Histrionic Personality Disorder

Histrionic Personality Disorder

A few years ago it became fashionable to use the term "histrionic" in the media. Following the arrest of a bank robber whose diagnosis was "Histrionic Personality Disorder", many communicators similarly labeled all kinds of people who displayed strange and outgoing behavior. The histrionic concept, which until then was not known much in popular culture, became fashionable. But what hides this disorder? What does it really consist of?


  • 1 Diagnostic criteria of histrionic personality disorder
  • 2 Characteristics of people with histrionic personality disorder
  • 3 Associated characteristics that support the diagnosis
  • 4 Differential diagnosis of histrionic personality disorder

Diagnostic criteria of histrionic personality disorder

According to the DSM-V (2014), this disorder is characterized by a general pattern of excessive emotionality and a search for attention, which begin at the beginning of adulthood and occur in various contexts, as indicated by five (or more) of the following items:

  1. He does not feel comfortable in situations where he is not the center of attention.
  2. Interaction with others is usually characterized by sexually seductive or provocative behaviors.
  3. It shows a superficial and rapidly changing emotional expression.
  4. He uses the physical aspect to draw attention to himself permanently.
  5. It has an excessively subjective and nuanced way of speaking.
  6. Shows self-dramatization, theatricality and exaggerated emotional expression.
  7. It is quite suggestible. For example: it is easily influenced by others or circumstances.
  8. Consider your relationships more intimate than they really are.

Characteristics of people with histrionic personality disorder

People who suffer from histrionic personality disorder usually have a excessive and generalized emotionality. His behavior is focused on seeking attention. It is a pattern of behavior that begins to manifest in adulthood and can appear in different contexts. Those who suffer from this disorder they feel uncomfortable and even undervalued when they are not the center of attention.

They often call attention to themselves. In the beginning they can even get attention for their openness and energy, but this is over when others realize the constant need to get attention. When they are not the center of attention they can start inventing stories or setting up a "scene" with the sole objective of focusing all eyes.

Sexual provocation and seduction also characterizes subjects with histrionic personality disorder. This behavior does not only occur with those people towards whom they have a special sexual interest, but also It can be observed in situations where the social context is not the most appropriate (social, labor or professional relations). The physical aspect is a constant element to get attention, so they spend a lot of time, money and energy on clothes and personal arrangements.

Associated features that support the diagnosis

There are a number of features that can support the diagnosis:

  • Difficulty achieving emotional intimacy in romantic or sexual relationships.
  • They can play roles in their relationships with others. They do it unconsciously. For example, they can adopt the role of victims.
  • The presence of control towards the couple is possible through emotional manipulation or seduction. But on the other hand, they show a great dependence.
  • They tend to move their friends away due to constant attention demands.
  • When they are not the center of attention they get depressed and upset.
  • They tend to get bored with the routine, so they look for novelty, excitement and stimulation.
  • They start projects with great enthusiasm but it dissolves very quickly.
  • There is an increased risk of suicidal signals and threats to get attention.
  • This disorder has been associated with higher rates of somatic symptom disorder, conversion disorder and major depressive disorder.
  • Frequently, histrionic personality disorder coincides with dependent, borderline, narcissistic and antisocial personality disorders.

Differential diagnosis of histrionic personality disorder

Borderline personality disorder. The difference is that in the TPL the person presents self-destructive behavior, as well as angry outbursts in intimate relationships, feelings of emptiness and a great alteration of identity.

Antisocial personality disorder. Despite sharing a large number of symptoms, the main distinction is that people with histrionic personality disorder tend to be more exaggerated in expressing their emotions and they are not antisocial. In addition, people with histrionic personality disorder obtain care through manipulation, while manipulation in antisocials is to obtain power, benefits or some material reward.

Narcissistic personality disorder. Narcissists always need to appear strong and superior, however, those who present with histrionic personality disorder may show that they are delicate, weak, fragile and dependent, if they attract attention.

Dependent personality disorder. The main difference is that they depend excessively on others while seeking praise and guidance. However, they do not present the extravagant and exaggerated features of those with histrionic personality disorder.

Personality change due to another medical condition. Traits of this type of personality arise from the effects of a medical condition on the central nervous system.

Substance use disorders. The disorder is due to the symptoms that can develop in relation to the continuous consumption of substances.


American Society of Psychiatry. (2014). Diagnostic and Statistical Manual of Mental Disorders. Madrid: Pan American Medical Editorial.