Histrionic personality disorder

· Histrionic personality disorder ICD-10 F60.4 ICD-9 301.50 OMIM {{{OMIM}}} EnfermedadesDB {{{EnfermedadesDB}}} Medline Plus {{{Medline Plus}}} eMedicina {{{eMedicineSubj}}}/{{{eMedicineTema}}} Malla {{{Número de malla}}} In psychiatry, histrionic personality disorder (HPD), or hysterical personality disorder, is a cluster B personality disorder, which involves a pattern of excessive emotional expression and attention-seeking, including an excessive need for approval and inappropriate seductiveness, that usually begins in early adulthood. The essential feature of the histrionic personality disorder is a pervasive and excessive pattern of emotionality and attention-seeking behavior. These individuals are lively, dramatic, entusiasta, and flirtatious. They may be inappropriately sexually provocative, express strong emotions with an impressionistic style, and be easily influenced by others. The literature differentiates HPD, according to gender. Women with HPD are described as self-centered, self-indulgent, and intensely dependent on others. They are emotionally labile and cling to others in the context of immature relationships. Females with HPD over identify with others; they project their own unrealistic, fantasied intentions onto people with whom they are involved. They are emotionally shallow, and have difficulty understanding others or themselves in any depth. Selection of marital or sexual partners is often highly inappropriate. Pathology increases with the level of intimacy in relationships. Women with HPD may show inappropriate and intense anger. They may engage in manipulative suicide threats as one aspect of general manipulative interpersonal behavior. [1] Males with HPD usually present with identity diffusion, disturbed relationships, and lack of impulse control. They have antisocial tendencies, and are inclined to exploit physical symptoms. These men are emotionally immature, dramatic, and shallow. [2] Both men and women with HPD engage in disinhibited behavior. [3] People with this disorder are usually able to function at a high level and can be successful socially and at work. Sin embargo, histrionic personality disorder may affect a person's social or romantic relationships or their ability to cope with losses or failures. People with this disorder may seek treatment for depression when romantic relationships end, even if they are likely to have this mental illness and they don't feel empathy about their relationship ending. They often fail to see their own situation realistically. En lugar de, they tend to dramatize and exaggerate. Responsibility for failure or disappointment is usually blamed on others. They may go through frequent job changes, as they become easily bored and have trouble dealing with frustration. Because they tend to crave novelty and excitement, they may place themselves in risky situations. All of these factors may possibly lead to greater risk of developing depression. Contents 1 Causas 2 Risk Factors 3 Síntomas 4 Diagnóstico 4.1 Criterios diagnósticos (DSM-IV-TR) 4.1.1 Mnemonic 4.2 History of the DSM-IV diagnosis 4.3 Criterios diagnósticos (ICD-10) 5 Tratamiento 6 Relaciones 7 Ver también 8 Referencias & Bibliografía 9 Textos clave 9.1 Libros 9.2 Papeles 10 Material adicional 10.1 Libros 10.2 Papeles 11 External links Causes The cause of this disorder is unknown, but childhood events and genetics may both be involved. It occurs more frequently in women than in men, although some feel it is simply more often diagnosed in women because attention-seeking and sexual forwardness is more socially acceptable for women. Histrionic personality disorder is only rarely found in men; men with similar symptoms are often diagnosed with antisocial personality disorder. [4] Sin embargo, in cases where the HPD diagnosis is more appropriate, there may be additional difficulties with regard to the person's sexual identification. One theory by Will Titshaw suggests that, because at a young age, people with HPD were always the center of attention and were admired, pero entonces, as they grew older and get less attention and admiration, people with HPD then go out of their way to, once again, get the attention and admiration that they used to get. Little research has been conducted to determine the biologic sources of this disorder. Psychoanalytic theories incriminate seductive and authoritarian attitudes by fathers of these patients. [5] Risk Factors Genetics Major character traits may be inherited Other character traits due to a combination of genetics and environment including adverse childhood experiences [6] Symptoms The symptoms include: Constant seeking of reassurance or approval. Excessive drama with exaggerated displays of emotions. Excessive sensitivity to criticism or disapproval. Inappropriately seductive appearance or behavior. Excessive concern with physical appearance. A need to be the center of attention (self-centeredness). Low tolerance for frustration or delayed gratification. Rapidly shifting emotional states that may appear shallow to others. Opinions are easily influenced by other people, but difficult to back up with details. Tendency to believe that relationships are more intimate than they actually are. Make rash decisions Speak dramatically but with few details and facts to back up opinions [7] May exaggerate physical illness or injury for attention Diagnosis The person's appearance, comportamiento, and history, and a psychological evaluation are usually sufficient to establish the diagnosis. There is no test to confirm this diagnosis. Because the criteria are subjective, some people may be wrongly diagnosed as having the disorder while others with the disorder may not be diagnosed. Treatment is often prompted by depression associated with dissolved romantic relationships. Medication does little to affect this personality disorder, but may be helpful with symptoms such as depression. Psychotherapy may also be of benefit. Diagnostic criteria (DSM-IV-TR) The Diagnostic and Statistical Manual of Mental Disorders, un manual ampliamente utilizado para diagnosticar trastornos mentales, defines histrionic personality disorder as a pervasive pattern of excessive emotionality and attention-seeking behavior, beginning by early adulthood and present in a variety of contexts, as indicated by 3 (o más) de los siguientes: Being 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 using physical appearance to draw attention to self. Have a style of speech that is excessively impressionistic and lacking in detail. Shows self-dramatization, theatricality, and exaggerated expression of emotion. Being suggestible (es decir. easily influenced by others or circumstances). Considers friendly relationships to be more intimate than they actually are. Mnemonic A mnemonic that can be used to remember the criteria for histrionic personality disorder is PRAISE ME[8][9]: P - provocative (or seductive) behavior R - relationships, considered more intimate than they are A - attention, must be at center of I - influenced easily S - discurso (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 History of the DSM-IV diagnosis Histrionic Personality Disorder shares a divergent history with Conversion disorder and Somatization Disorder. Históricamente, they are linked to the ancient notion of hysteria, or “wandering womb.” (Nota, sin embargo, that according to the Online Etymology Dictionary, la palabra "histrionic" dervies not from the Greek hystera, but from the Latin histrionicus, "pertaining to an actor.") Ancient Greeks thought that excessive emotionality in women was caused by a displaced uterus and sexual discontent. Christian ascetics during the Middle Ages blamed women's mental problems on witchery, sexual hunger, moral weakness, and demonic possession. By the 19th century, medical explanations proposed a weakness of women's nervous system related to biological sex. Así, "hysteria" reflected the stereotype for women as vulnerable, inferior, and emotionally unbalanced. The extent to which the definition of Histrionic Personality Disorder currently reflects gender bias remains the subject of a controversy (see writings by Paul Chodoff on this topic).  "Hysteria" differentiated into conversion hysteria (later to become Conversion disorder) and hysterical personality, as well as later to become Histrionic personality disorder) in the psychoanalytic literature as well as with the writings of Kraepelin, Schneider, y otros. Sigmund Freud wrote primarily about conversion hysteria. Wilhelm Reich wrote about hysteria as a set of personality characteristics and differentiated conversion hysteria as a transient disorder from hysterical character. These early conceptualizations of both kinds of hysteria carried notions of women's deficiency due to penis envy and feelings of castration. Paul Chodoff has written about the ways in which these diagnoses paralleled the misogynous sentiment of the times. The concept of hysterical personality was well developed by the mid-20th century and strongly resembled the current definition of Histrionic personality disorder. The first DSM featured a symptom-based category, “hysteria” (conversion) and a personality-based category, “emotionally unstable personality.” DSM-II distinguished between hysterical neurosis (conversion reaction and dissociative reaction) and hysterical (histrionic) personalidad. In DSM-III, the term Hysterical Personality changed to Histrionic Personality Disorder to emphasize the histrionic (derived from the Latin word histrio, or actor) behavior pattern and to reduce the confusion caused by the historical links of hysteria to conversion symptoms. The landmark case of Ruth E, helped to fully define and emphasize the characteristics of the current DSM-IV diagnostic.DSM-III-R attempted to reduce the overlap between Histrionic Personality Disorder and Borderline Personality Disorder by dropping three overlapping criteria and adding two criteria that emphasized histrionicity. DSM-IV dropped two more criteria that did not appear to contribute to the consistency of the diagnosis, according to research done by Bruce Pfohl. Diagnostic criteria (ICD-10) The International Statistical Classification of Diseases defines histrionic personality disorder as characterized by: Self-dramatization, theatricality, exaggerated expression of emotions; Suggestibility, easily influenced by others or by circumstances; Shallow and labile affectivity; Continual seeking for excitement and activities in which the patient is the centre of attention; Inappropriate seductiveness in appearance or behaviour; Over-concern with physical attractiveness. Associated features may include egocentricity, self-indulgence, continuous longing for appreciation, feelings that are easily hurt, and persistent manipulative behaviour to achieve own needs. Treatment Because of the lack of research support for work on personality disorders and long-term treatment with psychotherapy, the empirical findings on the treatment of these disorders remain based on the case report method and not on clinical trials. On the basis of case presentations, the treatment of choice is psychotherapy aimed at self-development through resolution of conflict and advancement of inhibited developmental lines. [10] Group therapy Family therapy Medications Alternative therapies [11] Relationships The HPD is highly reactive. If there is another major disorder present, such as borderline personality disorder, then emotional intensity will create anger, death threats, abuso, and distance in relationships. It is important for the therapist and family members to monitor and record all situations that trigger the HP so that the deep underlying overload of pain can be accessed and released for therapeutic change. [12] Associated Mental Disorders Conversion disorder Pedophilic disorder Somatization disorder Substance use disorder A previous version of this text is from the US National Library of Medicine. Histrionic PD: History of the disorder Historical sources Famous clinicians Histrionic PD: Epidemiology Histrionic PD: Incidence Histrionic PD: Prevalence Histrionic PD: Morbidity Histrionic PD: Mortality Histrionic PD: Racial distribution Histrionic PD: Age distribution Histrionic PD: Sex distribution Histrionic PD: Risk factors Histrionic PD: Known evidence of risk factors Histrionic PD: Theories of possible risk factors Histrionic PD: Etiology Histrionic PD: Known evidence of causes Histrionic PD: Theories of possible causes Histrionic PD: Diagnóstico & evaluation The person's appearance, comportamiento, and history, and a psychological evaluation are usually sufficient to establish the diagnosis. There is no test to confirm this diagnosis. Because the criteria are subjective, some people may be wrongly diagnosed as having the disorder while others with the disorder may not be diagnosed. Histrionic PD: Psychological tests Histrionic PD: Assessment isssues Histrionic PD: Evaluation protocols Histrionic PD: Treatment Treatment is often prompted by depression, associated with dissolved romantic relationships. Medication does little to affect this personality disorder, but may be helpful with symptoms, such as depression. Psychotherapy may also be of benefit. outcome studies Histrionic PD: Treatment protocols Histrionic PD: Treatment considerations Histrionic PD: Evidenced based treatment Histrionic PD: Theory based treatment Histrionic PD: Team working considerations Histrionic PD: Followup Histrionic PD: For people with this difficulty Histrionic PD: Service user: How to get help Histrionic PD: Service user: Self help materials Histrionic PD: Service user: Useful reading Histrionic PD: Service user: Useful websites Histrionic PD: Service user: User feedback on treatment of this condition Histrionic PD: For their carers Histrionic PD: Cuidador: How to get help Histrionic PD: Cuidador: Useful reading Histrionic PD: Cuidador: Useful websites Instructions_for_archiving_academic_and_professional_materials Histrionic PD: Academic support materials Histrionic PD: Académico: Lecture slides Histrionic PD: Académico: Lecture notes Histrionic PD: Académico: Lecture handouts Histrionic PD: Académico: Multimedia materials Histrionic PD: Académico: Other academic support materials Histrionic PD: Académico: Anonymous fictional case studies for training Histrionic PD: For the practitioner Histrionic PD: Practitioner: Further reading Histrionic PD: Practitioner: Useful websites Histrionic PD: Anonymous fictional case studies for training See also Antisocial personality disorder Borderline personality disorder Conversion disorder Dependent personality disorder Hysteria Narcissistic personality disorder Somatization Disorder References & Bibliografía ↑ Kernberg, Otto (1993). Severe Personality Disorders: Psychotherapeutic, 58-59, Prensa de la Universidad de Yale. ↑ Kernberg, Otto (1993). Severe Personality Disorders: Psychotherapeutic, 58-59, Prensa de la Universidad de Yale. ↑ [The Histrionic Personality Disorder (HPD) The Histrionic Personality Disorder (HPD)]. Dual Diagnosis and the Histrionic Personality Disorder (HPD). URL a la que se accede en 2007-01-10. ↑ Seligman, Martin E.P. (1984). Abnormal Psychology, W. W. Norton & Company. ↑ (2006). Histrionic Personality Disorder. Personality Disorders. WebMD. URL a la que se accede en 2007-01-10. ↑ (2006). Histrionic Personality Disorder. Histrionic Personality Disorder: Descripción, Incidencia, Prevalencia, Risk Factors, Causas, Associated Conditions, Diagnóstico, Signs and symptoms and treatment. Armenian Medical Network. URL a la que se accede en 2007-01-10. ↑ Histrionic Personality Disorder. Histrionic Personality Disorder. The Cleveland Clinic. URL a la que se accede en 2007-01-10. ↑ Pinkofsky HB. Mnemonics for DSM-IV personality disorders. Psychiatr Serv. 1997 Sep;48(9):1197-8. PMID 9285984. ↑ Personality Disorders. www.personalityresearch.org. URL: HTTP://www.personalityresearch.org/pd.html. Consultado en mayo 2, 2006. ↑ (2006). Histrionic Personality Disorder. Histrionic Personality Disorder - Choice of Treatment. Armenian Medical Network. URL a la que se accede en 2007-01-10. ↑ Histrionic Personality Disorder. Histrionic Personality Disorder - Choice of Treatment. Encyclopedia of Mental Disorders - Thomson Gale, a part of the Thomson Corporation. URL a la que se accede en 2007-01-10. ↑ (2006). Histrionic Personality Disorder. Histrionic Personality Disorder. Recurrent Depression Inc.. URL a la que se accede en 2007-01-10. Key texts Books Papers Additional material Books Papers Google Scholar External links Dual Diagnosis and the Histrionic Personality - well-referenced Histrionic personality disorder - Causas,Diagnóstico, Demografía, Tratamiento - well-referenced Psych Forums: Histrionic Personality Forum Treatment - Histrionic Personality Disorder Personality Disorder Personality disorder| Psychopathy DSM-IV Personality Disorders Cluster A (Odd) - Schizotypal, Schizoid, Paranoid Cluster B (Dramatic) - Antisocial, Borderline, Histrionic, Narcissistic Cluster C (Anxious) - Dependent, Obsessive-Compulsive, Avoidant Personality disorder not otherwise specified Assessing Personality Disorder MCMI| MMPI| Functional assessment Treating Personality Disorder DBT| TCC| Psychotherapy|Mindfulness-based Cognitive Therapy Prominent workers in Personality Disorder Millon| Linehan This box: view• talk• edit DSM-IV Personality Disorders edit Cluster A (Odd) - Schizotypal, Schizoid, Paranoid Cluster B (Dramatic) - Antisocial, Borderline, Histrionic, Narcissistic Cluster C (Anxious) - Dependent, Obsessive-Compulsive, Avoidant This page uses Creative Commons Licensed content from Wikipedia (ver autores).