Rethinking Histrionic Personality Disorder: A Dimensional, Trauma-Informed, and Gender-Sensitive Framework

Histrionic Personality Disorder (HPD) remains one of the most controversial and underexplored diagnoses within modern clinical psychology. Despite its longstanding presence in diagnostic manuals, HPD continues to suffer from poor empirical support, problematic gendered assumptions, and considerable overlap with other Cluster B disorders. This paper critically examines HPD through historical, dimensional, sociocultural, and trauma-informed lenses. Drawing from multiple scholarly and clinical sources—including DSM-5-TR, ICD-11, and the DSM-5 Alternative Model for Personality Disorders (AMPD)—we trace HPD’s evolution from hysteria to its modern classification, highlighting persistent validity concerns and diagnostic unreliability. Case data illustrate how HPD traits may emerge in response to childhood trauma and insecure attachment. We discuss treatment challenges such as boundary violations and therapeutic fusion, and propose trauma-informed cognitive and schema-based strategies. This manuscript calls for a rethinking of HPD as a dimensional, developmentally informed profile rather than a fixed disorder category.