Histrionic personality disorder

Histrionic personality disorder (HPD) exists along a continuum of severity, as do many other disorders. The presence of traits at one end of the continuum is critically important to the actor depending upon these characteristics to maintain the 'Hollywood' persona, while the person at the far end of the spectrum may resemble someone in a manic or hypomanic phase of bipolar disorder. Persons with a true HPD are lively, dramatic, and often charming in small doses. They crave attention, repeatedly draw the focus of conversation back to themselves, make grand entrances often at inopportune times, and are prone to exaggeration of behavior, emotion, and interpretation. HPD patients are arousal oriented, they crave stimulation, and often respond to minor stimuli with eruptions of inappropriate laughter or irrational, angry outbursts. Their interpersonal relationships are often severely impaired, they frequently rapidly exhaust their partners with their neediness. Others generally perceive them as shallow, lacking in genuineness, demanding, and overly dependent. Rejection from others may lead to depression and suicidal ideation. Although this chapter will focus on patients who meet the defining criteria for HPD, the concepts may also be applied to patients who demonstrate histrionic features superimposed upon another disorder, such as borderline or narcissistic personality disorders. This chapter offers models to assist clinicians in understanding the conceptualization cognitive and developing effective treatment strategies. Psychodynamic treatment and cognitive therapy treatment are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved). (create)