Көңіл шоғырландыру және эмоционалдық жоғары сезімталдық бұзылысы

Personality disorder involving excessive emotionality and attention seeking

Histrionic personality disorder (HPD) is defined by the American Psychiatric Association as a personality disorder characterized by a pattern of excessive attention seeking behaviors, usually beginning in early adulthood, including inappropriate seduction and an excessive desire for approval. People diagnosed with the disorder are said to be lively, dramatic, vivacious, enthusiastic, extraverted and flirtatious. HPD lies in the dramatic cluster of personality disorders, also known as the Cluster B. People with HPD have a high desire for attention, make loud and inappropriate appearances, exaggerate their behaviors and emotions, and crave stimulation. They very often exhibit pervasive and persistent 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 wants.

People diagnosed with HPD may be dramatic. They often fail to see their own personal situation realistically, instead dramatizing and exaggerating their difficulties. Patients with this disorder can have rapidly shifting emotions and a decreased ability to recognize the emotions of others. Their emotions may appear superficial or exaggerated to others. This disorder is associated with extraversion, a lower tolerance for frustration or delayed gratification, and openness to new experiences. People with HPD may have little self doubt and often appear egocentric. Research has also shown those with histrionic personality have a greater desire for social approval and reassurance and will constantly seek it out, making those with HPD more vulnerable to social media addiction. People with this disorder often display excessive sensitivity to criticism or disapproval. They will work hard to get others to pay attention to them, possibly as a method of testing the stability of relationships. They may enjoy situations in which they can be the center of attention, and may feel uncomfortable when people are not paying attention to them. and fake medical conditions in an attempt to draw other's attention. They may be inappropriately sexually provocative, flirtatious, or exploitative. Sexually suggestive, and exhibitionist behavior are also behaviors people with this condition sometimes exhibit. Some people with histrionic traits or personality disorder change their seduction technique into a more parental style as they age. When their desire for attention is not met, it can heighten the severity of their symptoms. They tend to be impressionable and easily manipulated, especially by those they respect. Patients with HPD are usually high functioning, both socially and professionally. They usually have good social skills, despite tending to use them to make themselves the center of attention. They may seek treatment for clinical depression when romantic (or other close personal) relationships end. such as alcohol use disorder or opioid use disorder, are all common in patients with histrionic personality disorder. They are also at higher risks of suicide, body dysmorphia (a preoccupation with perceived flaws in one's physical appearance), and divorce. 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. Despite these traits, they can be prideful of their own personality, and may be unwilling to change, viewing any change as a threat. They may even blame their personal failures or disappointments on others. HPD symptoms typically do not fully develop until the age of 15, while the onset of treatment only occurs, on average, at approximately 40 years of age.

Studies have shown that there is a strong correlation between the function of certain hormones, neurotransmitters and the Cluster B personality disorders such as HPD. This seems to be especially evident with respect to the catecholamines. Individuals diagnosed with HPD have a highly responsive noradrenergic system, which is responsible for the synthesis, storage, and release of the neurotransmitter norepinephrine. High levels of norepinephrine lead to anxiety proneness, dependency, novelty seeking, and high sociability. 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.

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, 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.

Most histrionics also have other mental disorders. Comorbid conditions include: antisocial, dependent, borderline, and narcissistic personality disorders, as well as depression, anxiety disorders, panic disorder, somatoform disorders, anorexia nervosa, substance use disorder and attachment disorders, including reactive attachment disorder.

In 2000, Theodore Millon suggested six subtypes of histrionic personality disorder. Any individual histrionic may exhibit one or more of the following:
SubtypePersonality TraitsAppeasing 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 (including hypomanic features, and possibly
narcissistic features)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 is often prompted by depression associated with dissolved relationships. Medication does little to affect the personality disorder, but may be helpful with symptoms such as depression. 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. 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. Major character traits may be inherited, while other traits may be due to a combination of genetics and environment, including childhood experiences. Approximately 65% of HPD diagnoses are women while 35% are men. In Marcie Kaplan's A Women's View of DSM III, she argues that women are overdiagnosed due to potential biases and expresses that even healthy women are often automatically diagnosed with HPD. 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. 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. 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.