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Histrionic Personality Disorder
Histrionic Personality Disorder
The DSM-IV defines a Personality disorder as a pervasive, non-normative pattern of thoughts and behaviors that are chronic and cause impairment to relationships and general social functioning (American Psychiatric Association, 2013). Histrionic personality disorder (HPD) is marked by pervasive emotionality and attention seeking (American Psychiatric Association, 2013). Criteria for HPD diagnosis are being uncomfortable in situations that he/she is not the center of attention, inappropriate sexually seductive or provocative behavior, rapid shifting of emotions, consistently uses physical appearance to draw attention to self, self-dramatization, theatricality, and exaggerated expression of emotion, easily influenced by others, easily influenced by others, and usually considers relationships to be more intimate than they actually are (American Psychiatric Association, 2013).
Supportive therapy is one modality recommended for treating HPD. This approach is aimed at reducing emotional distress, improving self-esteem, and enhancing patient coping skills using non-threatening, attentive and sympathetic listening (French & Shrestha, 2019).
Psychodynamic psychotherapy has also proven effective. This therapy looks at crucial emotional developmental milestones a client may have missed and integrates them into the present dysfunctional behaviors (French & Shrestha, 2019). By resolving underlying conflicts in the unconsciousness and recognizing inappropriate behaviors, patients can have better communication and relationships with others and develop self-esteem (French & Shrestha, 2019).
Currently there are no FDA approved medications to treat HPD but some symptoms can be mediated with psychopharmacology. Affect can be regulated with antidepressants, mood stabilizers, and antipsychotics. Impulse control specifically can by mood stabilizers like lithium lamotrigine, carbamazepine, topiramate, and valproate (French & Shrestha, 2019).
HPD patients are obsessed with how others view them so feedback regarding maladaptive behaviors and thoughts may upset them (Dixon-Gordon, Turner, & Chapman, 2011). The therapist should be honest and forth coming with the diagnosis of HPD and disclosing it to the patient. Telling the client that HPD is suspected and collaborating to develop a treatment plan can help maintain the client-therapist relationship (French & Shrestha, 2019).
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Dixon-Gordon, K. L., Turner, B. J., & Chapman, A. L. (2011). Psychotherapy for personality disorders. International Review Of Psychiatry, 23(3), 282-302. doi:10.3109/09540261.2011.586992
French, J.H., & Shrestha, S. (2019). Histrionic personality disorder. https://www.ncbi.nlm.nih.gov/books/NBK542325/
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