Histrionic Personality Disorder Checklist

Personal Information:
Name: ____________________________________ Age: ______________________ Sex: ________
Date & Time of Assessment: ___________________________

This is a checklist to help one understand Histrionic Personality Disorder (HPD). All information is
taken from the DSM-5.

Instruction:

Please check “yes” criteria that are evident in the client’s inner experiences and behaviors.

General Criteria of Personality Disorder

Section I: Must check TWO or more of the following:  Evident Remarks on displayed
Yes No behavior
Criteria A. The client shows an enduring pattern of inner
experience and behavior that deviates markedly from the
expectations of the individual's culture and is manifested in at
least two of the following areas:
1. Cognition ((i.e., ways of perceiving and interpreting /
self, other people, and events).
2. Affectivity (i.e., the range, intensity, lability, and /
appropriateness of emotional response).
3. Interpersonal functioning. /

4. Impulse control.

Section II: Must check ALL of the following:

Criteria B. The client’s shows a pattern of inflexibility and is /

pervasive across a broad range of personal and social
situations.
Criteria C. The client’s enduring pattern of behavior lead /
him/her to clinically significant distress or impairment in social,
occupational, or other important areas of functioning
Criteria D. The client’s pattern of behavior is stable and long /
duration, and its onset can be traced back at least to
adolescence or early adulthood.
Criteria E. The client’ s pattern of behavior is not better /
explained as a manifestation or consequence of another
mental disorder
Criteria F. The client’ s pattern of behavior is not attributable to /
the physiological effects of a substance (e.g., a drug of abuse, a
medication) or another medical condition (e.g., head trauma).

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 Diagnostic Criteria of Histrionic Personality Disorder
Section II: Must check FIVE or more of the following:
The client shows a pervasive pattern of excessive emotionality Evident Remarks on displayed
and attention seeking in a variety of contexts, as indicated by Yes No behavior
five (or more) of the following:
1. He/she is uncomfortable in situations in which he or she is /
not the center of attention.
2. His/her interaction with others is often characterized by /
inappropriate sexually seductive or provocative behavior.
3. He/she displays rapidly shifting and shallow expression of /
emotions.
4. He/she consistently uses physical appearance to draw /
attention to self.
5. He/she has a style of speech that is excessively /
impressionistic and lacking in detail.
6. He/she shows self-dramatization, theatricality, and /
exaggerated expression of emotion.
7. He/she is suggestible (i.e., easily influenced by others or /
circumstances).
8. He/she considers relationships to be more intimate than they /
actually are

*Note: The client must meet the minimum number of symptoms to be diagnosed of histrionic
personality disorder.

Diagnostic Features:

Recommendation:

Evaluated
by: Date:

• 2 Histrionic Personality Disorder Case & Checklist

Prepared by:

Florie Ann L. Fermil, RGC Date:

• 3 Histrionic Personality Disorder Case & Checklist