HISTRIONIC PERSONALITY DISORDER

Generality

Histrionic disorder is a "personality alteration characterized by constant attention seeking and exaggerated emotionality. The latter" manifests itself through theatrical modalities and constant attempts to obtain reassurance, approval and support from others.

Causes

This personality disorder is part of cluster B (being characterized by dramatic or eccentric behaviors): individuals with these traits appear amplifying, emotional or unpredictable.
Histrionic subjects have a poor sense of personal identity, which leads them to focus a lot on the external world: the theatricality in emotional expression is not synonymous with intensity, but with a great distance from their own emotional and affective internal world.
The causes of histrionic disorder are not yet well understood, but the opinion is shared that this condition may represent the result of the complex combination of several social, psychological, biological and genetic factors. These would intervene in the course of the individual's development, influencing his behavior and thinking.
The clinical picture can be favored by growing up in a family environment unable to provide the child with the necessary attention, by the instinctive desire to obtain social acceptance among peers and by the inability to cope with stressful situations.

Symptoms

Histrionic personality disorder appears by early adulthood and manifests itself in a variety of contexts (relational, professional and family).
The most commonly encountered symptoms are:

Unstable emotionality: subjects with histrionic personality disorder have exaggerated emotional reactions, tend to dramatize everything about them and are often superficial in building emotional relationships;

Egocentrism: people affected by this condition tend to experience a state of discomfort when they are not at the center of attention;

Inappropriate sexuality: the histrionic tends to resort to sensual or seductive behaviors to continually place himself at the center of attention;

Suggestibility: histrionic subjects are particularly impressionable, give excessive importance to the opinions of others and frequently tend to consider personal relationships more intimate than they really are.

The histrionic subject feels the need to be at the center of attention and, when he cannot focus this on himself, he experiences a strong sense of discomfort and tends to become depressed. The histrionic cannot bear the idea of being excluded, abandoned or that someone else is preferred. He is also led to express his feelings in a dramatic and theatrical way and manifests rapidly changing and superficial emotions.
The histrionic subject has an extremely seductive or provocative sexual behavior, but inappropriate, since he does not know how to place himself adequately in the relationship; he uses his physicality in order to attract the attention of others and considers relationships more intimate than they really are.
The histrionic subject appears suggestible, easily influenced by the external environment, by circumstances and by people. His speech is structured in such a way as to impress the listener, but is devoid of details. In the "histrionic", relationships are characterized by adhesiveness and where there is this aspect there cannot be a third person (the boundary between self and the other is missing).
Other personality disorders (especially antisocial, borderline, and narcissistic) are frequently associated with the condition, suggesting that they share a biological vulnerability. Some patients also present at the same time a somatoform disorder, which may be the reason for the medical consultation. Histrionic disorder can also coexist with major depression, dysthymia and conversion disorder.
Histrionic personality disorder has significant repercussions: if not properly treated, it can end up compromising the social and working life of the people affected by it. Possible suicide attempts of the histrionic are linked to the strong anguish that grips the subject, as he cannot bear separation, therefore he wants to communicate to the other, in the only way in which it is possible, his inability to tolerate the situation; however, there is always an underlying manipulative goal of attracting attention.

Diagnosis

The diagnosis of histrionic disorder is formulated by a specialist through some evaluation interviews, to understand the person's overall functioning and precisely examine the patient's personal and medical history. This "in-depth psychological analysis" makes it possible to search for repetitive and maladaptive thought and behavior patterns throughout the patient's developmental history.
The conflictuality of the histrionic emerges above all in the relational dimension. In particular, it is appropriate to explore the themes of addiction in the emotional-sexual sphere, the "adhesiveness and anguish induced by" abandonment and the difficulty in "facing the oedipal conflict (sense of exclusion and refusal).
The superficiality and the sudden theatrical humoral change could indicate a difficulty in processing intra-psychic conflicts and a massive use of repression as a defense mechanism. It would therefore be necessary to investigate what the histrionic protects himself from through superficiality.
The diagnostic assessment may also make use of a physical examination to ensure that the problem is not favored by organic causes.