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Histrionic Personality Disorder

Histrionic Personality Disorder is a topic covered in the 5-Minute Clinical Consult.

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  • 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 (2)[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.


  • 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 (1).

  • <1–3% in general population (1)[C]
  • Has been identified more frequently in females (1)

Etiology and Pathophysiology

  • 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, is 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.

Commonly Associated Conditions

  • 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) (1).

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Stephens, Mark B., et al., editors. "Histrionic Personality Disorder." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816379/all/Histrionic_Personality_Disorder.
Histrionic Personality Disorder. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816379/all/Histrionic_Personality_Disorder. Accessed April 18, 2019.
Histrionic Personality Disorder. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816379/all/Histrionic_Personality_Disorder
Histrionic Personality Disorder [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 April 18]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816379/all/Histrionic_Personality_Disorder.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Histrionic Personality Disorder ID - 816379 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816379/all/Histrionic_Personality_Disorder PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -