Personality Disorder Characterized by Dramatic, Emotional, or Erratic Behavior: Histrionic & Narcissistic


Histrionic Personality Disorder.

Histrionic personality disorder, often abbreviated as (HPD), is a type of personality disorder in which the affected individual displays an enduring pattern of attention- seeking and excessively dramatic behaviors beginning in early adulthood and present across a broad range of situations. Individuals with HPD are highly emotional, charming, energetic, manipulative, seductive, impulsive, erratic, and demanding.

It has a unique position among the personality disorders in that it is the only personality disorder explicitly connected to a patient’s physical appearance.. Some research has suggested that the connection between histrionic personality disorder and physical appearance holds for women rather than for men. Both women and men express a strong need to be the center of attention. Individuals with the disorder exaggerate, throw temper tantrums, and cry if they are not the center of attention. Cognitive style can be defined as a way in which an individual works with and solves cognitive tasks such as reasoning, learning, thinking, understanding, making decisions, and using memory.

Individuals with Histrionic personality disorder tend to be overly dramatic and often seem almost to be acting, which is why the term histrionic, which means theatrical in manner, is used.

Diagnostic Criteria for Histrionic Personality Disorder.

A pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
1. Is uncomfortable in situations in which he or she is not the center of attention.
2. Interaction with others is often characterized by inappropriate sexually seductive or provocative behavior.
3. Displays rapidly shifting and shallow expression of emotions.
4. Consistently uses physical appearance to draw attention to self.
5. Has a style of speech that is excessively impressionistic and lacking in detail.
6. Shows self-dramatization, theatricality, and exaggerated expression of emotion.
7. Is suggestible (i.e., easily influenced by others or circumstances).
8. Considers relationships to be more intimate than they actually are.


  • Center of attention
  • Sexually seductive
  • Shifting emotions
  • Physical appearance.
  • Speech style
  • Dramatic behaviors
  • Suggestibility
  • Overestimation of intimacy

Causes of Histrionic Personality Disorder.

This disorder is not definitively known, it is thought that HPD may be caused by biological, developmental, cognitive, and social factors. Neurotransmitters are chemicals that communicate impulses from one nerve cell to another in the brain and these impulses dictate behavior.

The tendency towards an excessively emotional reaction to rejection, common among patients with HPD, Most psychoanalysts agree that a traumatic childhood contributes towards the development of HPD. Bio social issues also contribute to the development of personality.

Socio cultural and personal variables have found some connections between the age of individuals with HPD and the behavior displayed by these individuals. The symptoms of HPD are long-lasting; however, histrionic character traits that are exhibited may change with age.

Treatment for Histrionic Personality Disorder.

1.Psychodynamic therapy: Like other personality disorders, may require several years of therapy and may affect individuals throughout their lives. Some professionals believe that psychoanalytic therapy is a treatment of choice for this disorder. It assists patients to become aware of their own feelings. Long-term psychodynamic therapy needs to target the underlying conflicts of individuals with HPD and to assist patients in decreasing their emotional reactivity.

2. Cognitive-behavioural therapy Cognitive therapy is a treatment directed at reducing the dysfunctional thoughts of individuals with this disorder. Such thoughts include themes about not being able to take care of oneself. Cognitive-behavioural training in relaxation for an individual with HPD emphasises challenging automatic thoughts about inferiority and not being able to handle one’s life.

3. Group therapy Group therapy is suggested to assist individuals with HPD to work on interpersonal relationships. Psychodrama techniques or group role play can assist individuals with HPD.

4. Family therapy Family therapy can support family members to meet their own needs without supporting the histrionic behavior of the individual with HPD who uses dramatic crises to keep the family closely connected.

5. Medications Pharmacotherapy is not a treatment of choice for individuals with HPD unless HPD occurs with another disorder.

6. Alternative therapies Meditation has been used to assist extroverted patients with this disorder to relax and to focus on their own inner feelings. Some therapists employ hypnosis to assist individuals with HPD to relax.

Narcissistic Personality Disorder

Narcissistic personality disorder is a condition characterized by an inflated sense of self-importance, need for admiration, extreme self-involvement, and lack of empathy for others. Individuals with this disorder are usually arrogantly self-assured and confident. They expect to be noticed as superior. Many highly successful individuals might be considered narcissistic. However, this disorder is only diagnosed when these behaviors become persistent and very disabling or distressing.

The word “narcissism” comes from a Greek myth in which a handsome young man named Narcissus sees his reflection in a pool of water and falls in love with it. Narcissistic personality disorder is one of a group of conditions called dramatic People with these disorders have intense, unstable emotions and a distorted self-image. Narcissistic personality disorder is further characterized by an abnormal love of self, an exaggerated sense of superiority and importance, and a preoccupation with success and power.

Diagnostic Criteria for Narcissistic Personality Disorder.

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
1. Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).
2. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
3. Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions).
4. Requests excessive admiration.
5. Has a sense of entitlement (i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations).
6. Is interpersonally exploitative (i.e., takes advantage of others to achieve his or her own ends).
7. Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others.
8. Is often envious of others or believes that others are envious of him or her.
9. Shows arrogant, haughty behaviors or attitudes.


  • Self centered and boastful
  • Seek constant attention and admiration
  • Considering themselves better than others
  • Exaggerate own talents and achievements
  • Believing for own special treatments.
  • Setting unrealistic goal Personality Disorders
  • Believing that you’re better than others
  • Fantasizing about power, success and attractiveness
  • Exaggerating your achievements or talents
  • Expecting constant praise and admiration
  • Failing to recognize other people’s emotions and feelings
  • Expecting others to go along with your ideas and plans
  • Taking advantage of others.


According to Freud concept that the root of narcissism lies from the childhood itself. It starts with the problem in parent child relationship. Child grows out of primary narcissism through opportunities to be mirrored by (i.e., gain approval from) his or her parents and to idealize them, acquiring a more realistic sense of self and a set of personal ideals and values through these two processes. On the other hand, if the parents fail to provide appropriate opportunities for idealization and mirroring, the child remains “stuck” at a developmental stage in which his or her sense of self remains grandiose and unrealistic while at the same time he or she remains dependent on approval from others for self-esteem.

This also views that the disorder roots in the child’s defense against a cold and unempathetic parent, usually the mother. Emotionally hungry and angry at the depriving parents, the child withdraws into a part of the self that the parents value, whether looks, intellectual ability, or some other skill or talent. This part of the self becomes hyperinflated and grandiose. Any perceived weaknesses are “split off” into a hidden part of the self. Splitting gives rise to a lifelong tendency to swing between extremes of grandiosity and feelings of emptiness and worthlessness. On the other dimension of disorder also count due to social and historical context.


1. Hospitalization: The hospitalization of patients with severe Narcissistic Personality occurs frequently. For some, such as those who are quite impulsive or self-destructive, or who have poor reality-testing, r. Hospitalizations should be brief, and the treatment specific to the particular symptom involved.

2. Psychosocial Treatment:
a. Individual Psychotherapy: Most psychiatrists will, as a practical matter, treat most of their severely narcissistic patients for symptoms related to crises and relatively external. we should not rely upon Positive transference and therapeutic alliance. Since the patient may not be able to acknowledge the real humanness of the therapist but may have to see him/her as either superhuman or devalued

b. Group Therapy: The goals are to help the patient develop a healthy individuality (rather than a resilient narcissism) so that he or she can acknowledge others as separate persons, and to decrease the need for self-defeating coping mechanisms.

Also read about Personality Disorder Characterized by Dramatic, Emotional, or Erratic Behavior: Antisocial & Borderline.


David H. Barlow, V. Mark Durand. Abnormal Psychology, An Integrative Approach. (7th ed).

Millon, Theodore and Seth, Grossman. (2002). Personality Disorders In Modern Life ,John Wiley and Sons, NY

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