Prevalence of Histrionic Personality Disorder
Most individual express histrionic personality characteristics either inform of chronic or maladaptive. Inadequate data derived from the overall population surveys indicate its prevalence ranges from 2% to 3%, although structured evaluation of inpatients as well as outpatient in a mental health setting indicate a rate of 10% to 15% (APA, 2000, pp. 713).
Patient’s characteristics
Women with Histrionic Personality Disorder are literary self-centred, largely dependent on others, and self-indulgent. Consequently, they are emotionally labile so that they often inappropriately express intense anger. In addition, they may intimidate suicide as a form of manipulative intent (Kernberg, 1992, pp. 58-59).
Men with histrionic Personality on the other hand, commonly portray impulsiveness in their inclination to utilize their physical indication. Usually, such urge qualifies as an antisocial tendencies, and often translate to promiscuity in which the patient involves in many sexual relationships (Kernberg, 1992, p.59).
Parent with this disorder often apply manipulative behaviours to shift their children’s attention to meet parental expectations. By so doing, they are able to skip parental responsibilities at the same time portraying a loving and concerned impression. Hence, this act can lead to exploitation and abandonment of their children which can expose them to emotional, sexual and physical abuse (Bornstein, Costello, ed., 1996, pp. 130-132).
Comparison with other personality disorders
The clinical symptoms of Histrionic Personality Disorders are often confused with those of other Personality Disorders. Hence, it is very crucial to differentiate amongst these personality disorders. If a patient present a personality behaviours that correspond with a single or more personality disorder besides the Histrionic Personality Disorder, all the disorders should be diagnosed (APA, 2000, pp. 713).
Borderline Personality Disorder can as well be signified by manipulative behaviour, attention seeking, and abrupt emotional swings. However, it can be differentiated by chronic in-depth sensation of emptiness and identity crisis, angry disturbance in close relationship, and self destruction.
On the other hand, Histrionic Personality Disorders and Antisocial Personality Disorder share a propensity to impulsiveness, manipulative, excitement seeking, superficiality, and seductiveness; although Histrionic Personality Disorder can be distinguish with a trend to be more concentrated in their emotions, while they don’t express antisocial characteristics (American Psychology Association, 2000, pp. 713).
Characteristically, Histrionic Personality Disorder patients distinguish from those with antisocial personality disorders by virtue of manipulating to gain nurturance as opposed to gaining power, profit or any other form of gratification.
Histrionic personality disorder patients are willing to be perceived as dependent or vulnerable in order to attract attention, converse to those with Narcissistic Personality Disorder who crave praise for their “superiority.”
Further, distinction of the Narcissistic personality disorder from Histrionic Personality Disorder lies in the fact that patients with this disorder may overstress the closeness of their relationship, while they are inclined to stress the “VIP” position or wealth of the persons.
Moreover, patients with dependent Personality disorder are distinguished from Histrionic personality disorder patients y virtue of being extremely dependence on others for praise and instructions, as opposed to flamboyant, embellished, emotional characteristics seen in the later (American Psychology Association, 2000, pp. 713).
The clinician must note the difference between the Histrionic personality disorder and Personality Change Due to a General Medical Condition arising from the primary effect of an overall health condition on the central nervous system.
In addition, he or she must be able to distinguish the symptoms of the Histrionic personality disorder from those that present due to chronic substance abuse especially Cocaine-Related Disorder (American Psychology Association, 2000, pp. 713).
Diagnosis
A pervasive form of attention seeking and extreme emotionality, apparent by preliminary adulthood and expressed in various circumstances, is indicated through the a number of distinct behaviours including:
- uneasiness in context where another person other than him or her is the centre of attraction;
- interaction with people often inclines towards improper sexual seduction or provocative behaviour;
- portrays abrupt swings and superficial emotional expression;
- consistently attracts attention to self using physical appearance;
- adopts a speech technique that is overly impressionistic at the same time deficient in detail;
- depicts exaggerated emotional expression, theatricality, and self dramatization;
- being suggestible, in the sense of being easily influenced by people or situations;
- exaggerates the intimacy of their relationship than they essentially are (American Psychology Association, 2000, pp. 714).
Treatment
Interventions which are based on actual and realistic evaluation of events and problems are important. Solution-based therapy is usually appropriate for this patient. Generally, therapy interventions should not be direct towards long-term personality modification, but instead on short-term improvement of the quality of life (DSM-IV-TR Diagnostic Code, 2006, pp. 2).
Histrionic Personal Disorder patients promptly seek treatment while exaggerating their symptoms and functional impairment. These patients often express reluctance in therapy termination due to their urge for emotional support. This situation should be circumvented through setting an agreement on the extent of the prescription regimen (DSM-IV-TR Diagnostic Code, 2006, pp. 2).
Generally, therapy should be supportive as that good rapport will be effortlessly developed with the client soonest. Often, clinician may be placed in the position of rescuer where he or she will be expected to consistently reassure and relief the patient from constant disturbances. Traditionally, every mental case should portray in a dramatic way (DSM-IV-TR Diagnostic Code, 2006, pp. 2).
Suicidal inclination is very common amongst patients of HPD, such that there is need for constant assessment of the patient for suicidal threats which demands prompt address of the situation. Noteworthy, suicide sometimes follows what was apparently intended to be a gesture, implying that all such conceptions and plans should be accorded serious attention.
In addition, self mutilation acts may also present in HPD, and must be regarded as an important agenda in a concession concerning therapy. Nevertheless, application of suicidal threat(s) should not be an excuse for the client to sustain therapy beyond the realistic limits (DSM-IV-TR Diagnostic Code, 2006, pp. 2).
Clinicians are encouraged to take a sceptical position in regard of this psychotic population on the ground of their tendency to exaggerate symptoms and crisis the patient may express.
This may trigger the patient go through series of reasoning and a realistic conclusion which may reveal impractical expectation and anxiety linked with various characteristics and believes (DSM-IV-TR Diagnostic Code, 2006, pp. 2).
Cognitive and insight-based therapy is often unhelpful because patients of this disorder are commonly unable to evaluate unconscious drives as well as their perceptions.
Facilitating the patient to assess interaction from a more objective perspective at the same time focusing on optional reasons for behaviour is more useful. Moreover, assessment and clarification of patient’s emotions are a worthy aspect of treatment (DSM-IV-TR Diagnostic Code, 2006, pp. 2).
Group and family therapy interventions are not encouraged, because the patient normally craves for attention by exaggerating all their moves and responses. Victims of this psychological condition often are portrayed as phoneys in their interpersonal association with people (DSM-IV-TR Diagnostic Code, 2006, pp. 3).
Reference List
American Psychology Association. 2000. Diagnostic and statistical manual of mental Disorders. (4 ed.). DSM-IV-TR. Arlington; American Psychiatry Publishing Inc. pp. 713-714
Bornstein, Robert F., 1996. “Dependency,” Personality Characteristics of the Personality Disordered. Charles G. Costello, editor. New York: John Wiley & Sons, Inc.
DSM-IV-TR Diagnostic code. 2006. Personality Disorders-Histrionic. Web.
Kernberg, Otto F., M.D. 1992. Aggression in Personality Disorderes and Perversions. New Haven: Yale University Press.