Histrionic Behavior

To be histrionic is to be overly theatrical and dramatic. Histrionic behavior is designed to impress and is typically insincere.

The main psychological disorders in which histrionic behavior is present are histrionic personality disorderOpens in new window and, to some extent, borderline personality disorderOpens in new window.

Personality is a long-standing pattern of behavior and inner experience, including characteristic thoughts and emotions. A personality disorder may be present when the following criteria are met:

The personality pattern differs significantly from the expectations of the individual’s culture in at least two of the following four areas: cognition, emotional response, interpersonal functioning, and impulse control.

The pattern is inflexible and generalizes across a variety of personal and social situations. Impairment in social or occupational functioning or significant distress, or both, are present. The pattern is long-lasting, persistent, and originated in early adulthood or earlier.

Histrionic personality disorder, as described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR; American Psychiatric Association, 2000), is a pattern of attention seeking and extreme emotionality that is present by early adulthood and expressed in a variety of situations and contexts.

Individuals with histrionic personality disorderOpens in new window present with at least five of the following symptoms:

  1. discomfort in situations in which they are not the center of attention;
  2. sexually seductive or provocative behavior when interacting with others;
  3. rapidly changing and shallow emotional expression;
  4. consistent use of physical appearance to gather attention;
  5. style of speech that is impressionistic and undetailed;
  6. theatrical, dramatic expression of emotion;
  7. easily influenced; and
  8. views relationships as closer in intimacy than others view them.

Leading theories on the origin of histrionic personality disorder derive from psychodynamic (Freudian) and cognitive perspectives on abnormal behavior. Most psychodynamic theorists, who focus on childhood relationships as causes of disorders, believe that individuals with histrionic personality disorder had cold, controlling parents who left their children feeling unloved and fearful of abandonment (e.g., Gunderson, 1988).

These individuals learned to behave in a dramatic fashion, inventing emergencies to solicit attention and protective behavior from others that may lead them to feel loved, at least temporarily.

Cognitive theorists focus on the way these individuals perceive the world and why their perceptual styles exist in their form.

According to such theorists (e.g., Hollender, 1988), people with histrionic personality disorder are so self-absorbed and emotional that they are unable to attend much to the world.

They learn less about the world than other people do and in the present moment must look to others to interpret events and other people’s behavior.

They feel helpless and continuously seek people who will protect them and satisfy their needs. Treatments for histrionic disorder are moderately successful and primarily include psychodynamic and cognitive forms of individual psychotherapy and group psychotherapy.

People with borderline personality disorder (BPD) exhibit persistent instability in mood, interpersonal relationships, and self-image and engage in frequent impulsive behavior.

    People with BPDOpens in new window have emotional lability (mood swings) accompanied by episodes of angerOpens in new window, depressionOpens in new window, and anxietyOpens in new window, lasting anywhere from a few hours to a few days; they are also prone to physical aggression and impulsivity. They tend to direct their anger inward, leading to a high rate of self-injury.

    Self-destructive behaviors in individuals with BPD include substance abuse (e.g., drugs or alcohol), binge eating, unsafe sex, reckless driving, and self-cuttign. Past research indicates that 60 to 80 percent of people with BPD have attempted suicide at least once in their lifetimes, while 10 percent of them die of suicide (James & Taylor, 2008).

    Risk factors for people with BPD completing suicide include those with comorbid major depressive disorder, antisocial personality disorder, those who are older with children, those who have less education, and those with a family history of substance use (Soloff, Fabio, Kelly, Malone, & Mann, 2005). Many of those with BPD suffer from deep feelings of emptiness, boredom, and confusion about their identity.

    Histrionic behavior may occur in individuals as within a normal range. It may also exist as a symptoms of behavior or mental process patterns that have been identified as abnormal, particularly as exhibited in histrionic personality disorder. Histrionic behavior thus sometimes requires psychological treatment and other times is simply a part of an individual’s unique expression of his personality.

    1. American Psychiatric Association. (2009). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
    2. Gunderson, J.G. (1988). Personality disorders. In A.M. Nicholi, Jr. (Ed.), The new Harvard guide to psychiatry (pp. 337 – 365). Cambridge, MA: Belknap Press.
    3. Hollender, M.H. (1988). Hysteria and memory. In H.M. Pertinati (Ed.), Hypnosis and memory (pp. 232 – 243). New York: Guilford.
    4. James L.M., & Taylor, J. (2008). Associations between symptoms of borderline personality disorder, externalizing disorders, and suicide-related behaviors. Journal of Psychopatholoty and Behavioral Assessment, 30, 1-9.
    5. Soloff, P.H., Fabio, A., Kelly, T.M., Malone, K.M., & Mann, J.J. (2005). High-lethality status in patients with borderline personality disorder. Journal of Personality Disorders, 19, 386 – 399.