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If you know someone like this, chances are they have a personality disorder. Let’s see what this is about.
We all have in mind people who attract the attention of others in an exaggerated way. Sometimes, some even take this attitude to pathological limits., so much so that they reach the borders of personality disorders. Specifically, the pathological behavior is known clinically as histrionic personality disorder (HPD).
Histrionic personality disorder is one of the 10 personality disorders recognized in the world. Diagnostic and Statistical Manual of Mental Disorders in its fifth edition (DSM-5). It is classified in Group B, a dimension in which behaviors characterized by being dramatic, excessively emotional or very erratic are grouped.
The HPD is one of the most ambiguous categories in psychiatry, and despite this it has been maintained in the latest edition of the DSM-5. He has done so with not a few critics, although for the moment it remains as an official diagnosis.
“Most of the world’s problems are caused by people who want attention.”
-Thomas Stearns Eliot-
General pattern of excessive attention seeking
The first time that HPD appeared in clinical diagnostic manuals was in 1968 by the Diagnostic and Statistical Manual of Mental Disorders in its second edition (DSM-II). Since the DSM-III it is the only disorder that retains the name hysteria. The term hysteria derives from the Greek etym “hystera”, which translates as ‘womb or uterus’.
Hysteria as a diagnosis has a long prevalence in the history of medicine. Its definition has varied throughout the ages, and has gone from being a consequence of blocked menstrual flow and sexual abstinence (Galen, 129-216 AD), to a manifestation of demonic possession (Augustine of Hippo, 354 -430 AD), to a disorder caused by the lack of libidinal evolution (Sigmund Freud, 1856-1939).
Today, experts describe HPD as a psychiatric disorder characterized by a pattern of exaggerated emotionality and attention-seeking behaviors. People with this pathology are usually defined as flirtatious, impulsive, seductive, manipulative, charming and lively.
In general, Those with histrionic personality disorder feel underestimated when they are not the center of attention, so they develop actions and attitudes to seek to be “the life of the party.” The DSM-5 highlights 8 characteristics that define a person with HPD:
He does not feel comfortable in situations where he is not the center of attention.Interaction with others is usually characterized by sexually seductive or provocative behavior. It shows a superficial and rapidly changing emotional expression.He constantly uses physical appearance to draw attention to himself.He has a way of speaking that is excessively subjective and lacks nuance.It shows self-dramatization, theatricality and exaggerated emotional expression.He is suggestible, since he is easily influenced by others or by circumstances. He considers his relationships to be more intimate than they really are.
“People with a big ego need to be the center of attention, they crave recognition and care very little about others. On the contrary, a healthy self-esteem allows us to respect our own desires and also those of others.”
-Andrew Matthews-
As a complement, most people use repression and dissociation as their main defense mechanism. To be clinically diagnosed with this disorder, you must meet at least 5 of the 8 criteria indicated.. The evaluation must be done by a psychology professional.
People with high emotional need
Individuals with HPD often make mistakes when evaluating their own personal situation. They lack realism, so they dramatize and exaggerate their difficulties. They may also change jobs frequently, just as they tend to get bored easily and may prefer to quit out of frustration rather than coping. This is why they are always looking for the new and exciting, which usually leads them into dangerous situations.
When you meet them, they seem like very attractive and fun people., because they show a lot of vitality, enthusiasm and interest in things. However, after a certain time, they are perceived by others as individuals who demand a lot of attention and are absorbing. They are very sociable and love to be surrounded by people, so others think they are just extroverts.
Histrionic personality disorder is usually diagnosed after age 18., so it is a pathology of adulthood. Its exact prevalence is unknown, although some experts suggest it is 0.4% in the general population. As with other (not all) personality disorders It is up to 4 times more common in women than in men.
The causes of histrionic personality disorder are not known. The most accepted hypothesis is that it is a pathology of multifactorial origin.. Childhood trauma, parenting style, parental influence, education, and accumulated experiences can mediate its development. It is thought that, like other personality disorders, may have a genetic component.
Comorbidity and psychiatric complications
HPD often coexists with other personality disorders. It tends to develop in the company of narcissistic personality disorder, borderline personality disorder, and dependent personality disorder. In fact, for many authors, HPD is a manifestation of some of these three pathologies, and not an isolated or individual diagnosis.
There is no cure for histrionic personality disorder, although there are multiple treatment approaches. In the absence of this, people can be exposed to psychiatric complications.. The most common are the following:
Suicide tendency. Especially in painful situations, such as a romantic breakup or heartbreak. It is pertinent to mention that in most cases these attempts do not really endanger their lives, but rather constitute another example of a wake-up call after experiencing strong emotions.Vulnerability to suffering from other psychological disorderssuch as: dysthymia, depression, anxiety, substance abuse, panic disorders, conversion disorder, brief reactive psychosis, somatization disorder, among others.
Final thoughts
Not all people who want attention have histrionic personality disorder. Although this is its main characteristic, it manifests itself pathologically and in the company of other symptoms.. Subjects with the disorder tend to deny their behavior, and are not very receptive to seeking professional help.
Given his disruptive behavior, those who are part of their inner circle show direct consequences. Partners, colleagues, family members and friends of people with HPD must constantly deal with their behaviors and attitudes. Therefore, they should encourage you to turn to a psychologist and accompany you in the process when your attitude is overwhelming.
“No one has learned the meaning of life until he has subdued his ego to serve his brothers.”
-Ralph Waldo Emerson-
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All cited sources were reviewed in depth by our team to ensure their quality, reliability, validity and validity. The bibliography in this article was considered reliable and of academic or scientific accuracy.
Bakkevig JF, Karterud S. Is the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, histrionic personality disorder category a valid construct? Buy Psychiatry. 2010 Sep-Oct;51(5):462-70.Crocq MA. Milestones in the history of personality disorders. Dialogues Clin Neurosci. 2013 Jun;15(2):147-53.French, JH, & Shrestha, S. Histrionic personality disorder. In StatPearls. Stat Pearls Publishing. 2020.Novais F, Araújo A, Godinho P. Historical roots of histrionic personality disorder. Front Psychol. 2015 Sep 25;6:1463.Ma, G., Fan, H., Shen, C., & Wang, W. Genetic and neuroimaging features of personality disorders: state of the art. Neuroscience bulletin. 2016; 32(3): 286-306.
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