11-year-old Keisha considers herself a “princess”. She was always told she was pretty and smart. Adults find her lively and amusing except when they turn their attention elsewhere. She will then create a drama, sulk or throw a tantrum until someone mollifies her. Keisha is often fondly called “drama queen” by family and friends. No one realizes that her behavior can result in something much more troublesome when she grows up.

Is Keisha just another child who likes to be the center of attention or are these signs of a deeper problem called “Histrionic Personality Disorder”? This is often a tough question to answer and an informed and watchful approach from parents is a helpful start.

Signs of Histrionic Personality disorder

A mnemonic that has sometimes been used to describe the criteria for histrionic personality disorder is “PRAISE ME”:

P – provocative (or seductive) behavior
R – relationships, considered more intimate than they are
A – attention, must be at center of
I – influenced easily
S – speech (style) – wants to impress, lacks detail
E – emotional shallowness

M – make-up – physical appearance used to draw attention to self
E – exaggerated emotions – theatrical

(From “Out of the Fog”, Gary Walters)

Like all other personality disorders, a person must be over 18 to be diagnosed with Histrionic Personality Disorder.

But the roots of Histrionic PD usually begin in childhood. According to Dr. Bochner, a leading expert on Histronic PD, when a child sees parents engaging in frequent quarrels (usually about how each parent feels the other should be doing more) the child believes he/she may be the cause of the fight. Usually the child ends up mediating the fights, often comforting one or both parents. The child also learns that a quick way to stop the fighting and the frightening experience of being alone is to engage in dramatic or tantrum throwing behaviour. Parents turn their attention to the child to soothe it and here begins a lifelong pattern of seeking attention to feel better.

What can be done?

  • If these signs look familiar, seek confirmation from a licensed psycho-therapist. Only trained practitioners can decipher if these signs are simply normal developmentally appropriate tantrums or a deeper issue like Attention Deficit Hyperactivity Disorder (ADHD) or Histrionic personality disorder.
  • Work through your own guilt. If your child has a problem, guilt will not help to make it better. The best way to reduce guilt is to take problem solving steps in the present.
  • Focus on strengthening the weak roots of the environment. In other words, seek help to repair marital conflicts and improve communication styles within the family.
  • Reconstruct boundaries. Set healthy limits with the child and be consistent with them. If the child throws a tantrum, ignore it and later reward him/her for good behavior. Discuss behavior modification with a counselor/therapist.
  • Teach your child that attention can be earned for things other than looks and drama. For ex: good grades, being polite, taking care of a little one, doing small chores etc.

Some research studies do suggest that damage in later life can be minimized to a large extent if signs of a personality disorder are identified early and coping skills are taught to the child.

This post originally appeared in the RobinAge.