The degree of characteristic behaviors that indicates histrionic personality disorder is determined:
a. at a preset level as objectively described for each essential feature in the DSM-IV
b. as the upper limit of "normal" as determined by the diagnostician
c. by comparing the subject's current level of behavior with his or her familial upbringing
d. when it results in significant distress or impairment after allowing for cultural differences
D
A diagnosis of histrionic personality disorder is appropriate when the degree of the disorder's characteristic behaviors result in significant distress or impairment after allowing for cultural differences. One must always keep in mind that different cultures have varying standards for what is an acceptable level of emotional expression. A key determinant is whether the level of emotional expression is considered excessive in the client's culture and such expression is causing the client distress and impairment in his or her life.
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