Theories Personality Psychology What Is Histrionic Personality Disorder (HPD)? By Kendra Cherry facebook twitter Kendra Cherry, MS, is an author, educational consultant, and speaker focused on helping students learn about psychology. Learn about our editorial process Kendra Cherry Medically reviewed by Medically reviewed by Akeem Marsh, MD on August 10, 2020 twitter linkedin Akeem Marsh, MD, is a board-certified child, adolescent, and adult psychiatrist who has dedicated his career to working with medically underserved communities. Learn about our Review Board Akeem Marsh, MD Updated on September 17, 2020 Print Francois De Heel / Getty Images Table of Contents View All What Is Histrionic Personality Disorder (HPD)? Symptoms Diagnosis Causes and Risk Factors Treatment Coping What Is Histrionic Personality Disorder (HPD)? Histrionic personality disorder is a mental condition characterized by a pattern of extreme emotionality and attention-seeking behavior that begins by early adulthood and is obvious in different situations. HPD is one of 10 personality disorders recognized in the DSM-5. It is classified as one of the Cluster B disorders, which are characterized as dramatic, overly emotional, and/or erratic. The word histrionic means “dramatic or theatrical." Roughly 9% of the general population in the U.S. has at least one personality disorder, and histrionic personality disorder affects approximately 2% to 3% of the general population. The disorder is characterized by shallow emotions, attention-seeking, and manipulative behavior. Introduction to the DSM Personality Disorders Symptoms In some cases, you may not realize that you have histrionic personality disorder because your way of thinking and behaving seems natural to you. And you may blame others for the challenges you face. People with histrionic personality disorder may: Display exaggerated symptoms of weakness or illness and may use threats of suicide to manipulate othersDisplay excessive but shallow emotions and attention-seeking behaviors (i.e., they are constantly “performing” in order to gain attention)Experience fleeting moods, opinions, and beliefs; they are also very suggestible and quick to respond to fadsNeed others to witness their emotional displays in order to gain validation or attentionUse sexually provocative behaviors to control others or gain attention Understanding Cluster B Personality Disorders Diagnosis Since HPD can have symptoms similar to other psychiatric disorders and medical illnesses, your doctor will likely first make a differential diagnosis to rule out other disorders or medical conditions that may be causing the symptoms. According to the DSM-5, a person must have five or more of the following signs or symptoms to be diagnosed with HPD: Discomfort in situations in which you're not the center of attentionInteraction with others that's often characterized by inappropriate sexually seductive or provocative behaviorRapidly shifting and shallow expression of emotionConsistently uses physical appearance to draw attention to selfStyle of speech that is excessively impressionistic and lacking in detailShows self-dramatization, theatricality, and exaggerated expression of emotionIs easily influenced by others or by circumstancesConsiders relationships to be more intimate than they actually are HPD vs. BPD There is a great deal of overlap between the features of histrionic personality disorder (HPD) and borderline personality disorder (BPD), so much so that some experts believe that HPD may not actually be distinguishable from BPD. According to DSM-5, "although borderline can also be characterized by attention-seeking, manipulative behavior, and rapidly shifting emotions, it is distinguished by self-destructiveness, angry disruptions in close relationships, and chronic feelings of deep emptiness and identity disturbance". The conditions share similarities including: Share the features of rapidly shifting and reactive emotionsAre associated with impulsive behaviorAre characterized by a very strong expression of emotion Some clinicians argue that the qualities of these symptoms are different in HPD versus BPD—specifically that the rapidly shifting emotions in HPD are not experienced with the same depth and intensity as those in BPD. Other experts, however, have argued that HPD and BPD are not necessarily distinct disorders. However, despite predictions that the HPD diagnosis would be dropped in DSM-5, it was not, and so it remains its own specific and unique diagnosis. What Is Borderline Personality Disorder (BPD)? Causes and Risk Factors Although the precise cause of histrionic personality disorder isn't known, it is thought to be caused by a combination of genetic and environmental influences. Your genes may make you vulnerable to developing a personality disorder, and a life situation may trigger the actual development. Genes: Certain personality traits may be passed on to you by your parents through inherited genes; these traits are sometimes called your temperament.Environment: Your environment involves the surroundings you grew up in, events that occurred, and relationships with family members and others. Other factors linked to an increased risk of developing or triggering personality disorders include: Parenting style, particularly inconsistent or over-indulgent boundariesParents who model dramatic or volatile behaviorsA family history of psychiatric disorders, substance use, or personality disordersChildhood trauma Related Conditions Histrionic personality disorder also tends to co-occur with other personality disorders, including: Borderline personality disorder (BPD) Narcissistic personality disorderDependent personality disorderSomatic symptom disorder There are only a few studies that have examined the co-occurrence of HPD and BPD. One often-quoted study found that HPD frequently occurs with BPD. In another study that used a community sample, about 10% of people with BPD also met criteria for HPD. Treatment Histrionic personality disorder is often difficult to treat, partly because people with the condition often seek treatment only when the disorder is causing them major problems or stress. When help is sought, treatment may include psychotherapy, medications, or a combination of the two along with lifestyle changes. Psychotherapy Psychotherapy can be effective in treating HPD, as it can help reduce emotional distress, improve self-esteem, and enhance the person's coping skills. Supportive psychotherapy is the preferred treatment of choice. This approach focuses on improving self-esteem, reducing emotional distress, and improving coping skills. Group therapy and family therapy are generally not recommended since HPD symptoms like seeking attention from group members and exaggerating symptoms may be triggered or worsened in a group atmosphere. The 9 Best Online Therapy Programs We've tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain. Medication While there are no FDA-approved medications for the treatment of histrionic personality disorder, medications may be used to treat affective dysregulation, or the mood swings, anger, tearfulness, anxiety, and depression that often accompany the disorder. Any associated depression or anxiety disorders could be treated with antidepressants. Holistic Therapy Mindfulness techniques, including yoga, tai chi, and biofeedback, may also help people with personality disorders control their inner feelings including impulsivity and emotional reactivity. Coping People with HPD often go underdiagnosed and undertreated, so perhaps the best way to improve your symptoms is to first identify them. With appropriate treatment, you can learn to manage symptoms and come up with a self-care plan to improve quality of life, including: Establishing consistent eating and sleeping scheduleExercising on a regular basisAvoiding drugs and alcoholEnlisting the help of trusted friends and family to keep you on track How to Cope With a Personality Disorder For Loved Ones If a friend or family member has histrionic personality disorder, it is important to encourage that person to seek help. Without professional treatment, it is unlikely that the symptoms and their related impacts on relationships will improve. Do your best to learn about HPD, including symptoms and treatment, so you can better understand and support your loved one. If you or a loved one are struggling with histrionic personality disorder, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.For more mental health resources, see our National Helpline Database. Was this page helpful? Thanks for your feedback! Ever wonder what your personality type means? Sign up to find out more in our Healthy Mind newsletter. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Angstman K, Rasmussen N. 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