The document discusses histrionic personality disorder. It defines histrionic PD according to the DSM-IV-TR as a pervasive pattern of excessive emotionality and attention seeking. Common characteristics include inappropriate seductiveness, need for approval, rapidly changing emotions, and exaggerated expressions of emotions. The causes may include dysfunctional family relationships, trauma, or biological factors. Treatment typically involves long-term psychotherapy to help patients develop healthier relationships and self-identity.

1. Presented by-
Jasleen Kaur Brar

2. INTRODUCTION
• The word personality is derived from the Greek term
persona.
• It was originally used to describe the theatrical mask
worn by some dramatic actors at the time. Over the
years, it lost its connotation of pretense and illusion
and came to represent the person behind the mask—
the “real” person.

3. • The Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition, Text Revision
(DSM-IV-TR) (American Psychiatric Association
[APA], 2000) defines personality traits as
“enduring patterns of perceiving, relating to,
and thinking about the environment and
oneself that are exhibited in a wide range of
social and personal contexts.”

4. Personality Disorders
• Personality disorders occur when these traits
become inflexible and maladaptive and cause
either significant functional impairment or
subjective distress.
• A personality disorder is an enduring pattern of
inner experience and behavior that deviates
markedly from the expectations of the individual’s
culture, is pervasive and inflexible, has an onset in
adolescence or early adulthood, is stable with time,
and leads to distress or impairment (American
Psychiatric Association [APA], 2000, p. 685).

5. Personality disorder subtypes classified
in DSM-IV TR
1. Cluster A: Behaviors described as odd or eccentric
• Paranoid personality disorder
• Schizoid personality disorder
• Schizotypal personality disorder
2. Cluster B: Behaviors described as dramatic, emotional, or
erratic
• Antisocial personality disorder
• Borderline personality disorder
• Histrionic personality disorder
• Narcissistic personality disorder
3. Cluster C: Behaviors described as anxious or fearful
• Avoidant personality disorder
• Dependent personality disorder
• Obsessive-compulsive personality disorder

6. Theories of Personality Disorders
• Family dynamics – growing up in a dysfunctional,
abusive, invalidating, overprotective, controlling,
or uncaring environment; poor parenting; parent-
child relationship
• Genetic Influences
• Biological/biochemical Influences
• Trauma & other significant experiences
• Continuum model – personality disorders
represent extreme variations of normal
personality traits

8. DEFINITION OF HISTRIONIC PERSONALITY
DISORDER
A pervasive pattern of excessive emotionality
and attention-seeking behavior
According to ICD-10 F60.4:- Histrionic
personality disorder is a pattern of excessive
emotionality and attention seeking including
an excessive need for approval and
inappropriate seductiveness.
• It begins in early adulthood

9. Facts & Figures:
• Prevalence: 2-3% in general population
• Gender: diagnosed more frequently in women;
prevalence may be equal for males & females
• Sex role stereotypes influence the behavioral
expression of the disorder
• Aging presents special difficulties
• Course: chronic, but may improve with age
• Contributing Factors: Unmet needs for attention
& success

10. ETIOLOGICAL FACTORS
FAILURE TO DEVELOP HEALTHY INTIMATE
RELATIONSHIPS
IRRATIONAL FORM OF THINKING
LACK OF TRUST ON SELF &OTHERS
MANIFESTATIONS
PSYCHODYNAMICS

11. MANIFESTATIONS
 Pervasive and excessive pattern of emotionality and
attention seeking, i.e. constant seeking of
reassurance or approval.
 Individuals are lively, excessive dramatics with
exaggerated display of emotions.
 Enthusiastic and flirtatious.
 Inappropriately seductive appearance or behavior.

12. • Excessive concern with physical appearance.
• Self centeredness, self indulgent and intensely
dependent on others.
• Low tolerance of frustration or delayed
gratification.
• Rapidly shifting emotional states that may
appear shallow

13.  Opinions are easily influenced by other people,
but difficult to back-up details.
 Tendency to believe that relationships are more
intimate than they actually are.
 Makes rash decisions.
 Threaten or attempts suicide to get attention.
 Inappropriately sexually provocative. Express
strong emotions with an impressionistic style.

14. • Project their own unrealistic fantasized
intentions onto people with whom they are
involved.
• Selection of marital or sexual partners is
highly inappropriate.
• Women may have inappropriate and intense
anger, may engage in manipulative suicide
threats by manipulating interpersonal
behavior.

15. • Males show identity diffusion, disturbed
relationships, lacks of impulse control
• Antisocial tendency are inclined to exploit physical
symptoms.
• Engage in uninhibited behavior.
• Able to function at a high level and can be
successful socially and at work.
• Affects persons’ social and romantic relationships
or their ability to cope with losses and failures.

16.  Often fails to see their own situation realistically, tends
to dramatize and exaggerate.
 Failure or disappointment is usually blamed on others.
 Goes through frequent changes in job, easily bored,
have trouble in dealing with frustration as they crave
for novality, competitiveness and excitement, they may
place themselves in risky situations, thus ending up in
depression.
 A style of speech, that is excessively impressionistic and
lacking in detail.

17.  Shows self dramatization, exaggerated expression of
emotions.
 Over involvement (superficial resonance with others )
 Aggressiveness
 Over concern with physical attractiveness.
 Egocentricity.
 Self indulgence.
 Persistent manipulative behavior in achieving the
needs.

18. Criteria of Histrionic Personality
Disorder (DSM IV-TR)
• 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

19. (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

20. Mnemonic
 A mnemonic that can be used to remember the criteria
for histrionic personality disorder is PRAISE ME:
 P - provocative (or seductive) behavior
 R - relationships, considered more intimate than they
are
 A - attention, must be at center of
 I - influenced easily
 S - speech (style) - wants to impress, lacks detail
 E - emotional lability, shallowness
 M - make-up - physical appearance used to draw
attention to self
 E - exaggerated emotions - theatrical

21. ICD 10 Creteria
• A. The general criteria of personality disorder (F60) must be
met.
• B. At least four of the following must be present:
(1) Self-dramatization, theatricality, or exaggerated expression
of emotions.
(2) Suggestibility, easily influenced by others or by
circumstances.
(3) Shallow and labile affectivity.
(4) Continually seeks excitement and activities in which the
subject is the centre of attention.
(5) Inappropriately seductive in appearance or behaviour.
(6) Overly concerned with physical attractiveness.

22. Dual diagnoses
• HPD has been associated with alcoholism and
with higher rates of somatization
disorder , conversion disorder , and major
depressive disorder .
• Personality disorders such as borderline,
narcissistic, antisocial, and dependent can
occur with HPD.

23. Diagnosis
• Observation of appearance, behaviour
• Collection of history
• Psychological evaluation

24. TREATMENT
Psychotherapy based on case report method
aimed at self development through resolution
of conflict.
Dynamic therapy remains the treatment of
choice to externalize patient’s inner emotions
in treatment of histrionic PD.
In this therapy interpretation of pathological
relationships may evoke intense feelings of
anxiety, which have to be handled
respectfully without humiliating the patients.

25. •Self help groups and therapeutic community
setting is more productive than
institutionalization in producing a change.
Family therapy based on manifestations

26. Complications:
• Individuals with this disorder may have
difficulty achieving emotional intimacy in
romantic relationships. Without being aware of
it, they often act out a role (e.g., "victim" or
"princess").
• They may seek to control their partner through
emotional manipulation or seductiveness on one
level, whereas displaying a marked dependency
on them at another level.
• Impaired relationships with same-sex friends
because of their sexually provocative behavior or
their demands for constant attention.

27. • They crave novelty, stimulation, and
excitement and have a tendency to become
bored with their usual routine.
• They often initiate a job or project with great
enthusiasm, their interest may lag quickly.
• The Diagnostic actual risk of suicide is not
known, but individuals with this disorder are
at increased risk for suicidal gestures and
threats to get attention

28. Defence Mechanisms use
--Denial
--Identification
--Somatization
--Repression
--Acting out
--Fantasy of love and attention
--Dissociation
--Regression