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Epidemiology
Approximately 1-3% of the population has Histrionic Personality Disorder. 10-15% of patients in clinical settings have HPD. [4]

Gender differences
HPD is diagnosed more frequently in females than males, but it is unclear whether such diagnoses actually reflect a higher prevalence rate of the disorder among females. It is often argued that the diagnosticcriterion for HPD issexually biased, since many of its traits are strongly correlated with what are often thought to be feminine behaviors.[1] Moreover, there is a strong sexual bias for men to be diagnosed with Antisocial Personality Disorder, which shares many similar traits with HPD.[2] Some personality researchers have argued that HPD and Antisocial Personality Disorder are separate gender gender manifestations of the same underlying condition. [3], and that HPD simply represents an exaggerated stereotypical version of female traits, and ASPD represents an exaggerated stereotypical version of male traits.

Cultural Differences
Variation in the prevalence of HPD also exists among different cultures. The disorder is less prevalent in Asian cultures, where overt sexual seductiveness is less frequent; and more prevalent in Hispanic and Latino cultures where overt sexual seductiveness is more frequent. Some researchers argue that such culture differences do not reflect differential prevalence rates among cultures. They believe it signifies a sexual bias in diagnostic criterion, since diagnoses are more prevalent among cultures where sexual seductiveness, a stereotypically feminine behavior, is more common. It is unclear whether criterion should be changed under such cultural contexts, because the DSM-IV criteria may also reflect biases regarding seductiveness that are not shared by other societies. [4 ]

Life-span
Due to this sexual seductiveness trait, the validity of HPD diagnostic criteria may also vary across life-span. Sexual seductiveness may become a less effective means to manipulate others or garnishing the attention of others as one gets older. On the other hand, previous research also suggests that histrionic traits may become more overt as a person ages, because histrionic persons continue to rely on ineffective means of getting attention despite being unsuccessful. [3]

Validity and Reliability
Despite the controversies surrounding the diagnostic criteria of HPD, a meta-analysis of HPD diagnoses by Nestadt et al found that HPD is a valid construct, and can be diagnosedreliably. Moreover, it found that HPD affects men and women equally among young adults, and that a differential sex prevalence rate did not emerge until the age of 45. It also found that women were diagnosed more frequently with HPD due to sampling biases found in hospital-based studies. Women were sampled more often than men in hospital-based facilities, thus making it appear as though the illness is more prevalent in women when in fact the study-samples were disproportionate. [4]

1.Ford, M. R., & Widiger, T. A. (Sex bias in the diagnosis of histrionic and antisocial personality disorders). Journal of Consulting and Clinical Psychology, 301-305. 2.Lilienfeld, S. O., Van Valkenburg, C., Larntz, K., & Akiskal, H. S. (1986). The relationship of histrionic personality disorder to antisocial personality and somatization disorders. . The American Journal of Psychiatry, 718-722. 3.Nestadt, G., Romanoski, A., Chahal, R., Merchant, A., Folstein, M., Gruenberg, E., & McHugh, P. (1990). An epidemiological study of histrionic personality disorder. Psychological Medicine, 413-422 4.Widiger, T. A., & Bornstein, R. F. (2001). Histronic, Narcissistic, and Dependent Personality Disorders. In H. E. Adams, & P. B. Sutker, Comprehensive Handbook of Psychopathology (pp. 509-534). New York: Plenum Publishers.