Twin studies have aided in breaking down the genetic vs. High levels of norepinephrine leads to anxiety-proneness, dependency, and high sociability. Individuals diagnosed with HPD have highly responsive noradrenergic systems which is responsible for the synthesis, storage, and release of the neurotransmitter, norepinephrine. Studies have shown that there is a strong correlation between the function of neurotransmitters and the Cluster B personality disorders such as HPD. HPD symptoms typically do not fully develop until the age of 15, while the onset of treatment only occurs, on average, at approximately 40 years of age. Traits such as extravagance, vanity, and seductiveness of hysteria have similar qualities to women diagnosed with HPD. Although direct causes are inconclusive, various theories and studies suggest multiple possible causes, of a neurochemical, genetic, psychoanalytic, or environmental nature. Little research has been done to find evidence of what causes histrionic personality disorder.
Make-up physical appearance is used to draw attention to self. 
Speech (style) wants to impress lacks detail. Influenced easily by others or circumstances. Relationships are considered more intimate than they actually are. Mnemonic Ī mnemonic that can be used to remember the characteristics of histrionic personality disorder is shortened as "PRAISE ME": Some people with histrionic traits or personality disorder change their seduction technique into a more maternal or paternal style as they age. Influenced by the suggestions of others. Being easily influenced by others, especially those who treat them approvingly. Blaming personal failures or disappointments on others. Tendency to believe that relationships are more intimate than they actually are. Rapidly shifting emotional states that may appear superficial or exaggerated to others. Low tolerance for frustration or delayed gratification. Using factitious somatic symptoms (of physical illness) or psychological disorders to garner attention. Inappropriately seductive appearance or behavior of a sexual nature. Pride of own personality and unwillingness to change, viewing any change as a threat. Excessive sensitivity to criticism or disapproval. Constant seeking of reassurance or approval. All of these factors may lead to greater risk of developing clinical depression. Because they tend to crave novelty and excitement, they may place themselves in risky situations. They may go through frequent job changes, as they become easily bored and may prefer withdrawing from frustration (instead of facing it). Individuals with HPD often fail to see their own personal situation realistically, instead dramatizing and exaggerating their difficulties. They may seek treatment for clinical depression when romantic (or other close personal) relationships end. HPD may also affect a person's social and romantic relationships, as well as their ability to cope with losses or failures. They usually have good social skills, despite tending to use them to manipulate others into making them the center of attention. People with HPD are usually high-functioning, both socially and professionally. 4.3.1 Functional ideographic assessment template. 
4.3 Coding client and therapist behaviors. 2.4 HPD and antisocial personality disorder.
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