The video below is the section for Histrionic Personality Disorder from Part 1 of TSM’s lecture series on DSM-5 and the EPPP, followed by a transcript. This lecture series aims to equip those preparing for the EPPP with everything they need to know about the impact DSM-5 will be having on the EPPP. To watch all of Part 1, click here.
Transcript of DSM-5 EPPP Lecture Video: Histrionic Personality Disorder
No changes were officially made to personality disorders in the DSM-5, although much research had gone into changing the classifications from “disorders” to “types” and there is still a desire by some to have personality disorders to be seen through more of a dimensional-categorical model. This alternative method of viewing personality disorders is included in a separate chapter in Section III of DSM-5. Interestingly, the DSM-5 work group recommended that Histrionic Personality Disorder still be represented as a disorder, rather than as a “type” (www.dsm5.org).
Histrionic Personality Disorder is a Cluster B Personality Disorder characterized by extreme emotionality and attention-seeking behavior.
Individuals with this disorder are usually not comfortable unless they are the center of attention. When attention is focused elsewhere, these individuals may engage in dramatic actions (e.g., making a scene, fabricating stories) in order to draw attention to themselves.
Individuals with Histrionic Personality Disorder may rely on their physical appearance in order to gain attention, often spending excessive time, money, and energy on their clothing or personal grooming.
They tend to be inappropriately sexually provocative in both dress and behavior. Although individuals with Histrionic Personality Disorder are excessive in their emotionality, their emotional expressions are typically shallow, with rapid shifts in affect. Overly dramatic or theatrical emotional displays are common.
Speech tends to be impressionistic, with sweeping generalizations that are lacking in detail.
Individuals with this disorder are generally passionate in their opinions, but can provide little rationale to back up their beliefs. This sort of superficiality extends to interpersonal relationships, as individuals with Histrionic Personality Disorder tend to view relationships as more intimate than they actually are (i.e., without adequate evidence to indicate intimacy). They may also abandon established relationships in favor of the excitement of a new relationship.
Novelty- and excitement-seeking behaviors are common in individuals with the disorder, as a high need for stimulation is often present. Situations in which gratification is delayed are met with frustration or anger. People with Histrionic Personality Disorder display a high degree of suggestibility and are easily influenced by others and current fads. These individuals tend to be overly trusting, especially of authority figures, who they see as having the ability to magically solve their problems.
In addition, people with Histrionic Personality Disorder depend upon others for validation. In order to obtain the approval of others, individuals with the disorder may engage in excessive flattery and gift giving.
The DSM-5 reports prevalence a rate of Histrionic Personality Disorder at 1.84%. A diagnosis of Histrionic Personality Disorder is associated with higher-than-average rates of Somatic Symptom Disorder, Conversion Disorder, and Major Depressive Disorder. Comorbidity with other personality disorders (e.g., Borderline, Narcissistic, Dependent, and Antisocial Personality Disorders) is common. In fact, there is some evidence to suggest that Histrionic Personality Disorder and Antisocial Personality Disorder are sex-typed expressions of the same underlying condition (Histrionic – or Borderline Personality Disorder – in women, Antisocial Personality Disorder in men).
Histrionic Personality Disorder
- A Cluster B Personality Disorder, marked by extreme emotionality and attention-seeking behavior; need to be the center of attention to be comfortable
- Overly dramatic/theatrical emotional displays are common, to draw attention; impressionistic speech
- Individuals rely on their physical appearance in order to gain attention; they tend to be inappropriately sexually provocative. Excessive yet shallow emotional expression
- Superficial interpersonal relationships; relationships may be perceived as more intimate than are in actuality
- Tendency to abandon established relationships in favor of excitement of a new relationship
- High novelty and excitement-seeking; delayed gratification met with frustration or anger
- High suggestibility; easily influenced by others and by current fads; overly trusting of authority figures
- Dependency upon others for validation; tendency for excessive flattery and gift-giving
Prevalence rate estimated at 1.84% percent; clear comorbidity with Somatization Disorder, Conversion Disorder, and Major Depressive Disorder, along with Borderline, Narcissistic, Dependent, and Antisocial Personality Disorder
635: Histrionic Personality Disorder is a diagnosis typically associated with women. Recent research suggests, however, that Histrionic Personality Disorder is a sex-typed manifestation of another underlying condition. While women with this condition are likely to display histrionic traits, men are likely to manifest the condition through:
A. Dependent Personality Disorder.
B. Schizoid Personality Disorder.
C. Narcissistic Personality Disorder.
D. Antisocial Personality Disorder.
RATIONALE: D is correct, as it may well be the case that, in men, the features of Antisocial Personality Disorder are a male counterpart of the symptoms of Histrionic Personality Disorder in women. None of the other responses, A, B, or C, has the corresponding features of emotional shallowness that make Histrionic and Antisocial Personality Disorders’ sex-typed manifestations of each other.