Cluster B: histrionic PD

Question 1

Cluster B

Answer 1

Dramatic, emotional, erratic

Question 2

Criteria

Answer 2

5 or more
* Uncomfortable when not the center of attention
* Interaction with others has inappropriate seductive or provocative behavior
* Rapidly shifting + Shallow expression of emotions
* Uses physical appearance to draw attention to themselves
* Speech is excessively impressionistic and shallow, lacking in detail
* Self-dramatization, theatricality, exaggerated expression of emotion
* Suggestible (easily influenced)
* Considers relationships more intimate than they actually are

Question 3

Individual characteristics

Answer 3

• Excessive emotionality and constant attention-seeking behavior
• Feels uncomfortable or unappreciated when not the center of attention
• Displays rapidly shifting and shallow expression of emotions
• Often uses physical apperance to draw attention to self
• Speech is excessively impressionistic and lacking in detail
• Shows self-dramatization, theatricality, and exaggerated expression of emotion
• Easily influenced by others or by circumstances
• Considers relationtionships to be more intimate than they actually are
• may be flirtatious, seductive, or overly charming
• Craves excitement, novelyty, and stimulation, often growing bored easily

Question 4

Diagnostic features

Answer 4

• Core is pervasive and excessive emotionality and attention seeking behavior
• Manifests through dramatic, lively, flirtatious, or exaggerated interpersonal behavior
• Seeks to be center of attention

Question 5

Differential diagnoses

Answer 5

• Borderline PD: Also has attention-seeking and emotional lability, but includes self-destructiveness, chronic emptiness, and unstable identity.
• Antisocial PD: Shares impulsivity and manipulativeness, but ASPD manipulates for gain or power, while HPD manipulates for nurturance or attention.
• Narcissistic PD: Craves admiration and may exaggerate achievements; HPD is more willing to appear weak or dependent to gain attention.
• Dependent PD: Dependent on others for guidance/praise, but lacks the emotional expressiveness of HPD.
• Personality Change Due to Another Medical Condition: Must rule out that behaviors aren’t due to neurological or medical illness.
• Substance Use Disorders: Ensure symptoms are not due to drug or alcohol effects.

Question 6

Associated features

Answer 6

• Struggles with emotional intimacy often using roles (victim, princess, etc) in relationships
• Attempts to control others through emotional manipulation or seductiveness
• Frequenty alienates same-sex friends due to provocative behavior or excessive need for attention
• May become depressed or upset when not focus of attention
• Trouble with long-term commitments
• intolerant of delayed gratification

Question 7

Gender and prevalence

Answer 7

Prevalence: 1.84%
More frequently diagnosed in females, thoigh this may reflect bias in clinical settings
No consistent significant difference in actual prevalence across genders in general population

Question 8

Cultural consideration

Answer 8

• Diagnostic thresholds must consider cultural norms:
  • Emotional expressiveness, physical appearance standards, and attention-seeking vary across cultures, genders, and age groups.
• Behaviors like flirtation or dramatic expression may be culturally encouraged or normative in some contexts.

Question 9

Early signs

Answer 9

• Early tendecies toward dramatic behavior, exaggerated emotions, and need for attention
• May show signs of suggestibility, overreliance on apperance, and discomfort outside the spotlight
• Parenting that reinforces approval-seeking or emotional expression as a form of attention may contribute
• Family history of similar traits, other PDs, or high emotional expressivity may increase risk