What causes histrionic personality disorder

Histrionic Personality Disorder Symptoms, Causes & Treatment

What is Histrionic Personality Disorder?

Histrionic personality disorder is a type of personality disorder that is primarily characterized by attention-seeking behavior.  

Histrionic personality disorder can have an impact on your relationships and can interfere with your performance at work or in school. This disorder is usually first noticed in your teens or early adulthood.  

Histrionic Personality Disorder Symptoms

Histrionic personality disorder often co-exists alongside another type of mental health condition, like anxiety. People with this disorder can be very successful. But, left untreated, the disorder can have a negative impact on your life. See your doctor if you notice symptoms of histrionic personality disorder, including:

  • Excessive attention seeking
  • Engaging in inappropriate behaviors to gain praise or approval
  • Acting out in order to always be the center of attention; feeling uncomfortable or out of place when not the center of attention
  • Being easily influenced by others
  • Having an obsessive focus on your appearance
  • Believing that relationships are closer or more intimate than they actually are
  • Dressing provocatively or in an inappropriately sexy way; using one's looks or physical appearance to gain attention
  • Rapidly shifting emotional states centered on how events affect them

Histrionic Personality Disorder Causes and Risk Factors

Histrionic personality disorder is not caused by one particular event or experience. A number of different risk factors can increase your risk of developing this disorder, such as:

  • Being rewarded for attention seeking behavior as a child
  • A family history of personality disorders, anxiety, or depression
  • Learning behaviors from a parent or caregiver with histrionic personality disorder
  • A lack of criticism or punishment as a child
  • Unpredictable attention from your parents
  • Previously experiencing depression or anxiety
  • A genetic susceptibility to personality disorders

Histrionic Personality Disorder Treatment

Histrionic personality disorder is treatable. It often becomes apparent alongside other disorders, like anxiety or depression. Your doctor can perform tests to determine if you have this disorder and what treatment plan is right for you. 

Medication: There is no medication to cure histrionic personality disorder. However, antidepressants, anti-anxiety drugs, and other medications can help treat your symptoms of histrionic personality disorder .   

Therapy: Therapy is very effective in treating this disorder. Psychodynamic therapy, talk therapy, behavioral therapy, and other types of therapy can help you learn how to gain control over your disorder. See your options for therapy.

Education: Learning more about histrionic personality disorder can help you understand your triggers and explain your condition to your family and friends. Learn more about mental health with our resources.

Support: Finding support to help you cope with histrionic personality disorder and other mental health conditions that you may be experiencing can help you feel better faster. Find a support group at Sheppard Pratt. 

Histrionic Personality Disorder Symptoms, Causes, Treatments

Written by WebMD Editorial Contributors

In this Article

  • What Are the Symptoms of Histrionic Personality Disorder?
  • What Causes Histrionic Personality Disorder?
  • How Is Histrionic Personality Disorder Diagnosed?
  • How Is Histrionic Personality Disorder Treated?
  • What Complications Are Associated With Histrionic Personality Disorder?
  • What Is the Outlook for People With Histrionic Personality Disorder?
  • Can Histrionic Personality Disorder Be Prevented?


Histrionic personality disorder is one of a group of conditions called "Cluster B" or "dramatic" personality disorders. People with these disorders have intense, unstable emotions and distorted self-images. For people with histrionic personality disorder, their self-esteem depends on the approval of others and does not arise from a true feeling of self-worth. They have an overwhelming desire to be noticed, and often behave dramatically or inappropriately to get attention. The word histrionic means "dramatic or theatrical."

This disorder is more common in women than in men and usually is evident by adolescence or early adulthood.

What Are the Symptoms of Histrionic Personality Disorder?

In many cases, people with histrionic personality disorder have good social skills; however, they tend to use these skills to manipulate others so that they can be the center of attention.

A person with this disorder might also:

  • Be uncomfortable unless they are the center of attention
  • Dress provocatively and/or exhibit inappropriately seductive or flirtatious behavior
  • Shift emotions rapidly
  • Act very dramatically, as though performing before an audience, with exaggerated emotions and expressions, yet appears to lack sincerity
  • Be overly concerned with physical appearance
  • Constantly seek reassurance or approval
  • Be gullible and easily influenced by others
  • Be excessively sensitive to criticism or disapproval
  • Have a low tolerance for frustration and be easily bored by routine, often beginning projects without finishing them or skipping from one event to another
  • Not think before acting
  • Make rash decisions
  • Be self-centered and rarely show concern for others
  • Have difficulty maintaining relationships, often seeming fake or shallow in their dealings with others
  • Threaten or attempt suicide to get attention


What Causes Histrionic Personality Disorder?

The exact cause of histrionic personality disorder is not known, but many mental health professionals believe that both learned and inherited factors play a role in its development. For example, the tendency for histrionic personality disorder to run in families suggests that a genetic susceptibility for the disorder might be inherited. However, the child of a parent with this disorder might simply be repeating learned behavior. Other environmental factors that might be involved include a lack of criticism or punishment as a child, positive reinforcement that is given only when a child completes certain approved behaviors, and unpredictable attention given to a child by their parent(s), all leading to confusion about what types of behavior earn parental approval. Personality disorders also usually develop in relation to individual temperament and psychological styles and ways people learn to cope with stress while growing up.

How Is Histrionic Personality Disorder Diagnosed?

If signs of this personality disorder are present, the doctor will begin an evaluation by performing a complete medical and psychiatric history. If physical symptoms are present, a physical exam and laboratory tests (such as neuroimaging studies or blood tests) may also be recommended to assure that a physical illness is not causing any symptoms that may be present.

If the doctor finds no physical reason for the symptoms, they might refer the person to a psychiatrist, psychologist, or other licensed behavioral health professional who may use specially designed interview and assessment tools to evaluate a person for a personality disorder.

How Is Histrionic Personality Disorder Treated?

In general, people with histrionic personality disorder do not believe they need therapy. They also tend to exaggerate their feelings and to dislike routine, which makes following a treatment plan difficult. However, they might seek help if depression -- possibly associated with a loss or a failed relationship -- or another problem caused by their actions causes them distress.

Psychotherapy (a type of counseling) is generally the treatment of choice for histrionic personality disorder. The goal of treatment is to help the individual uncover the motivations and fears associated with their thoughts and behavior, and to help the person learn to relate to others in a more positive way.

Medication might sometimes be used as  treatment for other conditions that might also be present with this disorder, such as depression and anxiety.

What Complications Are Associated With Histrionic Personality Disorder?

Histrionic personality disorder can affect a person's social, professional, or romantic relationships and how they react to losses or failures. People with this disorder are also at higher risk than the general population to suffer from depression.

What Is the Outlook for People With Histrionic Personality Disorder?

Many people with this disorder are able to function well socially and at work. Those with severe cases, however, might experience significant problems in their daily lives

Can Histrionic Personality Disorder Be Prevented?

Although prevention of the histrionic personality disorder might not be possible, treatment can allow a person who is prone to this disorder to learn more productive ways of dealing with situations.


Hysterical personality disorder - treatment of hysteroid disorders in the Allianz Central Medical Health Center

Hysterical (hysterical) personality disorder is one of the variants of personality disorder (the obsolete name is “psychopathy”), characterized, along with the common features for this group, by the following distinctive features:

  • strong desire to be the center of attention. Situations where they are deprived of this attention cause severe discomfort, up to the appearance of various physical ailments;
  • theatricality of behavior: dramatization of events, pretentiousness of speech and gestures, hypertrophied manifestation of emotions;
  • increased suggestibility: easily influenced by other people or situations;
  • superficiality and lability of emotional experiences, frequent mood swings;
  • extreme preoccupation with their appearance. Physical attractiveness is another way for them to get attention;
  • inadequate assessment of the degree of closeness of relationships with other people (they consider relationships closer than they really are), as well as frequent provocative behavior aimed at seduction.


Extreme emotional variability and sensitivity, combined with an all-encompassing thirst for attention, form the core of this pathology.

People with hysterical personality disorder are very much like actors who live for praise and applause. Alternative names: theatrical, histrionic (from the Latin histrio - “actor”) disorder, reflect its essence. It was previously thought that women were more susceptible to this pathology, however, recent studies have shown that it occurs with the same frequency in men and women.

People with histrionic personality disorder often resort to various types of manipulative behavior to quench their thirst for attention. These can be both the aforementioned dramatic and theatrical speech and gestures, extravagant appearance and clothing, as well as more serious, even potentially dangerous options, such as demonstrative suicide attempts or simulation of somatic diseases.

Despite the brightness of the symptoms of hysteroid disorder, an important component of the differential diagnosis is the exclusion or detection of a real concomitant somatic or mental pathology.


To conduct a competent differential diagnosis, you need to contact a specialist, otherwise there is a high risk of missing a concomitant disease and undergoing unnecessary medical examinations and procedures.

Treatment and prognosis

The prognosis for hysterical personality disorder is usually favorable - it is possible to achieve stable and long-term compensation.

Correction is easier in individuals whose hysterical manifestations are concentrated mainly in the sphere of physical sensations and ailments (a hysterical lump in the throat, trembling in the whole body or in separate parts, numbness and other disturbances of sensitivity, etc.). With adequate treatment, such people become well adapted socially and professionally by adulthood, although there are still noticeable elements of theatricality in their appearance, speech and gestures.

It must be emphasized that in this disorder, it is often not a true simulation of symptoms, in which the simulator lies about his malaise, but the result of the peculiarities of perception and thinking of a hysteroid personality. With this disorder, part of what is happening (external events or internal sensations) is perceived especially sharply, and part is only superficial or even escapes attention. In combination with the rich imagination inherent in people of this type, this leads to the fact that in places they blur the line between reality and fantasy. As a result, certain physical symptoms appear, which are not the fruit of true simulation, i.e. deliberate deception. A person really believes that the symptoms he produces are a manifestation of a real disease beyond his control.

The prognosis becomes less certain if the symptomatology is dominated by pathological fantasizing (pseudology), which manifests itself in telling a lot of invented facts about oneself, designed to impress listeners with the extraordinary significance and uniqueness of the narrator. Such people lie about themselves relentlessly and almost constantly, sometimes senselessly, even though it is obvious that they will be exposed. Often, pathological liars, possessing outstanding acting talent, resort to criminal activity - all kinds of fraud options.

Due to the peculiarities of the psyche, self-seeking for medical help is quite common for people with hysterical personality disorder. Treatment of this pathology, first of all, occurs by methods of psychotherapy. The most commonly used areas are: psychoanalysis, cognitive, psychodynamic and group psychotherapy. Drug treatment is used only in individual cases and is auxiliary.

The Alliance mental health center employs qualified psychotherapists who have effective methods for diagnosing and treating hysterical personality disorder. Our specialists have many years of successful experience in this field, individually and carefully approach the management of each case, which allows us to get a positive effect from the treatment in the shortest possible time and improve the patient's quality of life.

People with histrionic personality disorder are bright, emotionally charged and attention-hungry individuals. Resorting to various manipulations, they themselves are often used by others because of their suggestibility and desire to please. Tireless actors, they often lose the line between reality and fantasy. In a state of mental compensation, they manage to achieve a high level of social and professional adaptation and lead an active lifestyle.

How to recognize and deal with histrionic personality disorder

August 7, 2020LikbezHealth

Stress will help to heal, and to start therapy, it is enough to detect five out of ten signs.



If you have 100 people you know, about two of them Histrionic Personality Disorder have a histrionic personality disorder. Most likely, these two are women.

Histrionic personality disorder is diagnosed four times more often in women than in men.

But there is an assumption Histrionic Personality Disorder, that in the case of men, hysterical traits - demonstrative behavior, a thirst for recognition, emotional outbursts, communication in raised tones - simply seem acceptable to society, natural, therefore, they do not seem to require correction and treatment to a doctor. However, in fact, both men and women are hysterical with equal frequency.

Actually, for this reason, in English-language literature, the concept of "hysterical" (hysterical) was abandoned in favor of "dramatic, simulated, theatrical" (histrionic). The word "hysteria" comes from the ancient Greek "womb", which means that only women can suffer from a hysterical disorder. Histrionic Histrionic Personality Disorder The disorder is not related to gender.

Recognizing a "dramatic" violation is quite difficult. This conduct disorder (as F60.4 defines. Histrionic Personality Disorder International Classification of Diseases ICD-10) often looks like openness, originality, a kind of cute expression characteristic of charming creative characters.

Nevertheless, there are important signs indicating that a person has crossed the line that separates eccentricity from a mental disorder.

What are the symptoms of Histrionic Personality Disorder? To suggest a hysterical personality disorder, it is enough to notice at least five of them in a person’s behavior.

1. Egocentricity

A person feels the need to be in the center of attention, to outshine others. If for some reason this is objectively impossible, he will try to attract attention by all available means.

For example, if a histrionic is a student at a lecture, he will interrupt the lecturer with questions, and if, let's say, he is just a guest at a party with a star, he will deliberately laugh out loud or even intentionally break something.

2. Demonstrative behavior

This is, for example, the habit of talking loudly, active gestures, exaggerated display of emotions. For example, if such a person sees a friend, he will not limit himself to a simple “Hello!” He throws himself on his neck and kisses him.

3. The tendency to consider relationships with people closer than they are

Familiarity is another characteristic feature of histrionics. A person really wants to be loved and accepted, so he unconsciously seeks to show that everywhere and for everyone he is “his own”.

Histrionic easily pours out his soul, sometimes even to casual acquaintances. True, he speaks only on a limited number of topics: for example, how many trials he passed with dignity, how he was admired, or, on the contrary, how callously and vilely he was betrayed.

4. Love for provocative outfits

Unusual, eye-catching clothing is one of the easiest ways to stand out from the crowd and attract attention. And the histrionic uses it to the fullest, choosing things in bright colors, adding abundant decorations and creating provocative sets.

5. Inappropriately seductive appearance or behavior

If the histrionic is a woman, she is a vamp. If a man is a mysterious macho. A person with this disorder needs compliments and knows that the easiest way to "squeeze" them from the opposite sex. Hence the undisguised sexuality that permeates the entire image.

6. An obsessive thirst for recognition and approval

A Histrionic should be admired - only then will he be complacent and satisfied. If he is not noticed or, even worse, criticized, he will make a dramatic scandal and leave, wringing his hands theatrically, slamming the door in parting.

7. Frequent and rapid mood swings

A person with a hysterical disorder is very emotional, and the most insignificant factors can cause a violent change of emotions. For example, a histrionic may sob sincerely when he loses a twenty or discovers that someone has not washed his cup again. But in a minute he will laugh just as sincerely when he hears an insipid anecdote from a significant person.

8. Hypersensitivity to criticism

It is difficult to discuss conflict issues with a histrionic, whether domestic or work. The slightest dissatisfaction or a request not to do this again, he immediately takes into account. And he begins to defend himself, often according to the principle "the best defense is an attack."

The search for a compromise turns into a quarrel with raised voices and becomes hopeless.

9. Suggestibility

Critical thinking, fact-checking, analysis are not about histrionics. His point of view is based on emotions: “It’s close to me, so it’s true.”

A huge influence on the formation of the views of a person with a hysterical disorder is exerted by authorities, that is, people who are personally significant to him. He perceives their words completely uncritically, often as the ultimate truth.

10. Deterioration of the quality of life due to behavioral characteristics

This is a common symptom of behavioral disorders: they ruin a person's life.

For example, an overly emotional histrionic, prone to dramatization, cannot build stable personal or business relationships: partners run away from him after the very first theatrical scandals.

Or another angle: because of the gullibility and love for revealing outfits, the histrionic now and then finds himself in risky situations.

Here is another example: due to the inability to be critical of himself, he cannot draw conclusions from past mistakes, so he falls into the same rake again and again, blaming anyone but himself for his problems.

What to do if a person has histrionic personality disorder

The most effective Histrionic Personality Disorder treatment for histrionic personality disorder is psychotherapy. The problem is that histrionics, as a rule, do not consider their behavior to require correction and are often not ready to turn to a psychotherapist.

The easiest way is to proceed as follows. Sooner or later, the histrionic once again gets hit on the forehead by life. Against this background, he experiences severe stress, anxiety, sometimes he develops depression. It is at this moment that it is worth taking a person by the hand and leading him to a specialist. To begin with, to solve the “stress” problem, and after it, deal with histrionic disorder.

Most likely, the doctor will choose the so-called psychodynamic approach to work with the patient. It is based on psychoanalysis: with the help of a specialist, a person learns to understand what exactly makes him perform certain actions.

In the first step, the therapist will ask the patient to replace active behavior with words. For example, if a histrionic wants to throw himself on someone's neck, he should stop and explain to himself what is happening: "I'm glad to meet you." This deciphering of emotions, which should become a habit, helps to understand yourself and learn to communicate less theatrically with others.

Next, the psychotherapist will help the histrionic to realize that drama, excessive emotionality is just a way to attract attention, to feel significant. And he will tell you how to maintain self-confidence in other ways.

Unfortunately, it is impossible to predict how quickly psychotherapy will work.

Learn more