Histrionic Personality Disorder

Basics

Histrionic personality disorder (HPD) is one of the cluster B personality disorders (PDs).
HPD is characterized by persistent and excessive emotionality and attention seeking that deviate from cultural and social norms and produce functional impairment or distress.
Associated with overuse of general medical resources, particularly later in life (1)[B]
With the advent of the DSM-5, an alternative model is being promulgated that may come to define diagnosis as impairment in personality function AND the presence of pathologic traits. Using this alternative model, a person previously diagnosed with HPD would be diagnosed with PD—trait-specified. The alternative model does not include the HPD diagnosis. Poor construct validity has been suggested for the diagnostic category of HPD.

Incidence

No data available on the incidence of HPD
HPD typically begins to manifest by early adulthood and persists throughout life in the absence of treatment (2).

Prevalence

Both genetic and environmental factors play a role in development of HPD.
- Heritability estimated to be 31–63% (3)
- Adverse childhood experiences, particularly emotional neglect, are a risk factor for development (4).
Biosocial learning theory: According to the biosocial model in psychology, persons might develop HPD from inconsistent or inappropriately low parental attention. For example, a parent might respond only when the child has intense emotional affect, eventually leading the individual to unconsciously learn to be excessively emotional to draw attention to themselves.

Depression, anxiety, panic disorder
Bipolar disorders (5)[A]
Somatic symptom disorder
Body dysmorphic disorder
Anorexia
Posttraumatic stress disorder
Dissociative disorders
Substance use disorder
HPD can co-occur with other PDs, particularly other cluster B PDs (antisocial, borderline, narcissistic) (2).

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