Alcohol Use Disorder and Histrionic Personality Disorder

For some, the heightened emotions and attention seeking behavior of HPD comes along with excessive drinking that makes them the focus even if it’s for the wrong reasons.

What You’ll Learn:

• The characteristics of histrionic personality disorder that lead to alcohol use.

• What research has found about alcohol abuse risks with HPD

• The possible reasons for the strong connection between AUD and HPD

• Creating an AUD treatment plan with HPD in mind.

There are a few personality disorders that most people have heard about, but then there are a handful that are lesser known but almost as common. Histrionic personality disorder is one of the latter.

Alcohol use disorder is more common across every personality disorder, not just this one. Our guide to alcohol use disorder and personality disorders breaks down the risk and the research for each one.

It’s believed that a little less than 2% of people have HPD, which puts it in line with other personality disorders, makes it less prevalent than others and more common than a few conditions.

HPD is one of the types of disorders where the person has an exaggerated personality that isn’t withdrawn. Instead people with histrionic personality disorder are most notable for their desire for attention and being the center of focus.

It was once thought that HPD affected women at a rate that was four times higher than men, but modern research has found the personality disorder is about equal between men and women.

It can present differently between men and women, but the characteristics are found among both sexes.

The key characteristics of histrionic personality disorder include:

• Discomfort when not the center of attention

• Inappropriately seductive or provocative behavior

• Rapidly shifting and shallow emotional expression

• Consistent use of physical appearance to draw attention

• An impressionistic speaking style lacking detail

• Dramatic and exaggerated emotional expression

• High suggestibility

• Tendency to see relationships as more intimate than they actually are

Exhibit five or more of these characteristics and you meet the clinical criteria for histrionic personality disorder. And as you’ll discover in the rest of this overview, those characteristics are closely linked with alcohol dependence and addiction.

Why There’s a Strong Connection Between HPD and AUD

Histrionic personality disorder turns out to be one of the disorders that is most closely associated with alcohol abuse. The problem is we know little beyond that.

The Statistics For Alcohol Disorder With Histrionic Personality Disorder

What research has been done paints a very clear picture about the risk of drinking for people with histrionic personality disorder:

• Studies that used data from NESARC research along with new criteria found that the lifetime comorbidity rate with alcohol dependence was 49.79%. That’s the second-highest of any personality disorder measured, trailing only antisocial (49.19–52.09%) and actually exceeding borderline (47.41%).

• Histrionic PD also had the single highest comorbidity rate with drug dependence at 29.72%.

• The connection between HPD and AUD is stronger among women than men in clinical studies.

The research isn’t as expansive as with some other personality disorders, but it is clear.

The clear connection is why it’s important for anyone who is diagnosed with histrionic personality disorder to carefully evaluate their drinking habits and take initiative to curb alcohol use if it becomes chronic.

The Reasons Why People With Histrionic Personality Disorder Have a Higher Risk of Alcohol Use Disorder

It turns out that a well-known alcohol subtype model finds there is a lot of overlap between the characteristics of histrionic personality disorder and Type II alcoholism.

With Cloninger's alcoholism model the Type II subcategory has a profile that includes high novelty-seeking, low harm-avoidance and low reward-dependence.

However, it has to be noted that the model wasn’t used to examine HPD specifically, and the research on the disorder is slim.

There have been a lot of discussions about what could be causing the increased risk of developing AUD with histrionic personality disorder because right now it’s largely theoretical.

Contributing factors can include:

Impulsivity

Like some other personality disorders, the impulsive behavior that comes with HPD can increase the risk of problematic drinking.

Frequent Boredom

It’s not uncommon for people with HPD to get bored easily. Going out and drinking can be a way to relieve boredom or escape the boring toils of everyday life.

Craving Novelty

The norm can get old real quick for someone with histrionic personality disorder. They crave novelty, and that urge can be fulfilled by going out and drinking in social settings.

Seeking External Validation

The reason behind the need for attention is getting a sense of validation from the recognition. Drinking excessively can lead to spectacle that puts someone at the center of the attention and with it comes the validation they are seeking.

Center-of-Attention Status

Excessive drinking has a way of putting a person at the center of attention, which is the goal for someone with HPD. Someone can learn that drunken debacles are a surefire way to increase their center of attention status.

Ego Soothing After Lack of Attention or Validation

Another reason people with histrionic personality disorder use alcohol is to handle the mental backlash when they fail to receive the validation or attention they are trying to get.

Putting Together an AUD Treatment Plan For People With HPD

Unfortunately, being under-researched means there aren’t specific treatment protocols or suggestions for addressing alcohol use when a person has histrionic personality disorder.

Taking a multifaceted approach is likely the best idea in this situation. In general, AUD treatment is more effective when it addresses the mental and physical connection.

Many of the causes for drinking are psychological, but chronic drinking can lead to alcohol dependence that then causes physical reactions.

With time alcohol cravings develop, encouraging the person to drink again. Withdrawal symptoms can also start within a day or two of not drinking.

The physical side effects can be so strong that detoxing can be dangerous and should happen under medical supervision.

Many people with HPD that want to cut back or stop drinking turn to naltrexone medication for help. It blunts the effects of alcohol use immediately, helping to curb alcohol cravings and the interest in drinking.

Since the naltrexone eliminates the rewarding effect of alcohol, the brain begins to think about alcohol differently. It’s not seen as rewarding anymore.

With the physical aspect of alcohol addiction under control, it’s easier to focus on addressing the mental struggles that come with histrionic personality disorder and can increase the likelihood of alcohol use.

Working with a therapist can help you identify the HPD traits that are most troublesome for day-to-day life, how to handle them with healthier coping mechanisms and learning your triggers that can cause setbacks.

Choose Your Horizon’s telehealth platform is a single-source for treating AUD on all fronts. We offer prescription medications that are FDA-approved and clinically proven to help people control alcohol cravings.

There are also resources for connecting with qualified therapists and tools for self-directing care, staying motivated and tracking progress. We bring everything together for the most convenient care possible.

Get started by taking a few minutes to complete the online Alcohol Use Assessment.