Histrionic personality disorder (HPD) is defined by the American Psychiatric Association The American Psychiatric Association is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the most influential worldwide. Its some 38,000 members are mainly American but some are international. The association publishes various journals and pamphlets, as well as the Diagnostic and Statistical as a personality disorder Personality disorders, formerly referred to as character disorders, are a class of personality types and behaviors that the American Psychiatric Association defines as "an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the culture of the individual who exhibits it". Personality disorders characterized by a pattern of excessive emotionality and attention-seeking, including an excessive need for approval and inappropriate seductiveness, usually beginning in early adulthood. These individuals are lively, dramatic, enthusiastic, and flirtatious.

They may be inappropriately sexually provocative, express strong emotions with an impressionistic style, and be easily influenced by others. Associated features may include egocentrism The term derives from the Greek and Latin egô / ego, meaning "I," "me," and "self". An egocentric person cannot fully empathize, i.e. "put himself in other peoples' shoes," and believes everyone sees what she/he sees, self-indulgence, continuous longing for appreciation, feelings that are easily hurt, and persistent manipulative Psychological manipulation is a type of social influence that aims to change the perception or behavior of others through underhanded, unfair tactics. By advancing only the interests of the manipulator, often at another's expense, such methods could be considered exploitative, abusive, devious, and deceptive behavior to achieve their own needs.

Contents

History

This section needs attention from an expert on the subject. See the talk page for details. WikiProject Psychology or the Psychology Portal Sigmund Freud was an Austrian neurologist and the founder of the psychoanalytic school of psychology. His therapeutic technique frequently involved talking with his patients while they reclined on his famous couch may be able to help recruit an expert. (October 2009)
This section contains information which may be of unclear or questionable importance or relevance to the article's subject matter. Please help improve this article by clarifying or removing superfluous information. (October 2009)

Histrionic personality disorder shares a divergent history with conversion disorder Conversion disorder is a condition where a patient displays neurological symptoms such as numbness, paralysis, or fits, even though no neurological explanation is found and it is determined that the symptoms are due to the patient's psychological response to stress. Conversion is a psychiatric diagnosis in the International Statistical and somatization disorder Somatization disorder is a psychiatric diagnosis applied to patients who chronically and persistently complain of varied physical symptoms that have no identifiable physical origin. One common general etiological explanation is that internal psychological conflicts are unconsciously expressed as physical signs. Patients with Somatization Disorder. Historically, they are linked to the ancient notion of hysteria Hysteria, in its colloquial use, describes a state of mind, one of unmanageable fear or emotional excesses. The fear is often caused by multiple events in one's past that involved some sort of severe conflict; the fear can be centered on a body part or most commonly on an imagined problem with that body part . See also Body dysmorphic disorder and, or "wandering womb The uterus is a major female hormone-responsive reproductive sex organ of most mammals, including humans. It is within the uterus that the fetus develops during gestation. The term uterus is used consistently within the medical and related professions; the Germanic term, womb is more common in everyday usage. The plural of uterus is uteruses or."[1](Note, however, that according to the Online Etymology Dictionary, the word "histrionic" derives not from the Greek hystera, but from the Latin histrionicus, "pertaining to an actor.") Ancient Greeks Ancient Greece is the civilization belonging to the period of Greek history lasting from the Archaic period of the 8th to 6th centuries BCE to 146 BCE and the Roman conquest of Greece after the Battle of Corinth. At the center of this time period is Classical Greece, which flourished during the 5th to 4th centuries BC, at first under Athenian thought that excessive emotionality in women was caused by a displaced uterus The uterus is a major female hormone-responsive reproductive sex organ of most mammals, including humans. It is within the uterus that the fetus develops during gestation. The term uterus is used consistently within the medical and related professions; the Germanic term, womb is more common in everyday usage. The plural of uterus is uteruses or and sexual discontent.

Christian ascetics Asceticism describes a lifestyle characterized by abstinence from various sorts of worldly pleasures (especially sexual activity and consumption of alcohol) often with the aim of pursuing religious and spiritual goals. Christianity and the Indian religions (including yoga) teach that salvation and liberation involve a process of mind-body during the Middle Ages The Middle Ages is a period of European history covering roughly a millennium from the 5th century through to the 16th century. It is commonly dated from the fall of the Western Roman Empire, and contrasted with a later Early Modern Period; the time during which the rise of humanism in the Italian Renaissance and the Reformation unfolded, are blamed women's mental problems on witchcraft Witchcraft, in various historical, anthropological, religious and mythological contexts, is the use of certain kinds of supernatural or magical powers. Witchcraft can refer to the use of such powers in order to inflict harm or damage upon members of a community or their property. Other uses of the term distinguish between bad witchcraft and good, sexual hunger, moral weakness, and demonic possession Demonic possession is often the term used to describe the control over a human form by a demon. Descriptions of demonic possessions often include: erased memories or personalities, convulsions, “fits” and fainting as if one were dying. Unlike in channeling or other forms of possession, the subject has no control over the possessing entity and. By the 19th century, medical explanations proposed a weakness of women's nervous system The nervous system is an organ system containing a network of specialized cells called neurons that coordinate the actions of an animal and transmit signals between different parts of its body. In most animals the nervous system consists of two parts, central and peripheral. The central nervous system contains the brain and spinal cord. The related to biological sex. Thus, "hysteria" reflected the stereotype A stereotype is a commonly held public belief about specific social groups, or types of individuals. The concepts of "stereotype" and "prejudice" are often confused with many other different meanings. Stereotypes are standardized and simplified conceptions of groups, based on some prior assumptions for women as vulnerable, inferior, and emotionally unbalanced. The extent to which the definition of histrionic personality disorder currently reflects gender bias Sexism, a term coined in the mid-20th century, is the belief or attitude that one gender or sex is inferior to, less competent, or less valuable than the other. It can also refer to hatred of, or prejudice towards, either sex as a whole , or the application of stereotypes of masculinity in relation to men, or of femininity in relation to women. It remains the subject of a controversy.

"Hysteria" differentiated into conversion hysteria (later to become conversion disorder Conversion disorder is a condition where a patient displays neurological symptoms such as numbness, paralysis, or fits, even though no neurological explanation is found and it is determined that the symptoms are due to the patient's psychological response to stress. Conversion is a psychiatric diagnosis in the International Statistical) and hysterical personality (later to become histrionic personality disorder) in the psychoanalytic literature as well as with the writings of Kraepelin Emil Kraepelin was a German psychiatrist. The Encyclopedia of Psychology by H. J. Eysenck identifies him as the founder of contemporary scientific psychiatry, as well as of psychopharmacology and psychiatric genetics. Kraepelin believed the chief origin of psychiatric disease to be biological and genetic malfunction. His theories dominated the, Schneider, and others. Sigmund Freud Sigmund Freud , born Sigismund Schlomo Freud (May 6, 1856 – September 23, 1939), was a Jewish-Austrian neurologist who founded the psychoanalytic school of psychiatry. Freud is best known for his theories of the unconscious mind and the defense mechanism of repression and for creating the clinical practice of psychoanalysis for treating wrote primarily about conversion hysteria Conversion disorder is a condition where patients present with neurological symptoms such as numbness, paralysis, or fits, but where positive physical signs of hysteria can be found. It is thought that these problems arise in response to difficulties in the patient's life, and conversion is considered a psychiatric disorder in the International. Wilhelm Reich Wilhelm Reich was an Austrian-American psychiatrist and psychoanalyst, known as one of the most radical figures in the history of psychiatry. He was the author of several notable textbooks, including The Mass Psychology of Fascism and Character Analysis, both published in 1933 wrote about hysteria as a set of personality characteristics and differentiated conversion hysteria as a transient disorder from hysterical character. These early conceptualizations of both kinds of hysteria carried notions of women's deficiency due to penis envy and feelings of castration Castration is any action, surgical, chemical, or otherwise, by which a male loses the functions of the testicles or a female loses the functions of the ovaries. The term "castration" generally refers to males, but may occasionally refer to females. Paul Chodoff has written about the ways in which these diagnoses paralleled the misogynistic Marcus Tullius Cicero reports that Greek philosophers considered misogyny to be caused by gynophobia, a fear of women. In the late 20th century, feminist theorists proposed misogyny as both a cause and result of patriarchal social structures sentiment of the times.

The concept of hysterical personality was well developed by the mid-20th century and strongly resembled the current definition of histrionic personality disorder.[citation needed] The first DSM The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders. It is used in the United States and in varying degrees around the world, by clinicians, researchers, psychiatric drug regulation agencies, featured a symptom-based category, "hysteria" (conversion) and a personality-based category, "emotionally unstable personality." DSM-II The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides diagnostic criteria for mental disorders. It is used in the United States and in varying degrees around the world, by clinicians, researchers, psychiatric drug regulation agencies, health insurance companies, pharmaceutical distinguished between hysterical neurosis Neurosis is a class of functional mental disorders involving distress but neither delusions nor hallucinations, where behavior is not outside socially acceptable norms. It is also known as psychoneurosis or neurotic disorder, and thus those suffering from it are said to be neurotic. Once a common psychiatric diagnosis, the term is no longer part (conversion reaction and dissociative Dissociatives are a class of psychoactive drugs which are said to reduce or block signals to the conscious mind from other parts of the brain. Although many kinds of drugs are capable of such action, dissociatives are unique in that they do so in such a way that they produce hallucinogenic effects, which may include sensory deprivation, reaction) and hysterical (histrionic) personality.

In DSM-III The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides diagnostic criteria for mental disorders. It is used in the United States and in varying degrees around the world, by clinicians, researchers, psychiatric drug regulation agencies, health insurance companies, pharmaceutical, the term hysterical personality changed to histrionic personality disorder to emphasize the histrionic (derived from the Latin Latin is an Italic language originally spoken in Latium and Ancient Rome. With the Roman conquest, Latin was spread to countries around the Mediterranean, including a large part of Europe. Romance languages such as Aragonese, Corsican, Catalan, French, Italian, Portuguese, Romanian, Sardinian, Spanish and others, are descended from Latin, while word histrio, or actor) behavior pattern and to reduce the confusion caused by the historical links of hysteria to conversion symptoms. The landmark case of Ruth E. helped to fully define and emphasize the characteristics of the current DSM-IV diagnostic. DSM-III-R The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides diagnostic criteria for mental disorders. It is used in the United States and in varying degrees around the world, by clinicians, researchers, psychiatric drug regulation agencies, health insurance companies, pharmaceutical attempted to reduce the overlap between Histrionic Personality Disorder and borderline personality disorder Borderline personality disorder is a personality disorder defined in DSM-IV and described as a prolonged disturbance of personality function in a person (generally over the age of eighteen years, although it is also found in adolescents), characterized by depth and variability of moods. The disorder typically involves unusual levels of instability by dropping three overlapping criteria and adding two criteria that emphasized histrionicity. DSM-IV dropped two more criteria that did not appear to contribute to the consistency of the diagnosis, according to research done by Bruce Pfohl.

Diagnosis

The person's appearance, behavior, and history, along with a psychological evaluation A psychological evaluation or mental examination is an examination into a person's mental health by a mental health professional such as a psychologist. A psychological evaluation may result in a diagnosis[dubious – discuss] of a mental illness. It is the mental equivalent of a physical examination, are usually sufficient to establish the diagnosis. There is no test to confirm this diagnosis. Because the criteria are subjective, some people may be wrongly diagnosed as having the disorder while others with the disorder may not be diagnosed. Treatment is often prompted by depression associated with dissolved romantic relationships. Medication does little to affect this personality disorder, but may be helpful with symptoms such as depression. Psychotherapy Psychotherapy or personal counseling with a psychotherapist, is an intentional interpersonal relationship used by trained psychotherapists to aid a client or patient in problems of living may also be of benefit.[2]

Mnemonic

A mnemonic A mnemonic device is a mind memory and/or learning aid. Commonly, mnemonics are verbal—such as a very short poem or a special word used to help a person remember something—but may be visual, kinesthetic or auditory. Mnemonics rely on associations between easy-to-remember constructs which can be related back to the data that is to be remembered that can be used to remember the criteria for histrionic personality disorder is PRAISE ME:[3][4]

Characteristics

People with this disorder are usually able to function at a high level and can be successful socially and professionally. People with histrionic personality disorder usually have good social skills A social skill is any skill facilitating interaction and communication with others. Social rules and relations are created, communicated, and changed in verbal and nonverbal ways. The process of learning such skills is called socialization, but they tend to use these skills to manipulate Psychological manipulation is a type of social influence that aims to change the perception or behavior of others through underhanded, unfair tactics. By advancing only the interests of the manipulator, often at another's expense, such methods could be considered exploitative, abusive, devious, and deceptive other people and become the center of attention.[5] Furthermore, histrionic personality disorder may affect a person's social or romantic Romance is a general term that refers to the attempt to express love with words or deeds. It also refers to feelings of excitement associated with love relationships or their ability to cope with losses or failures.

People with this disorder lack genuine empathy The English word is derived from the Greek word ἐμπάθεια , "physical affection, passion, partiality" which comes from ἐν (en), "in, at" + πάθος (pathos), "passion" or "suffering". The term was adapted by Theodore Lipps to create the German word Einfühlung ("feeling into") from. They start relationships well but tend to falter when depth and durability are needed, alternating between extremes of idealization and devaluation When an individual is unable to integrate difficult feelings, specific defenses are mobilized to regulate these unbearable feelings. The defense that helps in this process is called splitting. Splitting is the tendency to view events or people as either all bad or all good. When viewing people as all good, you are said to be using the defense. They may seek treatment for depression Major depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and loss of interest or pleasure in normally enjoyable activities. The term "major depressive disorder" was selected by the American Psychiatric Association to designate this symptom cluster as a mood disorder in when romantic relationships end, although this is by no means a feature exclusive to this disorder.

They often fail to see their own personal situation realistically, instead tending to dramatize and exaggerate their difficulties. They may go through frequent job changes, as they become easily bored and have trouble dealing with frustration Frustration is a common emotional response to opposition. Related to anger and disappointment, it arises from the perceived resistance to the fulfillment of individual will. The greater the obstruction, and the greater the will, the more the frustration is likely to be. Causes of frustration may be internal or external. In people, internal. 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 depression.

Additional symptoms include:

Diagnostic criteria (DSM-IV-TR = 301.50)

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The Diagnostic and Statistical Manual of Mental Disorders The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders. It is used in the United States and in varying degrees around the world, by clinicians, researchers, psychiatric drug regulation agencies, fourth edition, DSM IV-TR, a widely used manual for diagnosing mental disorders, defines histrionic personality disorder (in Axis II Cluster B) as:[7]

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:
  1. is uncomfortable in situations in which he or she is not the center of attention
  2. interaction with others is often characterized by inappropriate sexually seductive or provocative behavior
  3. displays rapidly shifting and shallow expression of emotions
  4. consistently uses physical appearance to draw attention to self
  5. has a style of speech that is excessively impressionistic and lacking in detail
  6. shows self-dramatization, theatricality, and exaggerated expression of emotion
  7. is suggestible, i.e., easily influenced by others or circumstances
  8. considers relationships to be more intimate than they actually are.

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

Diagnostic criteria (ICD-10)

The World Health Organization's ICD-10 lists histrionic personality disorder as (F 60.4) Histrionic personality disorder.[8]

It is characterized by at least 3 of the following:
  1. self-dramatization, theatricality, exaggerated expression of emotions;
  2. suggestibility, easily influenced by others or by circumstances;
  3. shallow and labile affectivity;
  4. continual seeking for excitement and activities in which the patient is the centre of attention;
  5. inappropriate seductiveness in appearance or behaviour;
  6. over-concern with physical attractiveness.

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

Millon's subtypes

Theodore Millon identified six subtypes of histrionic [9][10]. Any individual histrionic may exhibit none or one of the following:

Differential diagnosis: associated and overlapping conditions

The HPD is highly reactive. If there is another major disorder present, such as delusional disorder, then emotional intensity will create anger, rage, abuse and distance in relationships.

It is important for the therapist and family members to monitor and record all situations that trigger the HPD so that the deep underlying overload of pain can be accessed and released for therapeutic change.[11]

Prevalence (epidemiology)

This section requires expansion.

Major character traits may be inherited. Other character traits due to a phenotypical combination of genetics and environment, including childhood experiences[12]

Causes (etiology)

The cause of this disorder is unknown, but childhood events such as deaths in the immediate family, divorce of parents and genetics may be involved. Histrionic Personality Disorder is more often diagnosed in women than men; men with some quite similar symptoms are often diagnosed with antisocial personality disorder.[13]

Little research has been conducted to determine the biological sources of this disorder. Psychoanalytic theories incriminate authoritarian or distant attitudes by one or both of the parents of these patients, or love based on expectations from the child that can never be fully met.[14]

Treatment

Because of the lack of research support for work on personality disorders and long-term treatment with psychotherapy, the empirical findings on the treatment of these disorders remain based on the case report method and not on clinical trials. On the basis of case presentations, the treatment of choice is psychotherapy and/or cognitive-behavioral therapy, aimed at self-development through resolution of conflict and advancement of inhibited developmental lines. Group therapy can assist individuals with HPD to learn to decrease the display of excessively dramatic behaviors, but must be closely monitored because it may provide the person with an audience to play to (perform for), thus giving opportunity to perpetuate histrionic behavior.[15]

See also

References

  1. ^ Prochaska, J. & Norcross, J. (2007). Systems of Psychotherapy: A Transtheoretical Analysis.Belmont, CA: Thomson Brooks/Cole.
  2. ^ Psych Central: Histrionic Personality Disorder Treatment
  3. ^ Pinkofsky HB. Mnemonics for DSM-IV personality disorders. Psychiatr Serv. 1997 Sep;48(9):1197-8. PMID 9285984.
  4. ^ Personality Disorders. www.personalityresearch.org. URL: http://www.personalityresearch.org/pd.html. Accessed May 2, 2006.
  5. ^ Histrionic Personality Disorder
  6. ^ "Histrionic Personality Disorder". Histrionic Personality Disorder. The Cleveland Clinic. http://www.clevelandclinic.org/health/health-info/docs/3700/3795.asp?index=9743. Retrieved 2007-01-10.
  7. ^ Histrionic personality disorder - Diagnostic and Statistical Manual of Mental Disorders Fourth edition Text Revision (DSM-IV-TR) American Psychiatric Association (2000)
  8. ^ Histrionic personality disorder - International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10)
  9. ^ Millon, Theodore, Personality Disorders in Modern Life, 2004
  10. ^ Millon, Theodore - Personality Subtypes
  11. ^ "Histrionic Personality Disorder". Histrionic Personality Disorder. Recurrent Depression Inc. 2006. http://www.recurrentdepression.com/site/histrionic-personality-disorder/. Retrieved 2007-01-10.
  12. ^ "Histrionic Personality Disorder". Histrionic Personality Disorder: Description, Incidence, Prevalence, Risk Factors, Causes, Associated Conditions, Diagnosis, Signs and symptoms and treatment. Armenian Medical Network. 2006. http://www.health.am/psy/histrionic-personality-disorder/. Retrieved 2007-01-10.
  13. ^ Seligman, Martin E.P (1984). Abnormal Psychology. W. W. Norton & Company. ISBN 039394459X.
  14. ^ "Histrionic Personality Disorder". Personality Disorders. WebMD. 2006. http://www.emedicine.com/med/topic3472.htm. Retrieved 2007-01-10.
  15. ^ "Histrionic Personality Disorder". Histrionic Personality Disorder - Choice of Treatment. Armenian Medical Network. 2006. http://www.health.am/psy/more/histrionic_personality_disorder_pro/. Retrieved 2007-01-10.
  16. ^ "Histrionic Personality Disorder". Histrionic Personality Disorder - Choice of Treatment. Encyclopedia of Mental Disorders - Thomson Gale, a part of the Thomson Corporation. http://www.minddisorders.com/Flu-Inv/Histrionic-personality-disorder.html. Retrieved 2007-01-10.

External links

DSM personality disorders
DSM-III-R only Sadistic · Self-defeating (masochistic)
DSM-IV
Cluster A (odd) Paranoid · Schizoid · Schizotypal
Cluster B (dramatic) Antisocial · Borderline · Histrionic · Narcissistic
Cluster C (anxious) Avoidant · Dependent · Obsessive-compulsive
Personality disorder not otherwise specified
Appendix B (proposed) Depressive · Negativistic (passive-aggressive)
ICD-10 personality disorders
Schizotypal Schizotypal
Specific
Anankastic · Anxious (avoidant) · Dependent · Dissocial · Emotionally unstable · Histrionic · Paranoid · Schizoid ·
Other Eccentric · Haltlose type · Immature · Narcissistic · Passive-aggressive · Psychoneurotic
Unspecified Unspecified
Mixed and other Mixed and other

Categories: Personality disorders

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