Social Media and Histrionic Personality Disorder

Source: Andrew Magill/Wikimedia Commons

Histrionic personality disorder involves symptoms such as expressing excessive emotions, being provocative, and seeking an excessive amount of attention in ordinary social situations. Together with narcissistic and borderline personality disorders, histrionic personality disorder is classified in DSM-V as a Cluster B personality disorder [1]. It typically begins in early adulthood and someone with the disorder presents symptoms in a variety of contexts such as hanging out with friends, while at work, in public, or on social media.

Little is known about the causes of histrionic personality disorder and social media might be among the causes or a factor that makes people who are predisposed to the disorder more likely to develop it. Platforms such as Facebook, Instagram, and other types of social media give people the opportunity to share pictures about themselves, show off, compete, and draw attention to themselves. That can be harmless fun for many people, but it is possible that social media can activate or worsen the symptoms of histrionic personality disorder.

Social media is likely unhelpful to people with a biological or social predisposition towards the disorder. Little is known about the causal factors and many people might have the disorder but be undiagnosed, therefore everyone should consider the potential risks. Because the disorder is known to develop in early adulthood, it is good to know about the symptoms of the disorder if you have children or are a young adult, and to consider the potential implications of social media.

In the DSM-V criteria for the diagnosis of histrionic personality disorder, someone with the disorder shows at least five of the following symptoms in a variety of contexts:

1. Considering relationships to be more intimate than they actually are.
2. Being easily influenced by other people or circumstances.
3. Being theatrical and dramatic in expressing emotions.
4. Speaking in a way that is excessively impressionistic but lacking in detail.
5. Consistently drawing attention to oneself through physical appearance.
6. Expressing emotions that are shallow in that shifting rapidly from one extreme to another, or from one emotion to another.
7. Engaging in seductive or provocative behaviour during ordinary social interactions where that kind of behaviour is inappropriate.
8. Feeling uncomfortable in situations where one is not the centre of attention.

Social media might worsen histrionic personality disorder by heightening opportunities to express symptoms of the disorder such as seeking attention, being easily influenced, or considering relationships to be more intimate than they are. Here are potential ways that social media can be destructive for people with the disorder. Social media can make people feel happy and rewarded when they receive attention (e.g., likes or retweets), but sad and dejected when they do not. This can promote a sense of feeling uncomfortable when one is not the centre of attention and doing more dramatic things to try and win back that attention. People with histrionic disorder might find it difficult to cope with rejection or negative reinforcement from social media, and therefore it might be helpful to limit their social media use or opt for platforms with a minimal psychological reward system built into them.

Social media gives people a false sense of reality in which relationships can appear more emotionally intimate than they actually are, which can heighten the symptom of histrionic personality disorder concerning the illusion of intimacy. Friendships based on social media may not be the same as friendships in real life. This does not mean that they are less important friendships, but friendships developed through social media are at risk of existing in a sense of faked intimacy. For people with histrionic personality disorder, friendships that exist within social media can be confusing and unhelpful in presenting an illusion of intimacy that confirms rather than challenges one of the disorder’s key symptoms.

Research is needed to assess the prevalence of histrionic personality disorder and to explore whether social media use increases the frequency or severity of the disorder’s symptoms. Research should also examine the causal role of social media in explaining histrionic personality disorder among people with other predisposing factors (e.g., a family history of the disorder, early life experiences). Social media might be a precipitating context for symptoms of histrionic personality disorder such as engaging in inappropriately provocative behaviour (e.g., trolling or Twitter arguments) in ways that would not be possible offline. It is also common for people on social media to express emotions that are shallow and that shift rapidly from one extreme to another, depending on what is trending.

Attention-seeking is common on social media and it can be harmless for most people but psychologically unhelpful in the case of histrionic personality disorder or people with a predisposition towards it. Social media can let people persistently draw attention to themselves through their physical appearance by giving them the chance to upload pictures that give them psychological rewards from followers. That can be harmless for most people, but these sorts of contexts might be hiding a prevalence of histrionic personality disorder. Social media might be concealing symptoms which, though normal in that context, can be psychopathological if they persist in various other contexts.

The time-consuming and rewarding world of social media might seem like harmless fun but the question remains about its impact on mental health and on the onset of conditions such as histrionic personality disorder. Although the disorder is diagnosed only if the symptoms are present in a variety of contexts, social media is a central part of many people’s waking hours, and therefore it is an important social interaction context that might increase the risk of histrionic personality disorder.