Histrionic vs Narcissistic Personality Disorder

Histrionic Personality Disorder
Read Time: 7 Minutes
Written by:Meaghan Rice PsyD., LPC

Published On: August 24, 2022

Medically reviewed by: Minkyung Chung, MS, LMHC

Reviewed On: August 24, 2022

Updated On: November 3, 2023


Histrionic personality disorder (HPD) and narcissistic personality disorder (NPD) are both mental health conditions impacting how someone thinks and behaves. They also significantly alter people’s perceptions of the world around them. Both conditions are classified as cluster B personality disorders, which means you’ll find some similarities when comparing histrionic personality disorder vs narcissistic personality disorder.

Yet while you can find several common traits between them, the conditions are actually fairly distinct. Specifically, the motivations behind thought patterns and behaviors can vary widely.

Read on to learn more about what separates HPD from NPD and why these differences are important.

Classification of the Two Personality Disorders

It’s estimated that an astounding 15% of adults in the United States are living with at least 1 of the ten identified types of personality disorders we know of.

Classifying the major differences between these conditions is essential. It allows us to diagnose someone accurately. Beyond that, these classifications help us find appropriate and effective plans so that with treatment, someone can live a productive, rewarding life with stable relationships and a healthy sense of self-worth.

There are three major clusters that personality disorders are broken down into (A, B, and C). Both HPD and NPD fall into cluster B.

Cluster B

Disorders in the same cluster share some symptoms and behaviors. HPD and NPD are cluster B personality disorders, which are known for dramatic, erratic, and emotional thoughts and behaviors.

In contrast, cluster A personality disorders are associated with unusual and abnormal thought patterns or behaviors, while cluster C personality disorders are marked by high levels of fear and anxiety. Other cluster B personality disorders include borderline personality disorder and antisocial personality disorder.

Differences Between Histrionic vs Narcissistic Personality Disorder

There are some clear identifiable differences that distinguish between histrionic and narcissistic personality disorders. Some of the main ones include the traits below.


One of the primary traits of narcissistic personality disorder is limited empathy. This can make it challenging for someone with NPD to connect with others or take anyone else’s feelings into consideration. A major distinction between HPD and NPD is that low empathy isn’t a part of the diagnostic criteria for histrionic personality disorder. Many people with HPD tend to be quite sensitive to other people’s feelings.

Reasons for attention seeking

When comparing histrionic vs narcissistic traits, you’ll find that people with either have a strong desire for attention from others. However, they crave different types of attention and want to be the center of attention for different reasons.

For example, NPD causes someone to crave positive feedback, admiration, and validation from others. People with NPD actually fear negative attention and criticism and may avoid or hide behaviors that others might view in a negative light. Most people with HPD, however, welcome all types of attention, regardless of whether it’s positive or negative.

Need for others

The desire for attention can cause people with HPD to become overly dependent on others. On the other hand, NPD causes someone to see themselves as superior to others. They feel entitled to special treatment and tend to only surround themselves with others they deem “worthy” of their company. Those with HPD want to fit in and be part of a group.

Emotional regulation

While emotional regulation can be an issue for people with NPD, research shows that HPD has a stronger link to emotional volatility and attention-seeking behavior.

Traits of histrionic personality disorder

HPD is relatively rare when compared to personality disorders overall. An estimated 1.8% of the population is thought to be affected by it. People with histrionic personality disorder desperately want attention, which can lead to unpredictable and dramatic behavior.

Other traits associated with HPD include:

  • Eagerly following trends or fads
  • Wearing theatrical or revealing clothing to attract attention
  • Engaging in excessive, exaggerated displays of emotion
  • Showing provocative or flirtatious behavior even when it’s inappropriate
  • Assuming that relationships are more intimate than they actually are
  • Emotional volatility
  • Shallow emotions that are easily influenced by others
  • Constantly seeking validation or approval from others
  • Experiencing intense distress when not the center of attention

iconExpert Insight

“Individuals with histrionic personality disorder tend to behave in a way that makes them the center of attention. The depths of what they’ll do to get the attention on them does not appear to have bounds.”
Doctor of Psychology (PsyD.), Licensed Professional Counselor (LPC) Meaghan Rice

Traits of narcissistic personality disorder

Narcissistic personality disorder might affect an estimated 6.2% of the population. People with NPD have an inflated view of themselves and believe they’re better than most others.

Additional traits associated with NPD may include:

  • Constantly craving admiration and approval than others
  • Lack of empathy
  • Feeling entitled to special treatment
  • Obsessively fantasizing about being successful and powerful
  • Exaggerating their own accomplishments
  • Favorably comparing themselves to others
  • Manipulating people around them for their own benefit
  • A genuine belief that they’re more talented or more deserving of success than others
  • Projecting their mistakes or shortcomings onto other people

iconExpert Insight

“While individuals with narcissistic personality disorder also want the attention on them, they are far less dramatic and way more egotistical. They demonstrate low empathy, care, and concern for others, which enables them to manipulate people to get what they want.”
Doctor of Psychology (PsyD.), Licensed Professional Counselor (LPC) Meaghan Rice

Can someone with NPD also have histrionic personality disorder?

It’s common for people with personality disorders to have comorbid conditions (meaning other mental health conditions, including other personality disorders, occurring simultaneously). Narcissistic personality disorder is most likely to co-occur with antisocial, borderline, or histrionic personality disorder. Histrionic narcissism can be difficult to diagnose, making the symptoms of both conditions more severe.

People with symptoms of narcissistic personality disorder and histrionic personality disorder are often referred to as having narcissistic personality disorder with histrionic traits. While people with histrionic narcissism are often charming and charismatic, their relationships with others are typically superficial. They often perceive themselves as victims and frequently engage in manipulative behavior.

What Causes HPD and NPD?

The truth is, like most mental health conditions, we just don’t yet know for sure what exactly causes either histrionic or narcissistic personality disorder. That said, it’s clear that neither condition is caused by a single factor. Instead, it’s generally accepted that a combination of several things — including environment, genetics, and biology — leads to the development of these personality disorders.

Certain factors can increase the risk for both HPD and NPD, but it’s unlikely that any one event or experience would be the sole cause of a condition. Personality disorders are highly complex, and there are many factors that can influence whether a person develops a condition.

Causes of histrionic personality disorder

While the precise cause of histrionic personality disorder is unknown, the condition is linked to certain risk factors, such as:

  • Having family members diagnosed with personality disorders
  • Modeling the behaviors of a parent with histrionic personality disorder
  • A lack of discipline during early childhood
  • Receiving positive feedback for attention-seeking behavior
  • Trauma during early childhood
  • Genetic vulnerability to personality disorders

Causes of narcissistic personality disorder

As with histrionic personality disorder, it’s likely that people who develop narcissistic personality disorder are exposed to a number of risk factors. Some of the potential causes of narcissistic personality disorder include:

  • Abuse or neglect during childhood
  • Overprotective parenting
  • Parents who fail to set appropriate boundaries
  • Receiving excessive praise from parents
  • Having other mental health conditions
  • Suffering from high blood pressure or other conditions that increase risk

Treatment for HPD and NPD

There’s no cure for HPD or NPD, and while it can be difficult to treat these personality disorders, you should know that treatment is possible.

When comparing treatments for histrionic personality disorder vs narcissistic personality disorder, you’ll find that options vary, even though the conditions share some symptoms and similarities.

  • Psychotherapy (also known as talk therapy) is the primary form of treatment for both conditions, but the types of therapy used may be different.
  • It’s common to treat HPD with either psychodynamic or supportive therapy, which can help to improve self-esteem and self-reliance.
  • Forms of therapy used to treat narcissistic personality disorder include transference-focused therapy and mentalization-based therapy.
  • NPD medication may be used to manage certain symptoms, such as feelings of depression or anxiety, but nothing has been approved to date to treat either condition.

Seek a Diagnosis with Talkspace

It can be difficult to distinguish between histrionic vs narcissistic traits, especially when you’re unfamiliar with personality disorders. If you or a loved one struggles with symptoms of HPD or NPD, you should seek help. An HPD or NPD diagnosis can help you understand symptoms better and develop a suitable treatment plan.

If you need help or are ready to start therapy, but feel the process is daunting, check out Talkspace. We’re an online therapy platform with licensed, trained, experienced mental health professionals who understand treatment and care for HPD and NPD. Talkspace makes getting therapy simple, affordable, and convenient. You can be on the path toward healing and managing your condition as soon as today when you reach out to Talkspace.

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Meaghan Rice

Meaghan Rice is a mental health consultant specializing in professionals who are looking to close the gap between where they are and where they envision themselves being. With a decade of experience in the mental health field, working in a variety of different capacities, Dr. Rice has found her niche amidst the therapist, consultant, and trainer roles.

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