The current trial of Jerry Sandusky, the former football coach at Penn State University accused of pedophilia with a number of young children, has recently brought histrionic personality disorder into the public imagination. It has been suggested in the press that the defense may suggest that Mr. Sandusky suffers from this personality disorder and that this is what lead him to sexually violate children. Whoa…that seems to be a stretch! Does histrionic personality disorder (HPD) cause pedophilia? Do these two disorders overlap a lot? In a word... no! In two words...no way!
Histrionic personality disorder is a bit of the Cinderella of Axis II (cluster B) disorders in the Diagnostic and Statistical Manual (DSM), the psychiatric “bible” of diagnoses. Certainly the other related personality disorders in this cluster (i.e., antisocial, narcissistic, and borderline) get much more attention and press. Those with histrionic personality disorder, in a nutshell, want love and attention and work hard to secure these goals in often maladaptive ways. They enjoy attention, can be highly dramatic, are emotional, impressionistic, and they can be sexually seductive. Yet their sexual expression, including flirting and seductive behavior, tends to be with other consenting adults not with young prepubescent children. So, this notion that histrionic personality disorder covaries or is often co-morbid with pedophilia seems very odd and not based on the best clinical science or practice.