histrionic personality disorder

Clinical manifestations

• excessive & rapidly shifting emotions
• attention seeking
• may appear overly seductive or provocative
• no inflated sense of self-importance or entitlement
• tendencies toward interpersonal conflict commonly due to beliefs that relationships are more intimate than they acutally are
• not associated with difficulty in regulating anger
• do not have the inflated sense of self-importance or entitlement
• elderly:
  • behavior may become excessively disinhibited & disorganized
  • may appear manic

Differential diagnosis

• borderline personality disorder
• narcissistic personality disorder

Management

• assess for & treat mood lability, depression, anxiety, substance abuse
• consistent, structured approach with well-defined boundaries to contain unacceptable behaviors
• team approach with a common plan (teamwork)
• behavioral contracts to address recurrent unacceptable behaviors
• resort to higher level of care if management ineffective
• do not personalize aggressive behavior directed towards staff
  • allow staff opportunities to vent

More general terms

• cluster B personality disorder