Histrionic Personality Disorder: A HealthCentral Explainer

Patient Expert

The trial of alleged child abuser Jerry Sandusky is entering its second week, and the former Penn State assistant football coach’s lawyers are set to begin presenting their evidence this week.  Prosecutors say the 68-year-old Sandusky abused at least 10 boys over a 15-year span, often using his access to underprivileged boys through the Second Mile charity organization that Sandusky helped found.

Among its evidence, Sandusky’s defense team has hinted that it will show that Sandusky suffers from a mental health condition known as histrionic personality disorder, which they feel may explain some of his behavior with the young boys.

Is it possible that a personality disorder could lead to some of the inappropriate behavior referenced in the case?  To answer this, let’s take a look at what this disorder is, how it’s caused, and how it can manifest in people diagnosed with this condition.

What is it?

According to the Cleveland Clinic, histrionic personality disorder is one of the dramatic personality disorders--conditions that cause their sufferers to be unstable and emotionally intense. People with dramatic personality disorders may also be impulsive, aggressive, and irritable, and they may be manipulative and demanding in their relationships with others.  Besides histrionic personality disorder, other dramatic personality disorders include borderline, narcissistic, and antisocial personality disorders.

In people who have histrionic personality disorder, self-esteem isn’t something that’s self-made; rather, their sense of self worth depends on the approval of others.  Because of this, they constantly seek attention, and they will often resort to dramatic and inappropriate ways to get it.  The condition is more common in women than in men, and it usually manifests in early adulthood.

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Experts are not certain what causes histrionic personality disorder, though they believe it’s linked to a combination of genetic and environmental factors.  The fact that it seems to run in families points to some sort of genetic origin. Environmental factors that could contribute to the condition include a lack of punishment or criticism during childhood and unpredictable attention given by a child’s parent.  These factors may contribute to a child becoming confused about what behaviors are appropriate ways to receive positive attention, and this problem carries forward into adulthood.

What kind of behavior does it cause?

Symptoms of histrionic personality disorder include:

-       Dressing provocatively or exhibiting seductive or flirtatious behavior to gain attention

-       Showing distress or discomfort if one is not the center of attention

-       Demonstrating excessive sensitivity to disapproval or criticism

-       Acting overly dramatic, as though constantly performing for an audience

-       Attempting suicide to gain attention

-       Constantly seeking reassurance or approval from others

-       Exhibiting difficulty maintaining relationships

Though sexual abuse is not typically a trait of histrionic personality disorder, the condition’s links to relationship problems, desire for approval, and sexually provocative behavior are.

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It’s believed that Sandusky’s defense team will call a psychologist to the stand to provide evidence that it’s this personality disorder may have contributed to Sandusky’s behavior, particularly to his writing what one alleged victim called “creepy love letters” over the course of his interaction with the boy. Court documents suggest that the psychologist will explain “that the words, tones, requests and statements made in the letters are consistent with a person who suffers from [this disorder].”

If you or someone you care about is exhibiting symptoms of this condition, it’s important to seek help. People with histrionic personality disorder have a higher risk of depression and suicide attempts, and the condition can wreak havoc in their personal and romantic relationships. Psychotherapy and medications can help treat the condition and help sufferers lead happier and more stable lives.

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Sources:  Cleveland Clinic; CNN, Physicians’ Desk Reference