The Diagnostic and Statistical Manual of Mental Disorders (DSM) defines Histrionic Personality Disorder (HPD) as a “Cluster B” personality disorder. “Cluster B” personality disorders are characterized by dramatic, emotional or erratic behavior (antisocial, borderline, and narcissistic personalities are also classified as Cluster B disorders). Individuals with HPD demonstrate an enduring pattern of attention-seeking and excessively dramatic behaviors. The disorder usually begins during adolescence and is expressed across a broad range of interpersonal relationships. The personality of people with HPD can be generally described as highly emotional, charming, energetic, manipulative, inappropriately seductive, impulsive, erratic and demanding.

A person must display five or more of the following eight behaviors/factors in order to meet the DSM diagnostic criteria of the disorder:

• Center of attention: Patients with HPD experience discomfort when they are not the center of attention;

• Sexually seductive: Patients with HPD displays inappropriate sexually seductive or provocative behaviors towards others;

• Shifting emotions: The expression of emotions of patients with HPD tends to be shallow and to shift rapidly;

• Physical appearance: Individuals with HPD consistently employ physical appearance to gain attention for themselves;

• Speech style: The speech style of patients with HPD lacks detail. Individuals with HPD tend to generalize, and when these individuals speak, they aim to please and impress;

• Dramatic behaviors: Patients with HPD display self-dramatization and exaggerate their emotions;

• Suggestibility: Other individuals or circumstances can easily influence patients with HPD; and

• Overestimation of intimacy: Patients with HPD overestimate the level of intimacy in a relationship.

A Mnemonic that is often taught to mental health professionals to help them remember the diagnostic criteria for the disorder is PRAISE ME.

P- provocative and seductive behavior

R- relationships, considered more intimate than they are

A- attention, must be the center of

I- Influenced easily

S- speech (style)-wants to impress, lacks detail

E-emotional lability, shallowness

M- make-up, physical appearance used to draw attention to self

E- exaggerated emotions- theatrical

HPD is diagnosed more frequently in women, and is unique amongst personality disorders in that it is expressly linked to physical appearance; researchers have found that the disorder is significantly more common in people that are considered by others to be above average in attractiveness.

People with HPD have stormy interpersonal relationships (characterized by cycles of idealization, neediness, disappointment and abandonment), which have a deleterious affect on their social life and careers. The cause of HPD is unknown, and medication is thought to be unhelpful in curbing unwanted behaviors. As such, people diagnosed with the disorder are generally treated with psychotherapy aimed at helping them discover the motivations behind their behavior so they can learn how to interact with others in a more positive way.

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