The DSM-III identified key criteria, including a pervasive pattern of excessive emotionality, a need for attention, and exaggerated behaviors. In 1980, the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) included Histrionic Personality Disorder as a diagnosable condition. HPD was formally recognized as a distinct diagnostic category in the mid-20th century. Freud's theories, although controversial and often criticized, laid the groundwork for the exploration of histrionic symptoms and behaviors. He proposed the concept of "hysteria" as a psychological disorder primarily affecting women and characterized by emotional excesses and attention-seeking behavior. In the late 19th century, during the era of psychoanalysis, Sigmund Freud contributed to the understanding of histrionic behavior. These individuals were described as "hysterical," a term derived from the Greek word "hystera," meaning uterus, as it was believed that these behaviors were exclusive to women and were caused by disturbances in the uterus. The roots of histrionic behavior can be traced back to ancient times when Greek and Roman physicians observed individuals who displayed excessive theatricality and emotional expression. People presenting with HPD typically demonstrate rapidly shifting and shallow emotions that others may perceive as insincere. They may be vibrant, enchanting, overly seductive, or inappropriately sexual. Individuals with HPD are often described as narcissistic, self-indulgent, flirtatious, dramatic, extroverted, and animated. Individuals with HPD may feel underappreciated or disregarded when they are not the center of attention. The condition is usually life-long, though onset is typically in late adolescence or early adulthood. Histrionic personality disorder (HPD) is characterized by a pervasive pattern of attention-seeking behaviors and a theatrical level of emotional reactions. Participating clinicians also review the differentiating characteristics compared to cluster personality disorders, emphasizing the need for interprofessional collaboration. This activity reviews the evaluation, treatment, and management of HPD as a life-long psychiatric disorder. Several psychologists have historically characterized HPD to define the criteria within DSM-5. Psychiatrists conduct the typical assessment, but input from primary care, emergency medicine, therapists, and a patient's family or friends is considered. Individuals with HPD may feel undervalued when not in the spotlight, leading to a persistent need for validation. Typically emerging in late adolescence or early adulthood, individuals with HPD are often characterized as narcissistic, self-indulgent, and flirtatious. Histrionic Personality Disorder (HPD) is a chronic and enduring condition marked by a consistent pattern of attention-seeking behaviors and an exaggerated display of emotions.
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