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^[1]Histrionic Personality Disorder

I am doing my article on Histrionic Personality Disorder, I plan on improving this article by applying concepts from class, digging deeper for find causes of this disorder such as environmental factors and genetic factors. Why are some people more emotionally than others, why do they like to seek more attention? What types of personalities enforce this type of behavior? Differences in Men vs. Women

Causes to talk about

-Culture

-Parenting Styles

-Peers

-Genetic/Neurobiology

^[2]

Histrionic personality disorder (HPD) is defined by the American Psychiatric Association as a personality disorder characterized by a pattern of excessive attention-seeking emotions, usually beginning in early adulthood, including inappropriately seductive behavior and an excessive need for approval. Histrionic people are lively, dramatic, vivacious, enthusiastic, and flirtatious. HPD is diagnosed four times as frequently in women as men.^[3] It affects 2–3% of the general population and 10–15% in inpatient and outpatient mental health institutions.^[4]

HPD lies in the dramatic cluster of personality disorders.^[5] People with HPD have a high need for attention, make loud and inappropriate appearances, exaggerate their behaviors and emotions, and crave stimulation.^[5] They may exhibit sexually provocative behavior, express strong emotions with an impressionistic style, and can be easily influenced by others. Associated features include egocentrism, self-indulgence, continuous longing for appreciation, and persistent manipulative behavior to achieve their own needs.

Signs and symptoms

People with HPD are usually high-functioning, both socially and professionally. They usually have good social skills, despite tending to use them to manipulate others into making them the center of attention.^[6] HPD may also affect a person's social and/or romantic relationships, as well as their ability to cope with losses or failures. They may seek treatment for clinical depression when romantic (or other close personal) relationships end.^{[citation needed]}

Individuals with HPD often fail to see their own personal situation realistically, instead dramatizing and exaggerating their difficulties. They may go through frequent job changes, as they become easily bored and may prefer withdrawing from frustration (instead of facing it). Because they tend to crave novelty and excitement, they may place themselves in risky situations. All of these factors may lead to greater risk of developing clinical depression.^[7]

Additional characteristics may include:

Exhibitionist behavior
Constant seeking of reassurance or approval
Excessive sensitivity to criticism or disapproval
Pride of own personality and unwillingness to change, viewing any change as a threat
Inappropriately seductive appearance or behavior of a sexual nature
Using somatic symptoms (of physical illness) to garner attention
A need to be the center of attention
Low tolerance for frustration or delayed gratification
Rapidly shifting emotional states that may appear superficial or exaggerated to others
Tendency to believe that relationships are more intimate than they actually are
Making rash decisions^[6]
Blaming personal failures or disappointments on others
Being easily influenced by others, especially those who treat them approvingly
Being overly dramatic and emotional^[8]

Some people with histrionic traits or personality disorder change their seduction technique into a more maternal or paternal style as they age.^[9]

Mnemonic

A mnemonic that can be used to remember the characteristics of histrionic personality disorder is shortened as "PRAISE ME":^[10]^[11]

Provocative (or seductive) behavior
Relationships are considered more intimate than they actually are
Attention-seeking
Influenced easily by others or circumstances
Speech (style) wants to impress; lacks detail
Emotional lability; shallowness
Make-up; physical appearance is used to draw attention to self
Exaggerated emotions; theatrical

Causes

Little research has been done to find evidence of what causes histrionic personality disorder and from where it stems. Although direct causes are inconclusive there are a few theories and studies conducted that suggests there are multiple possible causes. There are neurochemical, genetic, psychoanalytical, and environmental causes contributing to histrionic personality disorder. Traits such as extravagance, vanity, and seductiveness of hysteria have similar qualities to women diagnosed with HPD.^[12] HPD symptoms do not fully develop until the age of 15 with treatment only beginning at approximately 40 years of age.^[13] An example of over-zealousness could be compared to the famous "grande hystérie", a well-known demonstration of hypnotism by Jean-Martin Charcot by using his best-known subject, Blanche Wittmann. Wittmann was known for her attractiveness and ability to make herself the center of attention, based on her hysteria and lavish performance.^[14]

Neurochemical/Physiological

Studies have shown that there is a strong correlation between the function of neurotransmitters and the Cluster B personality disorders such as HPD. Individuals diagnosed with HPD have highly responsive noradrenergic systems which is responsible for the synthesis, storage, and release of the neurotransmitter, norepinephrine. High levels of norepinephrine leads to anxiety-proneness, dependency, and high sociability.^[15]

Genetic

Twin studies has aided in breaking down the genetic vs. environment debate. A twin study conducted by the department of Psychology at Oslo University attempted to establish a correlation between genetic and Cluster B personality disorders. With a test sample of 221 twins, 92 monozygotic and 129 dizygotic twins researchers interviewed the twins with the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II) and concluded that there was a correlation of 0.67 that Histrionic Personality Disorder is hereditary.^[16]

Psychoanalytic theory

Psychoanalytic theories incriminate authoritarian or distant attitudes by one (mainly the mother) or both parents, along with conditional love based on expectations the child can never fully meet.^[5] Using psychoanalysis, Freud believed that lustfulness was a projection of the patient's lack of ability to love unconditionally and develop cognitively to maturity, and that such patients were overall emotionally shallow.^[17] He believed the reason for being unable to love could have resulted from a traumatic experience, such as the death of a close relative during childhood or divorce of one's parents, which gave the wrong impression of committed relationships. Exposure to one or multiple traumatic occurrences of a close friend or family member's leaving (via abandonment or mortality) would make the person unable to form true and affectionate attachments towards other people.^[18]

HPD and antisocial personality disorder

Another theory suggests a possible relationship between histrionic personality disorder and antisocial personality disorder. Research has found 2/3 of patients diagnosed with histrionic personality disorder also meet criteria similar to those of the antisocial personality disorder,^[12] which suggests both disorders based towards sex-type expressions may have the same underlying cause. Women are hypersexualized in the media consistently, ingraining thoughts that the only way women are to get attention is by exploiting themselves, and when seductiveness isn't enough, theatricals are the next step in achieving attention.^[19] Men can just as well be flirtatious towards multiple women yet feel no empathy or sense of compassion towards them.^[12] They may also become the center of attention by exhibiting the "Don Juan" macho figure as a role-play.^[19]

Some family history studies have found that histrionic personality disorder, as well as borderline and antisocial personality disorders, tend to run in families, but it is unclear if this is due to genetic or environmental factors.^[20] Both examples suggest that predisposition could be a factor as to why certain people are diagnosed with histrionic personality disorder, however little is known about whether or not the disorder is influenced by any biological compound or is genetically inheritable.^[20] Little research has been conducted to determine the biological sources, if any, of this disorder.

Diagnosis

The person's appearance, behavior, and history, along with a psychological evaluation, are usually sufficient to establish a diagnosis. There is no test to confirm this diagnosis. Because the criteria are subjective, some people may be wrongly diagnosed.^[21]

DSM-IV-TR

The previous edition of the Diagnostic and Statistical Manual of Mental Disorders, DSM IV-TR, defines histrionic personality disorder (in Cluster B) as:^[4]

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:
is uncomfortable in situations in which he or she is not the center of attention

interaction with others is often characterized by inappropriate sexually seductive or provocative behavior

displays rapidly shifting and shallow expression of emotions

consistently uses physical appearance to draw attention to self

has a style of speech that is excessively impressionistic and lacking in detail

shows self-dramatization, theatricality, and exaggerated expression of emotion

is suggestible, i.e., easily influenced by others or circumstances

considers relationships to be more intimate than they actually are

The DSM-IV requires that a diagnosis for any specific personality disorder also satisfies a set of general personality disorder criteria.

ICD-10

The World Health Organization's ICD-10 lists histrionic personality disorder as:^[22]

A personality disorder characterized by:
shallow and labile affectivity,

self-dramatization,

theatricality,

exaggerated expression of emotions,

suggestibility,

egocentricity,

self-indulgence,

lack of consideration for others,

easily hurt feelings, and

continuous seeking for appreciation, excitement and attention.

It is a requirement of ICD-10 that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria.

Comorbidity

Most histrionics also have other mental disorders. Comorbid conditions include: antisocial, dependent, borderline, and narcissistic personality disorders,^[23] as well as depression, anxiety disorders, panic disorder, somatoform disorders, anorexia nervosa, substance use disorder^[24] and attachment disorders, including reactive attachment disorder.^{[citation needed]}

Millon's subtypes

Theodore Millon identified six subtypes of histrionic personality disorder. Any individual histrionic may exhibit none or one of the following:^[25]

Subtype	Description	Personality Traits
Appeasing histrionic	Including dependent and compulsive features	Seeks to placate, mend, patch up, smooth over troubles; knack for settling differences, moderating tempers by yielding, compromising, conceding; sacrifices self for commendation; fruitlessly placates the unplacatable.
Vivacious histrionic	The seductiveness of the histrionic mixed with the energy typical of hypomania. Some narcissistic features can also be present	Vigorous, charming, bubbly, brisk, spirited, flippant, impulsive; seeks momentary cheerfulness and playful adventures; animated, energetic, ebullient.
Tempestuous histrionic	Including negativistic features	Impulsive, out of control; moody complaints, sulking; precipitous emotion, stormy, impassioned, easily wrought-up, periodically inflamed, turbulent.
Disingenuous histrionic	Including antisocial features	Underhanded, double-dealing, scheming, contriving, plotting, crafty, false-hearted; egocentric, insincere, deceitful, calculating, guileful.
Theatrical histrionic	Variant of “pure” pattern	Affected, mannered, put-on; postures are striking, eyecatching, graphic; markets self-appearance; is synthesized, stagy; simulates desirable/dramatic poses.
Infantile histrionic	Including borderline features	Labile, high-strung, volatile emotions; childlike hysteria and nascent pouting; demanding, overwrought; fastens and clutches to another; is excessively attached, hangs on, stays fused to and clinging.

Treatment

Treatment is often prompted by depression associated with dissolved romantic relationships. Medication does little to affect the personality disorder, but may be helpful with symptoms such as depression.^[21] Treatment for HPD itself involves psychotherapy, including cognitive therapy.^[5]

Interviews and self-report methods

In general clinical practice with assessment of personality disorders, one form of interview is the most popular; an unstructured interview.^[26] The actual preferred method is a semi-structured interview but there is reluctance to use this type of interview because they can seem impractical or superficial.^[26] The reason that a semi-structured interview is preferred over an unstructured interview is that semi-structured interviews tend to be more objective, systematic, replicable, and comprehensive.^[26] Unstructured interviews, despite their popularity, tend to have problems with unreliability and are susceptible to errors leading to false assumptions of the client.^[26]

One of the single most successful methods for accessing personality disorders by researchers of normal personality functioning is the self-report inventory following up with a semi-structured interview.^[26] There are some disadvantages with the self-report inventory method that with histrionic personality disorder there is a distortion in character, self-presentation, and self-image.^[26] This cannot be assessed simply by asking most clients if they match the criteria for the disorder.^[26] Most projective testing depend less on the ability or willingness of the person to provide an accurate description of the self, but there is currently limited empirical evidence on projective testing to assess histrionic personality disorder.^[26]

Functional analytic psychotherapy

Another way to treat histrionic personality disorder after identification is through functional analytic psychotherapy.^[27] The job of a Functional Analytic Psychotherapist is to identify the interpersonal problems with the patient as they happen in session or out of session.^[27] Initial goals of functional analytic psychotherapy are set by the therapist and include behaviors that fit the client's needs for improvement.^[27] Functional analytic psychotherapy differs from the traditional psychotherapy due to the fact that the therapist directly addresses the patterns of behavior as they occur in-session.^[27]

The in-session behaviors of the patient or client are considered to be examples of their patterns of poor interpersonal communication and to adjust their neurotic defenses.^[27] To do this, the therapist must act on the client's behavior as it happens in real time and give feedback on how the client's behavior is affecting their relationship during therapy.^[27] The therapist also helps the client with histrionic personality disorder by denoting behaviors that happen outside of treatment; these behaviors are termed "Outside Problems" and "Outside Improvements".^[27] This allows the therapist to assist in problems and improvements outside of session and to verbally support the client and condition optimal patterns of behavior".^[27] This then can reflect on how they are advancing in-session and outside of session by generalizing their behaviors over time for changes or improvement".^[27]

Coding client and therapist behaviors

This is called coding client and therapist behavior.^[27] In these sessions there is a certain set of dialogue or script that can be forced by the therapist for the client to give insight on their behaviors and reasoning".^[27] Here is an example from"^[27] the conversation is hypothetical. T = therapist C = Client This coded dialogue can be transcribed as:

ECRB – Evoking clinically relevant behavior
CRB1 – In-session problems
CRB2 – In-session improvements
TCRB1 – Clinically relevant response to client problems
TCRB2 – Responses to client improvement

“(ECRB) T:Tell me how you feel coming in here today (CRB2) C: Well, to be honest, I was nervous. Sometimes I feel worried about how things will go, but I am really glad I am here. (TCRB2) T: That’s great. I am glad you’re here, too. I look forward to talking to you. (CRB1) C: Whatever, you always say that. (becomes quiet). I don’t know what I am doing talking so much. (TCRB1) T: Now you seem to be withdrawing from me. That makes it hard for me to give you what you might need from me right now. What do you think you want from me as we are talking right now?”.^[27]

Functional ideographic assessment template

Another example of treatment besides coding is Functional Ideographic Assessment Template.^[27] The functional ideographic assessment template, also known as FIAT, was used as a way to generalize the clinical processes of functional analytic psychotherapy.^[27] The template was made by a combined effort of therapists and can be used to represent the behaviors that are a focus for this treatment.^[27] Using the FIAT therapists can create a common language to get stable and accurate communication results through functional analytic psychotherapy at the ease of the client; as well as the therapist.^[27]

Epidemiology

Approximately 1–3% of the general population may be diagnosed with HPD.^[28] Major character traits may be inherited, while other traits may be due to a combination of genetics and environment, including childhood experiences.^[9] This personality is seen more often in women than in men.^[29] Approximately 65% of HPD diagnoses are women while 35% are men. Women are generally over diagnosed due to potential biases. In Kaplan's "A Women's View of DSM-III, she expresses that even healthy women are often automatically diagnosed with HBD.^[30] Many symptoms representing HPD in the DSM are exaggerations of traditional feminine behaviors. In a peer and self-review study it showed that femininity was correlated with Histrionic, Dependent, and Narcissistic personality disorders.^[31] Although two thirds of HPD diagnoses are female, however there have been a few exceptions.^[32] Whether or not the rate will be significantly higher than the rate of women within a particular clinical setting depends upon many factors that are mostly independent of the differential sex prevalence for HPD.^[33] Those with HPD are more likely to look for multiple people for attention which leads to marital problems due to jealousy and lack of trust from the other party. This makes them more likely to become divorced or separated once married.^[34] With few studies done to find direct causations between HPD and culture, cultural and social aspects play a role in inhibiting and exhibiting HPD behaviors.

History

The history of histrionic personality disorder stems from the word hysteria.^[35] Hysteria can be described as an exaggerated or uncontrollable emotion that people, especially in groups, experience.^[36] Beliefs about hysteria have varied throughout time. It wasn’t until Sigmund Freud who studied histrionic personality disorder in a psychological manner.^[35] “The roots of histrionic personality can be traced to cases of hysterical neurosis described by Freud.”^[17] He developed the psychoanalytic theory in the late 19th century and the results from his development led to split concepts of hysteria. One concept labeled as hysterical neurosis (also known as conversion disorder)^[37] and the other concept labeled as hysterical character (currently known as histrionic personality disorder).^[35] These two concepts must not be confused with each other, as they are two separate and different ideas.^[17]

Histrionic Personality Disorder is also known as hysterical personality. Hysterical personality has evolved in the past 400 years^[38] and it first appeared in the DSM II (Diagnostic and Statistical Manual of Mental Disorders, 2nd edition) under the name hysterical personality disorder. The name we know today as histrionic personality disorder is due to the name change in DSM III, 3rd edition. Renaming hysterical personality to histrionic personality disorder is believed to be because of possible negative connotations to the roots of hysteria, such as intense sexual expressions, demon possessions, etc.^[39]

Histrionic Personality Disorder has gone through many changes. From hysteria, to hysterical character, to hysterical personality disorder, to what it is listed as in the most current DSM, DSM-5.^{[clarification needed]} "Hysteria is one of the oldest documented medical disorders.”^[35] Hysteria dates back to both ancient Greek and Egyptian writings.^[35] Most of the writings related hysteria and women together, similar to today where the epidemiology of histrionic personality disorder is generally more prevalent in women and also frequently diagnosed in women.^[26]

Ancient times

Ancient Egypt – first description of the mental disorder, hysteria, dates back to 1900 BC in Ancient Egypt. Biological issues, such as the uterus movement in the female body, were seen as the cause of hysteria. Traditional symptoms and descriptions of hysteria can be found in the Ebers Papyrus, the oldest medical document.^[40]
Ancient Greece – Similar to ancient Egyptians, the ancient Greeks saw hysteria being related to the uterus. Hippocrates (5th century BC) is the first to use the term hysteria. Hippocrates believed hysteria was a disease that lies in the movement of uterus (from the Greek ὑστέρα hystera "uterus"). Hippocrates’s theory was that since a woman’s body is cold and wet compared to a man’s body which is warm and dry, the uterus is prone to illness, especially if deprived from sex. He saw sex as the cleansing of the body so that being overemotional was due to sex deprivation.^[40]
According to History Channel's Ancients Behaving Badly, Cleopatra and Nero had histrionic personality disorder.^[41]

Middle Ages

The Trotula—a group of three texts from the 12th century—discusses women’s diseases and disorders as understood during this time period, including hysteria. Trota of Salerno, a female medical practitioner from 12th-century Italy, is an authoritative figure behind one of the texts of the Trotula. (Authoritative in that it is her treatments and theories that are presented in the text). Some people believe Trota's teachings resonated with those of Hippocrates.^[40]

Renaissance

The uterus was still the explanation of hysteria, the concept of women being inferior to men was still present, and hysteria was still the symbol for femininity.^[40]

Modern age

Thomas Willis (17th century) introduces a new concept of hysteria. Thomas Willis believed that the causes of hysteria was not linked to the uterus of the female, but to the brain and nervous system.^[40]
Hysteria was consequence of social conflicts during the Salem witch trials.^[40]
Witchcraft and sorcery was later considered absurd during the Age of Enlightenment in the late 17th century and 18th century. Hysteria starts to form in a more scientific way, especially neurologically. New ideas formed during this time and one of them was that if hysteria is connected to the brain, men could possess it too, not just women.^[40]
Franz Mesmer (18th century) treated patients suffering from hysteria with his method called mesmerism, or animal magnetism.^[40]
Jean-Martin Charcot (19th century) studied effects of hypnosis in hysteria. Charcot states that hysteria is a neurological disorder and that it is actually very common in men.^[40]

Contemporary age

Sigmund Freud's work with Josef Breuer, Studies on Hysteria, contributes to a psychoanalytic theory of hysteria. Freud believed that hysteria was caused by a lack of libidinal evolution.^[40]

Social implications

The prevalence of Histrionic Personality Disorder in women is apparent and urges a re-evaluation of culturally constructed ideas around what is considered normal emotional behaviour. The diagnostic approach classifies Histrionic Personality Disorder behaviour as “excessive”, considering it in reference to a social understanding of normal emotionality.^[42]

References

^ Kernberg, Ott0 (1992). Aggression in Personality Disorders and Perversion. Yale University Press.{{cite book}}: CS1 maint: numeric names: authors list (link)
^ Reichborn-Kjennerud, Ted (2010-3). "The genetic epidemiology of personality disorders". Dialogues in Clinical Neuroscience. 12 (1): 103–114. ISSN 1294-8322. PMC 3181941. PMID 20373672. {{cite journal}}: Check date values in: |date= (help)CS1 maint: PMC format (link)
^ Seligman, Martin E.P. (1984). "Chapter 11". Abnormal Psychology. W.W. Norton & Company. ISBN 0-393-94459-X.
^ ^a ^b "Chapter 16: Personality Disorders". DSM-IV-TR Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Publishing. 2000.^{[permanent dead link‍]}
^ ^a ^b ^c ^d Bienenfeld, David (2006). "Personality Disorders". Medscape Reference. WebMD. Retrieved 10 January 2007.
^ ^a ^b "Histrionic Personality Disorder". The Cleveland Clinic. Retrieved 23 November 2011.
^ "Histrionic personality disorder". PubMed Health. Retrieved 17 June 2012.
^ https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002498/
^ ^a ^b Arthur, Melissa (2006). "Histrionic Personality Disorder". Histrionic Personality Disorder: Description, Incidence, Prevalence, Risk Factors, Causes, Associated Conditions, Diagnosis, Signs and symptoms and treatment. Armenian Medical Network. Retrieved 10 January 2007.
^ Pinkofsky, HB (September 1997). "Mnemonics for DSM-IV personality disorders". Psychiatric services. 48 (9). Washington, D.C.: 1197–1198. doi:10.1176/ps.48.9.1197. PMID 9285984.
^ "Personality Disorders". March 2001. Retrieved May 2, 2006.
^ ^a ^b ^c Barlow, H.D. & Durand, V.M. (2005). Personality Disorders. (pp. 443–444). Abnormal Psychology: An Integrative Approach (4th ed.). Belmont, CA: Thomas Wadsworth.
^ Lumen Learning. "Histrionic Personality Disorder". Lumen Learning. Retrieved 2018-03-13. {{cite web}}: Cite has empty unknown parameter: |dead-url= (help)
^ Fancher, R.E. & Rutherford, A. (2012). Pioneers of psychology. New York, NY: W.W. Norton & Company.
^ "Histrionic Personality Disorder". Courses Lumen. {{cite web}}: Cite has empty unknown parameter: |dead-url= (help)
^ Torgersen, Lygren, Øien, Skre, Onstad, Edvardsen, Tambs, Kringlen, Svenn, Sissel, Per Anders, Ingunn, Sidsel, Jack, Kristian, Einar (November 2000). "A Twin Studies of Personality Disorders". Comprehensive Psychiatric Journal. Retrieved 13 March 2018. {{cite web}}: Cite has empty unknown parameter: |dead-url= (help)CS1 maint: multiple names: authors list (link)
^ ^a ^b ^c Pfohl, B. (1995). Histrionic personality disorder. The DSM IV Personality Disorders, 173–192.
^ Nickert, J. (n.d.) Histrionic Personality Disorder.
^ ^a ^b Bornstein, R.F. & Widiger, T.A. (2001). Comprehensive Handbook of Psychopathology. Adams, H.E. & Sutker, P.B. (Ed.) New York, NY.
^ ^a ^b Nolen-Hoeksema, S. (2014). Personality Disorders. (pp. 266–267). Abnormal Psychology (6th ed.). New York, NY: McGraw-Hill.
^ ^a ^b "Psych Central: Histrionic Personality Disorder Treatment". Psych Central.
^ "Chapter V: Mental and behavioural disorders (F00-F99)". International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10). World Health Organization. 2010. (F60.4)
^ Hales E and Yudofsky JA, eds, The American Psychiatric Press Textbook of Psychiatry, Washington, DC: American Psychiatric Publishing, Inc., 2003
^ Armenian Medical Network
^ Millon, Theodore (2004). Personality Disorders in Modern Life. John Wiley & Sons, Inc., Hoboken, New Jersey. ISBN 0-471-23734-5.
^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ Sutker, P.B. (2002). Histrionic, Narcissistic, and Dependent Personality Disorders. Comprehensive handbook of psychopathology (3rd ed., pp. 513–514). New York: Kluwer Academic.
^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k ^l ^m ⁿ ^o ^p ^q Callaghan G.M.; Summers C.J.; Weidman M. (2003). "The treatment of histrionic and narcissistic personality disorder behaviors: A single-subject demonstration of clinical improvement using functional analytic psychotherapy". Journal of contemporary psychotherapy. 33 (4): 321–339. doi:10.1023/b:jocp.0000004502.55597.81.
^ Livesley, W. John (2001) Handbook of Personality Disorders: Theory, Research, and Treatment The Guilford Press. ISBN 978-1-57230-629-5.
^ Suinn, Richard M. (1984). Fundamentals of abnormal psychology (Updated ed.). Chicago: Nelson-Hall. pp. 335–336. ISBN 0-8304-1071-6.
^ Kaplan, Marcie (July 1983). "A Women's View on DSM-III" (PDF). American Psychologist: 7.
^ Klonsky, Jane, Turkheimer, Oltmanns, E. David, J. Serrita, Eric, Thomas (2002). "Gender Role and Personality Disorders". J Pers Disord. 16: 464–76. doi:10.1521/pedi.16.5.464.22121. PMC 4364134. PMID 12489312.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^ Corbitt, E., Widiger, T. (1995). "Sex differences among the personality disorders: An exploration of the data". Clinical Psychology: Science and Practice. 2 (3): 225–238. doi:10.1111/j.1468-2850.1995.tb00041.x.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^ Widiger, T. (1998). "Sex biases in the diagnosis of personality disorders". Journal of Personality Disorders. 12 (2): 95–118. doi:10.1521/pedi.1998.12.2.95. PMID 9661097.
^ Disney, K.L., Weinstein, Y., & Oltmanns, T.F. (2012). "Personality disorder symptoms are differentially related to divorce frequency". Journal of Family Psychology. 26 (6): 959–965. doi:10.1037/a0030446.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^ ^a ^b ^c ^d ^e Blais M.A.; Hilsenroth M.; Fowler C. (1998). "Rorschach correlates of the DSM-IV histrionic personality disorder". Journal of Personality Assessment. 70 (2): 355–365. doi:10.1207/s15327752jpa7002_12.
^ Hysteria [Def. 1]. (n.d.). In Google, Retrieved September 11, 2013, from https://www.google.com/search?q=hysteria.#q=hysteria+definition
^ Crimlisk H.; Ron M. (1999). "Conversion hysteria: history, diagnostic issues, and clinical practice". Cognitive Neuropsychiatry. 4 (3): 165–180. doi:10.1080/135468099395909.
^ Alam C.M.; Merskey H. (1992). "The development of hysterical personality". History of Psychiatry. 3 (10): 135–165. doi:10.1177/0957154x9200301001.
^ Bakkevig J.F.; Sigmund K. (2010). "Is the diagnostic and statistical manual of mental disorders, fourth edition, histrionic personality disorder category a valid construct?". Comprehensive Psychiatry. 51 (5): 462–470. doi:10.1016/j.comppsych.2009.11.009.
^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j Tasca C.; Rapetti M.; Carta M.G.; Fadda B. (2012). "Women and hysteria in the history of mental health". Clinical Practice & Epidemiology in Mental Health. 8: 110–119. doi:10.2174/1745017901208010110. PMC 3480686. PMID 23115576.
^ http://gothicsea.com/Ancient-History/chronology_ancient_near_east__cable_series_pagan.html#abb
^ ‘Histrionic Personality Disorder’, in American Psychiatric Association, The Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association, Arlington, VA, pp. 667.

External links

A.D.A.M. Editorial Board (2013). "Histrionic personality disorder". A.D.A.M. Medical Encyclopedia. PubMed.

[1] Kernberg, Ott0 (1992). Aggression in Personality Disorders and Perversion. Yale University Press.{{cite book}}: CS1 maint: numeric names: authors list (link)

[2] Reichborn-Kjennerud, Ted (2010-3). "The genetic epidemiology of personality disorders". Dialogues in Clinical Neuroscience. 12 (1): 103–114. ISSN 1294-8322. PMC 3181941. PMID 20373672. {{cite journal}}: Check date values in: |date= (help)CS1 maint: PMC format (link)

[seligman-3] Seligman, Martin E.P. (1984). "Chapter 11". Abnormal Psychology. W.W. Norton & Company. ISBN 0-393-94459-X.

[dsmiv-4] "Chapter 16: Personality Disorders". DSM-IV-TR Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Publishing. 2000.^{[permanent dead link‍]}

[WebMD-5] Bienenfeld, David (2006). "Personality Disorders". Medscape Reference. WebMD. Retrieved 10 January 2007.

[Cleveland-6] "Histrionic Personality Disorder". The Cleveland Clinic. Retrieved 23 November 2011.

[ADAM-7] "Histrionic personality disorder". PubMed Health. Retrieved 17 June 2012.

[8] ttps://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002498/

[AMN-9] Arthur, Melissa (2006). "Histrionic Personality Disorder". Histrionic Personality Disorder: Description, Incidence, Prevalence, Risk Factors, Causes, Associated Conditions, Diagnosis, Signs and symptoms and treatment. Armenian Medical Network. Retrieved 10 January 2007.

[10] Pinkofsky, HB (September 1997). "Mnemonics for DSM-IV personality disorders". Psychiatric services. 48 (9). Washington, D.C.: 1197–1198. doi:10.1176/ps.48.9.1197. PMID 9285984.

[11] "Personality Disorders". March 2001. Retrieved May 2, 2006.

[Barlow-12] Barlow, H.D. & Durand, V.M. (2005). Personality Disorders. (pp. 443–444). Abnormal Psychology: An Integrative Approach (4th ed.). Belmont, CA: Thomas Wadsworth.

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Classification	D ICD-10: F60.4 ICD-9-CM: 301.50 MeSH: D006677
External resources	MedlinePlus: 001531