What are the signs of Histrionic Personality Disorder?

Histrionic Personality Disorders - Centres for Health and Healing

A histrionic personality disorder is a mental health condition featuring a pattern of extreme attention-seeking and emotionally driven behaviours. 

It gets referred to as a ”Cluster B” or ”dramatic” personality type disorder.

What is a histrionic personality disorder?

People with a histrionic personality disorder may notice that their symptoms begin around adolescence and get triggered in various situations.

Histrionic personality disorder (HPD) gets classified as a Cluster B disorder and is one of ten personality disorders documented within the DSM- 5.

Mental disorders

The features synonymous with Cluster B  personality disorders get characterized as overly emotional, dramatic, and erratic behaviours.

Such symptoms get observed in other Cluster B psychiatric disorders, such as:

The word histrionic means ”theatrical” or ”dramatic”.

Histrionic personality disorder statistics

A histrionic personality disorder is characterized by shallow, attention-seeking and manipulative behaviours.

In addition, HPD is prevalent in around 2 – 3% of the general population.

In the United States alone, personality disorders such as HPD, Borderline personality disorder and narcissistic personality disorder affect around 9% of American citizens.

What are the symptoms of histrionic personality disorder?

Histrionic Personality Disorder symptoms - Centres for Health and Healing

People with a histrionic personality disorder may not recognize that they have a personality disorder. 

There is a likelihood that they believe their thoughts and behaviours are natural and, thus, may never seek treatment.

Those with HPD may project blame onto others and are likely to shift the responsibility for any inappropriate behaviours they exhibit onto other people.

Individuals with a histrionic personality disorder may exhibit several of the following personality traits and symptoms:

  • HPD sufferers tend to demonstrate excessive, shallow, and attention-seeking behaviours (e.g. they love being the centre of attention and are constantly ”performing” to gain attention and validation from others).
  • People with HPD often exhibit exaggerated symptoms of illness (or weakness) to gain attention and sympathy from others. They may also use threats of suicide to manipulate those around them.
  • Needing an audience to witness their emotional displays to get the attention and validation they crave.
  • People with HPD tend to experience fleeting emotions, beliefs and opinions and are easily suggestible to respond to others behaviours, thoughts and fads.
  • HPD sufferers tend to use sexually provocative behaviours and adopt inappropriate sexually seductive strategies to manipulate others.
  • Are overly concerned with physical appearance and often demonstrate shallow emotions (and volatile emotions)
  • HPD sufferers tend to act before thinking.
  • Adopt the use of theatrical behaviour, as though performing in front of an audience. People with HPD may also use exaggerated emotions, and expressions yet lack sincerity in their actions.
  • Be uncomfortable unless they are the centre of attention.
  • Self-centred.
  • Have difficulty maintaining relationships.
  • Emotional overreaction to outward stimuli
  • Excessively impressionistic
  • Others easily influence them.
  • Mood swings

Risk factors

Some risk factors put people at risk of developing a histrionic personality disorder, although the condition’s exact cause is unknown.

Genetic factors

However, many experts and mental health professionals believe that histrionic personality disorder is likely because of learned or genetic susceptibility.

For instance, personality disorders such as HPD tend to run in families, suggesting that inherited factors play a role in developing a personality disorder (and other mental health conditions).

Histrionic personalities as learned behaviour

Additionally, parents or caregivers with a histrionic personality disorder may exhibit specific behaviours, and, as a result, children end up repeating learned behaviours from their environment.

Other factors

Research suggests that other factors for developing histrionic personality disorder include inconsistent parental styles and childhood trauma.

Emotional reactivity

Such factors involve parents giving positive reinforcement when the child completes specifically approved behaviours, unpredictable attention given to the child by the parents, or a lack of punishment or criticism when a child misbehaves.

Inconsistent parenting styles like those mentioned above may lead to confusion about what type of behaviour earns parental approval.

Studies show that personality disorders also develop because of psychological styles, temperament and the coping mechanisms people adopt to manage conflict and stress during childhood.

Histrionic personality disorder diagnosis

When individuals present with symptoms of histrionic personality disorder in the clinic, their doctor will usually perform a complete medical history.

The above may include a comprehensive evaluation of the individual’s physical and psychiatric health history.

Complete medical history

In cases where physical symptoms are present, a medical practitioner may also perform a physical exam, and if needed, order laboratory tests, such as blood tests and neuroimaging studies.

Suppose an individual’s test results show no signs of physical illness. In that case, the physician will likely refer them to a mental health professional such as a psychologist or a psychiatrist for further assessment.

Such assessments may involve specially designed interviews to evaluate a person for a personality disorder (or other psychiatric disorders such as anxiety disorders or clinical depression).

Differential diagnosis

Because histrionic personality disorder has symptoms similar to other personality disorders and physical illnesses, a physician will likely make a differential diagnosis to rule out the possibility of any other conditions.

The DSM- 5 (diagnostic and statistical manual) states that a person must have at least 5 (or more) of the following symptoms to receive a histrionic personality disorder diagnosis:

  • Rapidly shifting and shallow expression of emotion
  • Having interactions with others that frequently gets characterised by provocative or inappropriate sexually seductive behaviour
  • Constantly using physical appearance to draw attention to self
  • Using a style of speech that is dramatic, excessively impressionistic and lacking in detail or sincerity
  • Often demonstrating theatricality, exaggerated expression of emotion, and self – dramatisation (or other attention-seeking behaviour)
  • Experiencing discomfort when not the centre of attention
  • Get easily influenced by circumstances or other people


Treatment for histrionic personality disorder typically involves a combination of psychotherapy style – treatments and medication.

However, people with a histrionic personality disorder often do not believe they need therapy; they also dislike routine, making following a treatment plan challenging.

Histrionic personality disorder treated.

Treatment for Histrionic Personality Disorder - Centres for Health and Healing

Although, studies show that those with HPD may seek treatment if depression is a factor, particularly in cases where failed relationships are prevalent – or other challenges related to their behaviour causes them distress.


Psychotherapy is an effective treatment for those with HPD and is often the treatment of choice for people with the disorder.

Treatment goals are centred around uncovering fears and motivations associated with negative thoughts and behaviours, all of which seek to build self-esteem and reduce emotional distress.

In cases where anxiety and depression are present, certain medications may also get prescribed to help alleviate symptoms.


Fortunately, many people with histrionic personality disorder are well-adjusted and can function well personally and professionally.

However, those with severe symptoms of HPD may experience complications and significant problems with daily living that can affect a person’s professional, social or romantic relationships.

Therefore, people at higher risk of developing histrionic personality disorder must seek treatment as soon as possible.

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If you think you might be experiencing any of the above symptoms, please get in touch with one of our specialists at Centres for Health and Healing who can help.

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