2019 |title=Coexistence between personality disorders and substance use disorder. Madrid study about prevalence of dual pathology |url=https://pubmed.ncbi.nlm.nih.gov/31869422/ |journal=Actas Españolas de Psiquiatría |volume=47 |issue=6 |pages=218–228 |issn=1578-2735 |pmid=31869422}}</ref> are all common in patients with Histrionic Personality Disorder.<ref name=":4">{{Cite journal |last=Torgersen, Lygren, Øien, Skre, Onstad, Edvardsen, Tambs, Kringlen |first=Svenn, Sissel, Per Anders, Ingunn, Sidsel, Jack, Kristian, Einar |date=November 2000 |title=A Twin Studies of Personality Disorders |journal=Comprehensive Psychiatry |volume=41 |issue=6 |pages=416–425 |doi=10.1053/comp.2000.16560 |pmid=11086146}}</ref><ref>Gillespie NA, Aggen SH, Neale MC, Knudsen GP, Krueger RF, South SC, Czajkowski N, Nesvåg R, Ystrom E, Kendler KS, Reichborn-Kjennerud T. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6043378/ Associations between personality disorders and cannabis use and cannabis use disorder: a population-based twin study]. Addiction. 2018 Aug;113(8):1488-1498. doi: 10.1111/add.14209. Epub 2018 Apr 13. PMID 29500852; PMCID: PMC6043378.</ref> They are also at higher risks of [[suicide]],<ref>Shafiee-Kandjani AR, Amiri S, Arfaie A, Ahmadi A, Farvareshi M. [https://pubmed.ncbi.nlm.nih.gov/27433491/ Relationship between Personality Profiles and Suicide Attempt via Medicine Poisoning among Hospitalized Patients: A Case-Control Study.] Int Sch Res Notices. 2014 Nov 20;2014:675480. doi: 10.1155/2014/675480. PMID 27433491; PMCID: PMC4897309.</ref><ref>Ortigo KM, Westen D, Bradley B. [https://pubmed.ncbi.nlm.nih.gov/19752649/ Personality subtypes of suicidal adults]. J Nerv Ment Dis. 2009 Sep;197(9):687-94. doi: 10.1097/NMD.0b013e3181b3b13f. PMID 19752649; PMCID: PMC2746062.</ref> [[Body dysmorphic disorder|body dysmorphia]],<ref>Gruber M, Jahn R, Stolba K, Ossege M. [https://pubmed.ncbi.nlm.nih.gov/28791577/ "Das Barbie Syndrom“. Ein Fallbericht über die Körperdysmorphe Störung] ['Barbie Doll Syndrome'. A case report of body dysmorphic disorder]. Neuropsychiatr. 2018 Mar;32(1):44-49. German. doi: 10.1007/s40211-017-0241-2. Epub 2017 Aug 8. PMID 28791577.</ref><ref>Holt DJ, Phillips KA, Shapiro ER, Becker AE. [https://pubmed.ncbi.nlm.nih.gov/12893504/ "My Face Is My Fate": biological and psychosocial approaches to the treatment of a woman with obsessions and delusions.] Harv Rev Psychiatry. 2003 May-Jun;11(3):142-54. doi: 10.1080/10673220390217917. PMID 12893504; PMCID: PMC1622895.</ref> and [[divorce]].<ref>Disney KL, Weinstein Y, Oltmanns TF. [https://pubmed.ncbi.nlm.nih.gov/23244459/ Personality disorder symptoms are differentially related to divorce frequency]. J Fam Psychol. 2012 Dec;26(6):959-65. doi: 10.1037/a0030446. PMID 23244459; PMCID: PMC3569846.</ref> They may go through frequent job changes, as they become easily bored and may prefer withdrawing from [[frustration]] (instead of facing it). Because they tend to crave [[novelty]] and excitement, they may place themselves in risky situations. All of these factors may lead to greater risk of developing clinical depression.<ref name="ADAM2" /> People with this condition can have an impressionistic and undetailed style of speech.<ref name=":5">{{cite journal |author=Widiger, T. |year=1998 |title=Sex biases in the diagnosis of personality disorders |journal=Journal of Personality Disorders |volume=12 |issue=2 |pages=95–118 |doi=10.1521/pedi.1998.12.2.95 |pmid=9661097}}</ref>
+Patients with HPD are usually high-functioning, both socially and professionally. They usually have good [[social skills]], despite tending to use them to make themselves the center of attention.<ref name="Cleveland2" /> HPD may also affect a person's social and [[Romance (love)|romantic]] relationships, as well as their ability to cope with losses or failures. People with HPD tend to consider relationships closer than they usually are.<ref>{{cite journal | url=https://pubmed.ncbi.nlm.nih.gov/16260481/ | pmid=16260481 | year=2005 | last1=Cunliffe | first1=T. | last2=Gacono | first2=C. B. | title=A Rorschach investigation of incarcerated female offenders with antisocial personality disorder | journal=International Journal of Offender Therapy and Comparative Criminology | volume=49 | issue=5 | pages=530–546 | doi=10.1177/0306624X04273198 | s2cid=27327861 }}</ref><ref name=":3">{{Citation |last1=French |first1=Jennifer H. |title=Histrionic Personality Disorder |date=2022 |url=http://www.ncbi.nlm.nih.gov/books/NBK542325/ |work=StatPearls |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=31194465 |access-date=2022-07-21 |last2=Shrestha |first2=Sangam}}</ref><ref>{{Cite web |title=Histrionic Personality Disorder (HPD) - Psychiatric Disorders |url=https://www.msdmanuals.com/en-gb/professional/psychiatric-disorders/personality-disorders/histrionic-personality-disorder-hpd |access-date=2022-07-25 |website=MSD Manual Professional Edition |language=en-GB}}</ref> They may seek treatment for [[clinical depression]] when romantic (or other close personal) relationships end.<ref name=":3" /> [[Substance use disorder|Substance disorders]],<ref>{{Cite journal |last1=Noorbakhsh |first1=Simasadat |last2=Zeinodini |first2=Zahra |last3=Khanjani |first3=Zeynab |last4=Poorsharifi |first4=Hamid |last5=Rajezi Esfahani |first5=Sepideh |date=2015 |title=Personality Disorders, Narcotics, and Stimulants; Relationship in Iranian Male Substance Dependents Population |journal=Iranian Red Crescent Medical Journal |volume=17 |issue=6 |pages=e23038 |doi=10.5812/ircmj.23038v2 |issn=2074-1804 |pmc=4553170 |pmid=26328064}}</ref><ref>{{cite journal | url=https://pubmed.ncbi.nlm.nih.gov/19333525/ | pmid=19333525 | year=2009 | last1=Lorea | first1=I. | last2=Fernández-Montalvo | first2=J. | last3=López-Goñi | first3=J. J. | last4=Landa | first4=N. | title=Cocaine addiction and personality disorders: A study with the MCMI-II | journal=Adicciones | volume=21 | issue=1 | pages=57–63 | doi=10.20882/adicciones.252 }}</ref> such as [[Alcoholism|Alcohol Use Disorder]] or [[Opioid use disorder]],<ref>{{Cite journal |last1=Albein-Urios |first1=Natalia |last2=Verdejo-Román |first2=Juan |last3=Soriano-Mas |first3=Carles |last4=Asensio |first4=Samuel |last5=Martínez-González |first5=José Miguel |last6=Verdejo-García |first6=Antonio |date=2013 |title=Cocaine users with comorbid Cluster B personality disorders show dysfunctional brain activation and connectivity in the emotional regulation networks during negative emotion maintenance and reappraisal |url=https://pubmed.ncbi.nlm.nih.gov/23712090/ |journal=European Neuropsychopharmacology: The Journal of the European College of Neuropsychopharmacology |volume=23 |issue=12 |pages=1698–1707 |doi=10.1016/j.euroneuro.2013.04.012 |issn=1873-7862 |pmid=23712090|s2cid=12081832 }}</ref><ref>{{Cite journal |last1=González |first1=Ester |last2=Arias |first2=Francisco |last3=Szerman |first3=Nestor |last4=Vega |first4=Pablo |last5=Mesias |first5=Beatriz |last6=Basurte |first6=Ignacio |date=2019 |title=Coexistence between personality disorders and substance use disorder. Madrid study about prevalence of dual pathology |url=https://pubmed.ncbi.nlm.nih.gov/31869422/ |journal=Actas Españolas de Psiquiatría |volume=47 |issue=6 |pages=218–228 |issn=1578-2735 |pmid=31869422}}</ref> are all common in patients with Histrionic Personality Disorder.<ref name=":4">{{Cite journal |last=Torgersen, Lygren, Øien, Skre, Onstad, Edvardsen, Tambs, Kringlen |first=Svenn, Sissel, Per Anders, Ingunn, Sidsel, Jack, Kristian, Einar |date=November 2000 |title=A Twin Studies of Personality Disorders |journal=Comprehensive Psychiatry |volume=41 |issue=6 |pages=416–425 |doi=10.1053/comp.2000.16560 |pmid=11086146}}</ref><ref>{{cite journal | pmc=6043378 | year=2018 | last1=Gillespie | first1=N. A. | last2=Aggen | first2=S. H. | last3=Neale | first3=M. C. | last4=Knudsen | first4=G. P. | last5=Krueger | first5=R. F. | last6=South | first6=S. C. | last7=Czajkowski | first7=N. | last8=Nesvåg | first8=R. | last9=Ystrom | first9=E. | last10=Kendler | first10=K. S. | last11=Reichborn-Kjennerud | first11=T. | title=Associations Between Personality Disorders and Cannabis Use and Cannabis Use Disorder: A Population-Based Twin Study | journal=Addiction | volume=113 | issue=8 | pages=1488–1498 | doi=10.1111/add.14209 | pmid=29500852 }}</ref> They are also at higher risks of [[suicide]],<ref>{{cite journal | pmid=27433491 | year=2014 | last1=Shafiee-Kandjani | first1=A. R. | last2=Amiri | first2=S. | last3=Arfaie | first3=A. | last4=Ahmadi | first4=A. | last5=Farvareshi | first5=M. | title=Relationship between Personality Profiles and Suicide Attempt via Medicine Poisoning among Hospitalized Patients: A Case-Control Study | journal=International Scholarly Research Notices | volume=2014 | page=675480 | doi=10.1155/2014/675480 | pmc=4897309 | doi-access=free }}</ref><ref>{{cite journal | pmid=19752649 | year=2009 | last1=Ortigo | first1=K. M. | last2=Westen | first2=D. | last3=Bradley | first3=B. | title=Personality subtypes of suicidal adults | journal=The Journal of Nervous and Mental Disease | volume=197 | issue=9 | pages=687–694 | doi=10.1097/NMD.0b013e3181b3b13f | pmc=2746062 }}</ref> [[Body dysmorphic disorder|body dysmorphia]],<ref>{{cite journal | url=https://pubmed.ncbi.nlm.nih.gov/28791577/ | pmid=28791577 | year=2018 | last1=Gruber | first1=M. | last2=Jahn | first2=R. | last3=Stolba | first3=K. | last4=Ossege | first4=M. | title='Barbie Doll Syndrome'. A case report of body dysmorphic disorder | journal=Neuropsychiatrie | volume=32 | issue=1 | pages=44–49 | doi=10.1007/s40211-017-0241-2 | s2cid=148611124 }}</ref><ref>{{cite journal | pmid=12893504 | year=2003 | last1=Holt | first1=D. J. | last2=Phillips | first2=K. A. | last3=Shapiro | first3=E. R. | last4=Becker | first4=A. E. | title="My Face is My Fate": Biological and psychosocial approaches to the treatment of a woman with obsessions and delusions | journal=Harvard Review of Psychiatry | volume=11 | issue=3 | pages=142–154 | doi=10.1080/10673220303951 | pmc=1622895 }}</ref> and [[divorce]].<ref>{{cite journal | pmid=23244459 | year=2012 | last1=Disney | first1=K. L. | last2=Weinstein | first2=Y. | last3=Oltmanns | first3=T. F. | title=Personality disorder symptoms are differentially related to divorce frequency | journal=Journal of Family Psychology | volume=26 | issue=6 | pages=959–965 | doi=10.1037/a0030446 | pmc=3569846 }}</ref> They may go through frequent job changes, as they become easily bored and may prefer withdrawing from [[frustration]] (instead of facing it). Because they tend to crave [[novelty]] and excitement, they may place themselves in risky situations. All of these factors may lead to greater risk of developing clinical depression.<ref name="ADAM2" /> People with this condition can have an impressionistic and undetailed style of speech.<ref name=":5">{{cite journal |author=Widiger, T. |year=1998 |title=Sex biases in the diagnosis of personality disorders |journal=Journal of Personality Disorders |volume=12 |issue=2 |pages=95–118 |doi=10.1521/pedi.1998.12.2.95 |pmid=9661097}}</ref>
 Despite these traits they can be [[pride]]ful of their own personality, and may be unwilling to change, viewing any change as a threat. They may even blame their personal failures or disappointments on others.<ref name="AMN2" />

Classification	D ICD-10: F60.4 ICD-9-CM: 301.50 MeSH: D006677
External resources	MedlinePlus: 001531