Thursday, November 15, 2018

Into the DSM - Histrionic Personality Disorder

Let's visit Cluster B personality disorders. You know ones. The dramatic, emotional, erratic group: antisocial, borderline, narcissistic, and, today's spotlight item, histrionic personality disorder.

Personality disorders--as opposed to just personality--involve patterns of beliefs and behaviors that severely impair those diagnosed with them. A full 10-15%  of people meet criteria for a personality disorder. That's a whole lot of people suffering, and often making others suffer, with long-standing, difficult-to-treat conditions.

Those with histrionic personality disorder seek attention more-or-less constantly, exhibiting extremes of feeling and behavior. Focus is often on excessive flirting, attention to looks, and severe reactions when attention isn't given.

Five of the following must be present to make a diagnosis:
  • When not receiving attention, feels less valued.
  • Inappropriate flirting and seduction.
  • Mood lability (quickly changing feelings).
  • Attracts attention via physical appearance.
  • Vague, detail-lacking style of speech.
  • Extreme displays of feeling (aka "drama").
  • Easily swayed by others and by fads.
  • Rapid attachments with overestimated depth. 
There's a fair amount of overlap with BPD, but it's not the same thing. For the LCSW exam look for flirting, looks-focus, and attention-seeking as signs that a fictional, vignette client is possibly meeting criteria for histrionic PD. 

For more detail, plus a mnemonic (PRAISE.ME) to help remember criteria, take a look at Wikipedia: https://en.wikipedia.org/wiki/Histrionic_personality_disorder

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