Histrionic Personality Disorder PDF

3/27/24, 9:38 PM Print Preview Chapter 12: Personality Disorders: 12-3c Histrionic Personality Disorder Book Title: Psychopathology: An Integrative Approach to Mental Disorders Printed By: Wefae Ali ([email protected]) © 2023 Cengage Learning, Inc., Cengage Learning, Inc. 12-3c Histrionic Personalit...

3/27/24, 9:38 PM Print Preview Chapter 12: Personality Disorders: 12-3c Histrionic Personality Disorder Book Title: Psychopathology: An Integrative Approach to Mental Disorders Printed By: Wefae Ali ([email protected]) © 2023 Cengage Learning, Inc., Cengage Learning, Inc. 12-3c Histrionic Personality Disorder Individuals with histrionic personality disorder (Cluster B (dramatic, emotional, or erratic) personality disorder involving a pervasive pattern of excessive emotionality and attention seeking.) tend to be overly dramatic and often seem almost to be acting, which is why the term histrionic, which means theatrical in manner, is used. Consider the case of Dariya. Dariya… Always Onstage When we first met, Dariya seemed to radiate enjoyment of life. She was single in her mid-30s and was going to night school for her master’s degree. She often dressed flamboyantly. During the day, she taught children with disabilities, and when she didn’t have class, she was often out late on a date. When I first spoke with her, she enthusiastically told me how impressed she was with my work in the field of developmental disabilities and that she had been extremely successful in using some of my techniques with her students. She was clearly overdoing the praise, but who wouldn’t appreciate such flattering comments? Because some of our research included children in her classroom, I saw Dariya often. Over a period of weeks, however, our interactions grew strained. She often complained of various illnesses and injuries (falling in the parking lot, twisting her neck looking out a window) that interfered with her work. She was disorganized, often leaving to the last minute tasks that required considerable planning. Dariya made promises to other people that were impossible to keep but seemed to be aimed at winning their approval. When she broke the promise, she usually made up a story designed to elicit sympathy and compassion. For example, she promised the mother of one of her students that she would put on a “massive and unique” birthday party for her daughter but forgot about it until the mother showed up with cake and juice. Upon seeing her, Dariya flew into a rage and blamed the principal for keeping her late after school, although there was no truth to this accusation. Dariya often interrupted meetings about research to talk about her latest boyfriend. The boyfriends changed almost weekly, but her enthusiasm (“Like no other man I have ever met!”) and optimism about the future (“He’s the guy I want to spend the rest of my life with!”) remained high for each of them. Wedding plans were seriously discussed with almost every one, despite their brief acquaintance. Dariya was ingratiating, especially to the male teachers, who often helped her out of trouble she got into because of her disorganization. https://ng.cengage.com/static/nb/ui/evo/index.html?deploymentId=607607251305910651374883797&eISBN=9780357657881&id=1993194890&nbId… 1/5 3/27/24, 9:38 PM Print Preview When it became clear that she would probably lose her teaching job because of her poor performance, Dariya managed to manipulate several of the male teachers and the assistant principal into recommending her for a new job in a nearby school district. A year later, she was still at the new school but had been moved twice to different classrooms. According to teachers she worked with, Dariya still lacked close interpersonal relationships, although she described her current romantic relationship as “deeply involved.” After a rather long period of depression, Dariya sought help from a psychologist, who diagnosed her as also having histrionic personality disorder. Clinical Description People with histrionic personality disorder are inclined to express their emotions in an exaggerated fashion—for example, hugging someone they have just met or crying uncontrollably during a sad movie (Lengel, 2020). They also tend to be vain, self-centered, and uncomfortable when they are not in the limelight. They are often seductive in appearance and behavior, and they are typically concerned about their looks. (Dariya, for example, spent a great deal of money on unusual jewelry and was sure to point it out to anyone who would listen.) In addition, they seek reassurance and approval constantly and may become upset or angry when others do not attend to them or praise them. People with histrionic personality disorder also tend to be impulsive and have great difficulty delaying gratification. The cognitive style associated with histrionic personality disorder is impressionistic (Beck, Freeman, & Davis, 2007), characterized by a tendency to view situations in global, blackand-white terms. Speech is often vague, lacking in detail, and characterized by exaggeration (American Psychiatric Association, 2013; Nestadt et al., 2009). For example, when Dariya was asked about a date she had had the night before, she might say it was “amazing” but fail to provide more detailed information. The high rate of this diagnosis among women versus men raises questions about the nature of the disorder and its diagnostic criteria (Boysen, Ebersole, Casner, & Coston, 2014). As we discuss in the beginning of this chapter, there is some thought that the features of histrionic personality disorder—such as overdramatization, vanity, seductiveness, and overconcern with physical appearance—are characteristic of the Western “stereotypical female” and may lead to an overdiagnosis among women. Sprock (2000) examined this important question and found some evidence for a bias among psychologists and psychiatrists to associate the diagnosis with women rather than men. People with histrionic personality disorder tend to be vain, extravagant, and seductive. https://ng.cengage.com/static/nb/ui/evo/index.html?deploymentId=607607251305910651374883797&eISBN=9780357657881&id=1993194890&nbId… 2/5 3/27/24, 9:38 PM Print Preview Jose Luis Pelaez Inc/DigitalVision/Getty Images Causes Despite its long history, little research has been done on the causes or treatment of histrionic personality disorder (Lengel, 2020). The ancient Greek philosophers believed that many unexplainable problems of women were caused by the uterus (hysteria) migrating within the body (Abse, 1987; Ussher, 2013). As has been shown, however, histrionic personality disorder also occurs among men. One hypothesis involves a possible relationship with antisocial personality disorder. Evidence suggests that histrionic personality and antisocial personality co-occur more often than chance would account for. Lilienfeld and colleagues (1986), for example, found that roughly two-thirds of people with a histrionic personality also met criteria for antisocial personality disorder. The evidence for this association has led to the suggestion (see, for example, Cloninger, 1978; Lilienfeld, 1992) that histrionic personality and antisocial personality may be sex-typed alternative expressions of the same unidentified underlying condition. Women with the underlying condition may be predisposed to exhibit a predominantly histrionic pattern, whereas males with the underlying condition may be predisposed to exhibit a predominantly antisocial pattern. Whether this association exists remains a controversial issue, however, and further research on this potential relationship is needed (Dolan & Völlm, 2009; Salekin, Rogers, & Sewell, 1997), particularly given that borderline personality disorder has also been conceptualized as a female variant of psychopathy (Sprague, Javdani, Sadeh, Newman, & Verona, 2012). Treatment https://ng.cengage.com/static/nb/ui/evo/index.html?deploymentId=607607251305910651374883797&eISBN=9780357657881&id=1993194890&nbId… 3/5 3/27/24, 9:38 PM Print Preview Although a great deal has been written about ways of helping people with histrionic personality disorder, little of the research demonstrates success (Lengel, 2020). Some therapists have tried to modify the attention-getting behavior. Kass, Silvers, and Abrams (1972) worked with five women, four of whom had been hospitalized for attempts to take their own lives and all of whom were later diagnosed with histrionic personality disorder. The women were rewarded for appropriate interactions and fined for attention-getting behavior. The therapists noted improvement after an 18-month follow-up, but they did not collect scientific data to confirm their observation. DSM 5 Table 12.7 Diagnostic Criteria for Histrionic Personality Disorder 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. From American Psychiatric Association, (2022), Diagnostic and statistical manual of mental disorders (5th ed., Text Revision). A large part of therapy for these individuals usually focuses on the problematic interpersonal relationships. They often manipulate others through emotional crises, using charm, sex, seductiveness, or complaining (Beck et al., 2007). People with histrionic personality disorder often need to be shown how the short-term gains derived from this interactional style result in long-term costs, and they need to be taught more appropriate ways of negotiating their wants and needs. https://ng.cengage.com/static/nb/ui/evo/index.html?deploymentId=607607251305910651374883797&eISBN=9780357657881&id=1993194890&nbId… 4/5 3/27/24, 9:38 PM Print Preview Chapter 12: Personality Disorders: 12-3c Histrionic Personality Disorder Book Title: Psychopathology: An Integrative Approach to Mental Disorders Printed By: Wefae Ali ([email protected]) © 2023 Cengage Learning, Inc., Cengage Learning, Inc. © 2024 Cengage Learning Inc. All rights reserved. No part of this work may by reproduced or used in any form or by any means graphic, electronic, or mechanical, or in any other manner - without the written permission of the copyright holder. https://ng.cengage.com/static/nb/ui/evo/index.html?deploymentId=607607251305910651374883797&eISBN=9780357657881&id=1993194890&nbId… 5/5