June 11th, 2012
05:45 PM ET

What is histrionic personality disorder?

The trial of  Jerry Sandusky has begun. Prosecutors accuse the former Penn State assistant football coach of abusing at least 10 boys, allegations that have become widely known.

What may be less familiar is a mental illness his lawyers are connecting with him: Histrionic personality disorder.  The defense attorneys say they intend to offer expert testimony from a psychologist who "will explain that the words, tones, requests and statements made in the letters are consistent with a person who suffers from a Histrionic Personality Disorder," according to documents.

Histrionic personality disorder is part of a class of conditions called dramatic personality disorders, which are marked by unstable emotions and distorted self-images, according to the Cleveland Clinic.

For these people, self-esteem doesn't come from true feelings of self worth, but rather from the approval from other people, and those suffering from this disorder will often engage in dramatic or inappropriate behaviors to call attention to themselves.

“People develop this disorder because they have a need to be appreciated and to feel valued and worthwhile and special,” said Nadine Kaslow, psychologist at Emory University School of Medicine, who has not treated Sandusky.

About 2% to 3% of the general population is thought to have histrionic personality disorder, she said.  "We all have traits that resemble this, but it becomes a problem when all of the symptoms are combined in a way that makes functioning difficult."

Inflicting sexual abuse is not a commonly recognized trait of this condition, but sexually-provocative behavior is, she adds.

People with this personality disorder may also change emotions rapidly, overly dwell on physical appearance, and take criticism or disapproval sensitively. They are easily influenced by others and make rash decisions, according to the Cleveland Clinic.  Rarely showing concern for others, they often find it challenging to maintain relationships.  People with histrionic personality disorder may even threaten or attempt suicide for the sake of getting attention.

No one knows what causes this disorder, but experts say it's probably a combination of nature and nurture.  The personality disorder can run in families, suggesting a genetic connection, but children may also be influenced by their parents in ways that would lead kids to crave attention or be confused about how to get parents' approval.

The standard treatment for this disorder is a type of counseling called psychotherapy, in which a mental health professional helps the person delve into what's causing their thoughts and behaviors, and figure out how to create more positive relationships. Depression and anxiety may be issues for some patients, and may be treated with medications.  But generally this personality disorder has not received a lot of attention in terms of evidence-based treatments, Kaslow said.

It's important to seek help if you believe you have symptoms of histrionic personality disorder, especially if it's causing trouble in your romantic or professional life.

soundoff (856 Responses)
  1. Gaias Child

    All the personality disorders have in common the absence of empathy for others . . . histrionic typically affects more women than men . . . the only personality disorder associated with felonious type behaviors is the antisocial personality disorder which we used to call sociopathic . . . so sandusky's lawyers are going for a much more benign diagnosis than i would . . . but then I don't to represent the man . . . which would not be possible for me to do even if I were a lawyer. I don't think histrionic is all it is.

    June 15, 2012 at 16:48 | Report abuse | Reply
    • Rusty Shakelford

      "All the personality disorders have in common the absence of empathy for others"

      Nailed it. Sadly, most people commenting all over the internet have this problem.

      June 15, 2012 at 17:20 | Report abuse |
    • jbkb012575

      I hope they call this expert to testify:

      Dr. Glen Gabbard, clinical professor of psychiatry at Baylor College of Medicine in Houston, said histrionic personality disorder is overwhelmingly diagnosed in women and could in no way be seen as a reason or explanation for the abuse of children. "That diagnosis, if he has it, would be completely irrelevant to anything having to do with criminal responsibility for acts of pedophilia," said Gabbard, who is an expert on personality disorders. Read more: http://aol.sportingnews.com/ncaa-football/story/2012-06-15/jerry-sandusky-trial-update-judge-histrionic-personality-disorder-child-sex-abus#ixzz1y5bCSDhl

      June 17, 2012 at 17:45 | Report abuse |
    • SMG

      I was diagnosed with 3 personality disorders many years ago, (none of them histrionic PD) but am doing very, very well and am a happy, healthy person. I respectfully disagree with your statement – if anything, I have too much empathy for others.

      June 19, 2012 at 21:24 | Report abuse |
    • guest

      Pure, full criteria personality disorders are not common. Constructing a personality is a subtle process ,often taking years. If one ever has an interest in scanning a DSM IV they will be convinced they have almost every pathology in the manual. I am really not sure what relevance this even has in the Sandusky case . It certainly will not affect the outcome.

      June 19, 2012 at 22:44 | Report abuse |
    • JP

      "All the personality disorders have in common the absence of empathy for others"

      ..PS not ALL personality disorders have absence of empathy for others as a defining characteristic. It is common within the cluster B or "dramatic" personality disorders, but not necesssarily present in cluster A or C. I would not be so quick to generalize, especially during mental health awareness month.

      May 22, 2014 at 17:03 | Report abuse |
    • russellis1946

      From what I have learned is that you cannot treat this disorder as a learned disorder bt behavior modification as these people will even take control of a controlled group and that is why the avoid group therapy. Today we try treating these behaviors as a learned problem when they are a medical mental illness and caused by a brain malfunction or brain trauma. I believe I lost someone very dear to me because of this disorder, when it could have been treated, her end was to not tell anyone she had brain cancer except her husband who promised not to tell anyone.. She was high on the sympathy she was getting and played it to long, at the last with just a few days left to live, I have been rushed to a hospital where they found a mass on my brain and we got the phone call. No one would listen, because so many are so misinformed on this problem even a psychologist failed us when she was yet a child, after a night with him he said she knew we didn't love her but just her other brothers and sisters so we should spoil her with name brand cloths and romance her. Histrionic personality disorder, he miss it, manipulated by a young girl who planned her own pink funeral. We talked over and over on the phone before her death and every other word was I love you dad.. but everyone said they knew knew she hated us.. it was the most heartbreaking thing to hear her voice again after she cut us out of her life for year saying we cut her out and everyone believed her.

      March 26, 2016 at 22:55 | Report abuse |
  2. pj

    I'll tell you what Histrionic Personality Disorder is – an excuse.
    How do these lawyers live with themselves?

    June 16, 2012 at 20:27 | Report abuse | Reply
    • shelley farrell


      June 19, 2012 at 21:16 | Report abuse |
    • Dominic Maka

      Difficult to ascertain. However, they take an oath to practice law representing their client to the best of their ability. The larger question might be (considering private practice),why does a particular attorney choose to represent a particular client?

      June 28, 2012 at 23:55 | Report abuse |
    • idunno

      Because they have to. Whether they believe he's guilty or not they have to defend him, and with that mountain of charges and only Sandusky's word (and he didn't even take the stand), the lawyers had to think of something... Afterall, it just takes one juror to believe the disorder is real

      July 3, 2012 at 08:23 | Report abuse |
  3. jethro bodine

    Personality disorder or not, Sandusky is an adult and sane adults have to understand that children can not process sexual advances directed to them. They can only be victims. He is obviously a total selfish human with little or no empathy for anyone. His root problem is selfishness and I hope the victims in this case can heal in time.

    June 17, 2012 at 03:05 | Report abuse | Reply
    • Kenichi

      Horoscopes can be very harmful they sohlud be given a proper Time and Place, and that sohlud rarely be sitting on the Throne of Your Attention. Your horoscope, if and when you read it, sohlud be way, way down on your list of priorities.

      September 14, 2012 at 01:47 | Report abuse |
  4. Dando

    A quick execution would rid him and us of this problem. 🙁

    June 17, 2012 at 11:13 | Report abuse | Reply
    • troy

      innocent until proven guilty asshead. maybe someone would think you should be executed. are you so much better a human because you don't have a sexual deviance? alert the vatican. candidate for sainthood. don't be so quick to kill. it's quite possible the man is not guilty. doubtful. but... even if he is found guilty a cell will do nicely.

      June 18, 2012 at 04:23 | Report abuse |
    • Really?

      Troy, go to hell. You are probably a pedophilic deviant as well. No room in this country for enablers. POS.

      June 18, 2012 at 13:05 | Report abuse |
    • Mike

      Death would be good but I'd rather see him put in prison among the general population. I think he would get his just reward then!

      July 3, 2012 at 01:39 | Report abuse |
  5. ginae

    The only thing wrong with him is he's a pervert. Period!

    June 17, 2012 at 11:15 | Report abuse | Reply
    • MARK


      June 22, 2012 at 23:58 | Report abuse |
  6. Platofish

    By going down the 'personality defect' route the defense is more or less admitting that Sandusky is guilty, and they are just looking for ways to lessen his sentence. At age 68 would it really mater if he gets sentenced to 90 years or 50 years? Does the defense team think the public will feel – poor guy, it was his disorder that made him do it, go lightly on him? Sandusky is clearly a cunning man, capable of setting up a charity as a source of future victims. I can't imagine anyone will feel its wrong to send Sandusky to prison for the rest of his natural life if found guilty.

    June 17, 2012 at 13:53 | Report abuse | Reply
    • ChrisB

      I agree with you, completely. The only flaw that I see in your post is, 'if he is found guilty' – I think should read, 'when he is found guilty'.

      God help anyone that feels any sympathy for this POS – we know he is sick, it's just clearly not any excusable kind of 'sickness'. I feel the same way about Magnotta.

      June 17, 2012 at 20:15 | Report abuse |
  7. Gyre

    Histrionic Personality Disorder. Yeah, right! I guess the next BS defense "experts" pull out of their cavities is that Jerry was "high" on whatever (twinkies, Jesus, GW Bush, etc.). Criminal defense attorneys will use whatever shill they think might hang up the juror with the lowest IQ. Guess that's what we're seeng now.

    June 17, 2012 at 16:07 | Report abuse | Reply
  8. Only in America

    Only in America can perverts, abuser, murders, and thiefs get away with a crime just because some doctor made up a a name and gave them a condition. He will claim he is sick!
    I think they should get all those SICK people and send them to the gas chamber.

    June 17, 2012 at 17:59 | Report abuse | Reply
  9. ChrisB

    I don't care if Sandusky has the most extreme case of Histrionic PD or any other illness known to mankind – he is/was a powerful, calculating, scheming monster. He should have just plead guilty because making those young men testify seems so cruel and I shudder to think that ol Jer relives his crimes while they do. Unfortunately, I do not think there is a punishment in the US, including the death penalty (too bad his crimes don't qualify him for that), that is fitting for this POS. Jer, may you burn in the eternal flames, buddy – even they are too good for you!!!

    June 17, 2012 at 20:10 | Report abuse | Reply
  10. Jacaranda

    Please accept my apologies for my english. But what I read about this Mr. Jerry Sandusky and what he's done to these young boys makes me feel sick and sad and shocked and I am so angry, I'm fuming. I could hit away his false smile. I hope he will not smile/grin at his victims or at anyone for that matter for a very long time..
    And if he gets away with 'histrionic personality disorder' then I don't understand the word 'justice' anymore.

    June 18, 2012 at 12:43 | Report abuse | Reply
    • kathy

      Jacaranda, no need to apologize. You stated so clearly exactly what I'm feeling, too. May justice be served.

      June 22, 2012 at 02:58 | Report abuse |
  11. Really?

    The most powerful piece of this trial up until now was not the testimony, but the fact that one of these young men that testified was SO embarrased that he left the courtoom with a PLASTIC BAG over his head. This man totally destroyed these boys childhoods, and will leave an eternal mark on their minds. I hope he ROTS in jail, and gets exactly what he gave out!!

    June 18, 2012 at 13:04 | Report abuse | Reply
  12. James Hotz

    The disorder is that he gets off in a kids mouth, that's where he gets his thrill, and knowing that the kid is too ashamed to say any thing. But not to worry this guy has done this many times, the rest are to embarrased to come forward. I can remember being approched by many gizzers like him when I was growing up, they like to prey on young boys and young men like sailors. One told me I like sea food.

    June 18, 2012 at 13:08 | Report abuse | Reply
  13. LB

    Good...His cell mates can console him when he is upset and not feeling pretty

    June 18, 2012 at 17:25 | Report abuse | Reply
  14. Dr. David Hartman

    Personality Disorder, even if applicable to JS, is not a mitigating excuse for pedophilia. I would like to see a copy of the psychologist's testimony explaining how an individual with a propensity for dramatization ( per the dx) somehow would be compelled to molest children. On the face of it, it seems to be an entirely irrelevant, if not entirely inaccurate diagnosis.

    June 20, 2012 at 15:42 | Report abuse | Reply
  15. Jaycey

    I would like to know which disorder caused him to say what he said to Bob Costas.

    June 21, 2012 at 15:41 | Report abuse | Reply
  16. Kathy

    Boy this is a stretch! I'll tell you what's wrong with Sandusky, he's a sociopathic pedophile. The end.

    June 22, 2012 at 15:52 | Report abuse | Reply
  17. Jake36

    I don't give a tinker's damn what happens to JS as long as it does no more damage to the PSU football program.

    June 22, 2012 at 17:58 | Report abuse | Reply
  18. jeff

    only in America can people get away with murder of the wife, or her child. or sodomizing little boys. oh don't forget the boys who get done by the church and everyone says what a shame. do something people. for god's sake do something. if jerry touched my kids i'd make him eat his own privates.

    June 22, 2012 at 19:11 | Report abuse | Reply
  19. Tim

    It seems to me the only way a PD could be considered a criminal defence is if the case could be made caused a major break with reality which is the chief characteristic of the class of mental disorders subsumed under the various forms of Psychotic Disorders....which Histionic PD is not. It seems to me the very best Sandusky's defense could hope for is to have the court accept this diagnosis as a possible mitigating factor. It seems a long shot to me but really what else do they have available to them.

    June 23, 2012 at 15:03 | Report abuse | Reply
  20. SueDonym

    What will happen to all of those who witnessed or knew about the abuse and did nothing? Any charges against them?

    June 24, 2012 at 14:40 | Report abuse | Reply
  21. Sheila

    Didn't the parents of any of these boys notice a change in their own children ?

    June 25, 2012 at 19:38 | Report abuse | Reply
  22. Kevin

    A Personality Disorder is the opposite of Neurotic. The book "Road Less Traveled" has a good explanation. You want to be able to identify these people in your life; they are far more mentally ill than they appear – or will *EVER* admit. They are psycho's in stealth mode, and truly evil.

    June 27, 2012 at 15:13 | Report abuse | Reply
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  25. Adam Brumbaugh

    I would have thought Anti-social PD would be more apt; but I haven't followed the case much or heard the psychiatrists testimony.

    July 3, 2012 at 10:28 | Report abuse | Reply
  26. Mary B

    Doesn't matter, as one previously said, it's an excuse. We make up lots of them, different disorder coming up every week it seems like. But no matter what disorder you do or don't have, it's never going to be an excuse for pedophilia, or child abuse, or any criminal activity. But you blame the lawyers - what about the dumb jurors that jump on believing the garbage they spew? Spewing isn't fun unless it sticks ... and there's a potential 12 suckers in every jury pool ... and then they tell others and pretty soon we all believe in one stupid disorder or another. Excuses. Being sick mentally or physicaly isn't an excuse for criminal activity anyway. Sick or not, you have to pay the price. Death isn't the answer, getting rid of excuses and BHLs would do better.

    July 3, 2012 at 18:48 | Report abuse | Reply
  27. AreYouKiddingMe?

    Histrionic personality disorder should not be used as an excuse for what that monster did. Sandusky and his wife need to die and go to hell.

    July 9, 2012 at 19:19 | Report abuse | Reply
  28. KMH

    I have Poundapedophile disorder. This is my excuse for my overwhelming need to beat the snot out of perverts who abuse children.

    July 12, 2012 at 11:53 | Report abuse | Reply
  29. zainab

    I have a cousin who fits all of the listed criteria for this disorder- she's undergone psychotherapy for numerous 'issues', and has been through several rehab programmes. She's manipulative, selfish, lacks any trace of empathy and acts out sexually, and she's been that way all her life. And you know what, you can't 'cure' what ails her. It is her. How do you 'treat' or 'cure' a personality, however dysfunctional it may be?

    I wish the psychiatric community would remove this disorder from the books, as they did with a couple of the Cluster A personality disorders. You can probably describe any personality type as a pathological condition, it would be roughly as useful as this diagnosis. Jerry Sandusky is accused of a series of heinous crimes, diagnosing him as having a defective personality is not going to change, explain or excuse what he has done. Personality disorders are not like mental illnesses such as schizophrenia, they don't remove culpability for a person's actions. Any person who's behind bars now has a potentially diagnosable 'personality disorder' that could be used to explain their actions, all you'd need if for someone in the psychiatric community to propose it, and others in that community to start diagnosing it. But they still chose to break society's laws and they should still pay the penalty.

    July 22, 2012 at 10:09 | Report abuse | Reply
  30. lancet98

    The motivation behind claiming hystrionic PD was to discount the 'I love you' letters to the one victim. To make them look like just a person's efforts to seek attention from the victim, rather than the efforts of a pedophile to groom or maintain access to a victim. The effort was ridiculous. Sandusky has no history of being diagnosed with such a disorder nor are there any indications his behavior was anything other than a pedophile attempting to maintain access to victims.

    July 22, 2012 at 15:26 | Report abuse | Reply
  31. Guest

    All the power in these relationships was his. Children are no match for an adult. He also enjoyed a sort of "second childhood" by surrounding himself with kids. At the end of the day, he had absolutely no sympathy for his victims' suffering. It was all about Sandusky. He should be made to feel what they felt.

    July 23, 2012 at 14:52 | Report abuse | Reply
  32. Guest 2/10/2013

    Sandusky is a pedophile plain and simple; Sandusky is not "histrionic". Histrionic Persoanlity Disorder in its purest form is characterized by attention seeking behavior usually based on a preoccupation with physical appearance and the seduction of or soliciting of attention from of members of the opposite sex.

    February 10, 2013 at 01:50 | Report abuse | Reply
  33. Rahul Sharma

    Hi, I think I am also suffering from this Histrionic Personality disorder as I have tried to commite Suicide twice and I am also not happy with my marriage life as we are not living together and I always try to seek attention, want to appriciated by other. Please help me, what can I do with this?

    July 18, 2013 at 17:45 | Report abuse | Reply
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