Histrionic personality disorder

Q. What is a histrionic personality?

answered by Kim Mixon Hill, Advocate at Health Union (2018-present)

Histrionic personality disorder is not a disorder you hear about quite as much as some other disorders but believe it or not, it has been featured in movies and television shows like Criminal Minds. Here is a little on this disorder, how many people it affects, the problems it causes, and how it is treated.

Histrionic personality disorder only affects about 2 percent of the population. But when you think about the fact that over 2 million people are affected, it is important to know about this mental health disorder. It is interesting to note that more women are affected by histrionic personality disorder than men. In fact, this is by almost two thirds and there is a theory behind that. Some believe that with women, it is more socially acceptable to be provocative, one of the symptoms of the disorder.

What Is It Like?

A person with histrionic personality disorder may constantly seek attention, partake in seductive behavior, and overreact emotionally. Simply put, this person has to be the center of attention and may display inappropriate sexual behavior in order to do so.

What Causes It?

As far as what causes it, according to the experts:

There is no known specific cause for this disorder. Researchers do believe that genetics and even childhood events may be part of what causes histrionic personality disorder. HPD may be caused by biological, developmental, cognitive, and social factors.

Some factors include neurochemical or physiological causes, developmental causes, biosocial learning causes, sociocultural causes, and of course there are always personal variables.

For instance, under the developmental causation umbrella are variables such as repression, denial, dissociation, displacement, and rationalization.

Take personal variables, for example. It may be normal for a younger person to display seductive behavior for attention, but if this were to continue into adulthood, it may be indicative of histrionic personality disorder.

Now keep in mind that it’s not quite as simple as that. There are, in fact, groups of personality disorders called clusters. And anyone with histrionic personality disorder may be a part of one of the clusters.

The symptoms are complex but have a lot in common with being the center of attention. For example, a person with this disorder may persistently seek approval or attention. They may appear shallow, act seductive, and are easily influenced. Some may believe that a relationship is more serious than it really is and their emotions are exaggerated and dramatic.

How Is It Treated?

One of the issues with histrionic personality disorder is that the person with this condition may not realize it. Yet, the main type of therapy for this disorder is psychotherapy. The goal of the counselor is to uncover the fears and motivations of the patient to be able to help the patient relate to others in a positive and different way than before.


Elinor Greenberg – Thank you for the lovely clear summary of information. I especially like that you pointed out that this could occur in different diagnostic groups. For perspective, in my practice I have had histrionic clients with NPD, OCD, and one who had Schizoid Personality Disorder.

Karen Kessler – Dr. Greenberg, How did HPD and SPD manifest in that client? I am wondering what that looks like; the seductivemess and attention seeking in combination with the avoidance and fear of “real” intimacy. I can guess how that might have played out as a sort of “approach and avoid” dynamic or maybe “seduce and flirt but disappear before it gets too deep.” But I’m just guessing. That seems like an unusual comorbidity. Which was the more dominant PD?

Elinor Greenberg – He was not seductive. He was over the top dramatic in a way that is rare with clients with SPD. Check out Ralph Klein’s wonderful chapters on SPD in Disorders if the Self—The Master Approach. He was my teacher on Schizoid and the only one who described the Histrionic permutation of SPD to me in his work. I would have been quite confused about that client, if I had not trained with Dr. Klein at the Masterson Institute.

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