Internet Mental Health

HISTRIONIC PERSONALITY DISORDER






Internet Mental Health Quality of Life Scale (Client Version)

Internet Mental Health Quality of Life Scale (Therapist Version)

Big 5 Factors Of Mental Illness And Code For This Disorder
(The "6th Big Factor" of Mental Health, "Physical Health", Is Coded Normal or Green)

Onset:

Histrionic Personality Disorder occurs in 1.8% of Americans. Individuals with this disorder have a pervasive pattern of attention seeking and excessive emotionality. This disorder is characterized by moderate to severe: excessive sociability (attention seeking [theatrical, inappropriately seductive behavior]) and negative emotion (emotional instability). For this diagnosis to be given, the individual must be at least in early adulthood. This disorder is only diagnosed when these behaviors become persistent and very disabling or harmful to others.

Treatment:

There is insufficient evidence to justify using any psychological intervention or medication for adults with this disorder. Lacking such evidence, it would be prudent to only offer short-term crisis intervention, rather than long-term psychotherapy.

Prognosis:

Histrionic Personality Disorder can persist for a lifetime.

Problems

Occupational-Economic Problems:

  • Causes significant impairment in academic, occupational and/or social functioning

  • Works poorly with others

Sociable (High Extraversion):

    Inappropriate attention seeking:

    • Is uncomfortable in situations in which she is not the center of attention

    • Consistently uses physical appearance to draw attention to herself

    • Interaction with others is often characterized by inappropriate sexually seductive or provocative behavior

    • Shows self-dramatization, theatricality, and exaggerated expression of emotion

    • Displays rapidly shifting and shallow expression of emotions

    • Has a style of speech that is excessively impressionistic and lacking in detail

    • Is suggestible, i.e., easily influenced by others or circumstances

    • Considers relationships to be more intimate than they actually are


SAPAS Personality Screening Test

Individuals with this disorder would answer "Yes" to the red questions:

      In general, do you have difficulty making and keeping friends?
      Would you normally describe yourself as a loner?
      In general, do you trust other people? (No)
      Do you normally lose your temper easily?
      Are you normally an impulsive sort of person?
      Are you normally a worrier?
      In general, do you depend on others a lot?
      In general, are you a perfectionist?



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Click Here For Free Diagnosis

Limitations of Self-Diagnosis

Self-diagnosis of this disorder is often inaccurate. Accurate diagnosis of this disorder requires assessment by a qualified practitioner trained in psychiatric diagnosis and evidence-based treatment.

However, if no such professional is available, our free computerized diagnosis is usually accurate when completed by an informant who knows the patient well. Computerized diagnosis is less accurate when done by patients (because they often lack insight).

Example Of Our Computer Generated Diagnostic Assessment of President Trump



Editor's Comment

This website's focus has always been on educating the public about mental health. Our website's unique contribution has been our free, interactive psychiatric diagnosis program.

I have been a psychiatrist for 35-years, and for years I was one of four psychiatrists supervising the Vancouver General Hospital psychiatric emergency ward (which assessed more than 4,000 patients per year). It is my psychiatric opinion that both President Trump and Vladimir Putin have three highly interrelated disorders: Naracissistic, Antisocial, and Paranoid Personality Disorders. In addition, President Trump has severe Histrionic Personality Disorder.

President Trump's Diagnosis

Histrionic Personality Disorder 301.50

This diagnosis is based on the following findings:

  • Is uncomfortable in situations in which he was not the center of attention (still present)

  • Inappropriate sexually seductive or provocative behavior. (still present)

  • Has a style of speech is excessively impressionistic and lacking in detail (still present)

  • Shows self-dramatization, theatricality and exaggerated expression of emotion (still present)

  • Is suggestible (i.e., easily influenced by others or circumstances) (still present)

  • Considers relationships to be more intimate than they actually are (still present)

Treatment Goals:

  • Goal: stop always trying to be the center of attention.
    If this problem persists: He will alienate people by her constant demands for attention. When not the center of attention, he will continue to do something dramatic (e.g., make up stories, create a scene) to draw the focus of attention to himself.

  • Goal: stop being inappropriately sexually provocative or seductive.
    If this problem persists: He will alienate same-sexed friends because of his sexually provocative behavior towards his friend's romantic partners.

  • Goal: stop expressing strong opinions without supporting evidence.
    If this problem persists: He will alienate others with his strong opinions that are expressed with dramatic flair, but without supporting facts and details.

  • Goal: stop being so suggestible.
    If this problem persists: His opinions and feelings will continue to be easily influenced by others and by current fads. He must stop being overly trusting, especially of strong authority figures who will magically solve his problems.

  • Goal: be less dramatic and theatrical.
    If this problem persists: He will embarrass others by her excessive public display of emotions. Others will accuse him of faking his feelings because his emotions seem to be turned on and off too quickly to be deeply felt.

  • Goal: stop considering relationships to be more intimate than they actually are.
    If this problem persists: He will continue to think that mere acquaintances are actually close friends, or believe that casual relationships are more romantically intimate than they actually are.


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Histrionic Personality Disorder F60.4 - ICD10 Description, World Health Organization

Histrionic Personality Disorder is characterized by shallow and labile affectivity, self-dramatization, theatricality, exaggerated expression of emotions, suggestibility, egocentricity, self-indulgence, lack of consideration for others, easily hurt feelings, and continuous seeking for appreciation, excitement and attention.

ICD-10 International Personality Disorder Examination Screening Questions

  • I show my feelings for everyone to see.

  • I'm too easily influenced by what goes on around me.

  • My feelings are like the weather; they're always changing.

  • I like to dress so I stand out in a crowd.

  • I would rather not be the center of attention (False).

  • I have a reputation for being a flirt.

ICD-10 Diagnostic Criteria (For Research)

    A. The general criteria of personality disorder must be met:

    • Evidence that the individual's characteristic and enduring patterns of inner experience and behavior deviate markedly as a whole from the culturally expected and accepted range (or 'norm').

    • The deviation must manifest itself pervasively as behavior that is inflexible, maladaptive, or otherwise dysfunctional across a broad range of personal and social situations (i.e. not being limited to one specific 'triggering' stimulus or situation).

    • There is personal distress, or adverse impact on the social environment, or both, clearly attributable to the behavior.

    • There must be evidence that the deviation is stable and of long duration, having its onset in late childhood or adolescence.

    • The deviation cannot be explained as a manifestation or consequence of other adult mental disorders.

    • Organic brain disease, injury, or dysfunction must be excluded as possible cause of the deviation.

    B. At least four of the following must be present:

    • Self-dramatization, theatricality, or exaggerated expression of emotions.
        (E.g., "I show my feelings for everyone to see.")

    • Suggestibility, easily influenced by others or by circumstances.
        (E.g., "I'm too easily influenced by what goes on around me.")

    • Shallow and labile affectivity.
        (E.g., "My feelings are like the weather; they are always changing.")

    • Continually seeks excitement and being the centre of attention.
        (E.g., "I like being the center of attention.")

    • Inappropriately seductive in appearance or behavior.
        (E.g., "I have a reputation for being a flirt.")

    • Overly concerned with physical attractiveness.
        (E.g., "I like to dress so that I stand out in a crowd.")

    • Comments: Egocentricity, self-indulgence, continuous longing for appreciation, lack of consideration for others, feelings that are easily hurt, and persistent manipulative behavior complete the clinical picture, but are not required for the diagnosis.

Histrionic Personality Disorder - Diagnostic Criteria, American Psychiatric Association

A pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts, as indicated by 5 (or more) of the following:

  • This enduring pattern of inner experience and behavior must deviate markedly from the expectations of the individual's culture.

  • This enduring pattern is inflexible and pervasive across a broad range of personal and social situations.

  • This enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning.

  • Empirically Derived Taxonomy for Personality Diagnosis: Histrionic Personality Disorder

    (This section uses an alternative classification system to that of the American Psychiatric Association)

    These individuals:

    • Are emotionally dramatic and prone to express emotion in exaggerated and theatrical ways.

    • Their reactions tend to be based on emotion rather than reflection, and their cognitive style tends to be glib, global, and impressionistic (e.g., missing details, glossing over inconsistencies, mispronouncing names).

    • Their beliefs and expectations seem cliche or stereotypical, as if taken from storybooks or movies, and they seem naive or innocent, seeming to know less about the ways of the world than would be expected.

    • Are sexually seductive or provocative. They use their physical attractiveness to an excessive degree to gain attention and notice, and they behave in ways that seem to epitomize gender stereotypes. They may be flirtatious, preoccupied with sexual conquest, prone to lead people on, or promiscuous.

    • Become involved in romantic or sexual "triangles" and may be drawn to people who are already attached or sought by someone else.

    • Have difficulty directing both tender feelings and sexual feelings toward the same person, tending to view others as either virtuous or sexy, but not both.

    • Are suggestible or easily influenced, and idealize and identify with admired others to the point of taking on their attitudes or mannerisms.

    • Fantasize about ideal, perfect love, yet tend to choose sexual or romantic partners who are emotionally unavailable, or who seem inappropriate (e.g., in terms of age or social or economic status).

    • Become attached quickly and intensely; however, beneath the surface, they often fear being alone, rejected, or abandoned.

      • (Editor's Note: These behaviors would be considered "normal" in 14-year-olds just "discovering" the opposite sex. Most adolescents mature out of their personality disorders within 2 years. Thus the question is: why do these maladaptive adolescent behaviors persist into adulthood in Histrionic Personality Disorder?)


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    Diagnostic Features

    Individuals with Histrionic Personality Disorder have a pervasive pattern of attention seeking and excessive emotionality. This disorder is characterized by moderate to severe excessive sociability (attention seeking [theatrical, inappropriately seductive behavior]) and negative emotion (emotional instability). This disorder is only diagnosed if: (1) it begins no later than early adulthood, (2) these behaviors occur at home, work, and in the community, and (3) these behaviors lead to clinically significant distress or impairment in social, occupational, or other important areas of functioning. Histrionic Personality Disorder should not be diagnosed if its symptoms can be better explained as due to another mental disorder, Substance Use Disorder, or another medical condition (e.g., head trauma).

    Individuals with this disorder may have difficulty achieving emotional intimacy in romantic relationships. Without being aware of it, they often act out a role (e.g., "victim" or "princess"). They may seek to control their partner through emotional manipulation or seductiveness on one level, whereas displaying a marked dependency on them at another level.

    Individuals with this disorder often have impaired relationships with same-sex friends because of their sexually provocative behavior or their demands for constant attention. They crave novelty, stimulation, and excitement and have a tendency to become bored with their usual routine. Often old relationships are neglected to make way for the excitement of new relationships. Although they often initiate a job or project with great enthusiasm, their interest may lag quickly.

    Like all personality disorders, Histrionic Personality Disorder is a deeply ingrained and enduring behavior pattern, manifesting as an inflexible response to a broad range of personal and social situations. This behavior represents an extreme or significant deviation from the way in which the average individual in a given culture relates to others. This behavior pattern tends to be stable.

    Complications

    The actual risk of suicide is not known, but individuals with Histrionic Personality Disorder are at increased risk for attention seeking suicidal gestures or threats.

    Comorbidity

    Some other disorders frequently occur with this disorder:

      Non-Personality Disorders

              Depressive Disorders:
        • Major Depressive Disorder
              Somatic Symptom and Related Disorders:
        • Somatic Symptom Disorder, Conversion Disorder (Functional Neurological Symptom Disorder)

      Personality Disorders

              Dependent Personality Disorder

              Antisocial Personality Disorder

              Borderline Personality Disorder

              Narcissistic Personality Disorder

    Associated Laboratory Findings

    No laboratory test has been found to be diagnostic of this disorder.

    Prevalence

    The frequency of Histrionic Personality Disorder is equal in males and females, and this disorder is present in about 1.8% of the general population (and 10%-15% of psychiatric outpatients).

    Controlled Clinical Trials Of Therapy

    Click here for a list of all the controlled clinical trials of therapy for this disorder.

    Psychotherapy

    There is insufficient evidence to justify using any psychological intervention for adults with this disorder. Lacking such evidence, it would be prudent to only offer short-term crisis intervention, rather than long-term psychotherapy.

    Pharmacotherapy

    There are currently no medications approved by the FDA to treat this disorder. Vitamins, nutritional supplements, and special diets are all ineffective for all Personality Disorders.

    A Dangerous Cult


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    Videos


    Stories

    Rating Scales

    Histrionic Traits

    Individuals with Histrionic Personality Disorder must be the center of attention and "the life of the party". They are overly concerned with impressing others by their appearance. They are highly suggestible, and easily influenced by others and by fads. They are hypersensitive to criticism. They are impulsive, excitement seeking, reckless, and seductive.

    Lack Of Social Skills In Personality Disorders

    There are certain social skills that are essential for healthy social functioning. Individuals with Histrionic Personality Disorder lack the essential social skills of genuineness, chastity, and caution. They lack emotional stability (that is also lacking in individuals with Borderline Personality Disorder) and cooperation/generosity (that is also lacking in Narcissistic Personality Disorder).

      Social Skills That Are Lacking In Histrionic Personality Disorder

      SOCIAL SKILL HISTRIONIC PERSONALITY NORMAL
      Sincerity Attention seeking Being sincere (not overly theatrical or attention seeking)
      Chastity Desire for casual or illicit sex Avoidance of casual sex ("one night stands" AND absence of intense desire for illicit sex)
      Caution Harmful impulsiveness Thinking carefully before acting or speaking; being cautious
      Emotional Stability Emotional instability (rapidly shifting and shallow expression of emotions) Having a predictable mood which does not quickly change

    A Good Life

    How does one live a good life?

    One approach to answering this question is to study the behavior of individuals who live troubled lives. Could the opposite of their maladaptive behavior define how to live a good life?

    Consider the troubled lives of people with histrionic personality disorder. Individuals with histrionic personality disorder are inappropriately attention seeking and seductive.

    Could the opposite of the maladaptive behaviors seen in histrionic personality disorder be a clue to how to live a good life? Many religions teach that we should be sincere and not seductive. This is the opposite of the inappropriately attention seeking and seductive behavior seen in histrionic personality disorder.

      Histrionic Personality Disorder The Opposite Of Histrionic Personality Disorder
      Inappropriate attention seeking: Sincerity:
      Shows self-dramatization, theatricality and exaggerated expression of emotion Does not show self-dramatization, theatricality, or exaggerated expression of emotion
      Is uncomfortable in situations in which she was not the center of attention Is comfortable in situations in which she is not the center of attention
      Consistently uses physical appearance to draw attention to herself Does not consistently use physical appearance to draw attention to herself
      Displays rapidly shifting and shallow expression of emotions Does not display rapidly shifting and shallow expression of emotions
      Has a style of speech is excessively impressionistic and lacking in detail Does not have a style of speech that is excessively impressionistic and lacking in detail
      Considers relationships to be more intimate than they actually are Does not consider relationships to be more intimate than they actually are
      Is suggestible (i.e., easily influenced by others or circumstances) Is not suggestible, i.e., not easily influenced by others or circumstances
      Inappropriate sexually seductive or provocative behavior. Does not show inappropriate sexually seductive or provocative behavior

    Parental Behaviors Which Increase The Risk Of Developing A Personality Disorder

    Research has shown that genetic, environmental, and prenatal factors all play important roles in the development of personality disorder. Research has also shown that low parental affection and harsh parenting increase the risk of a child later developing a personality disorder.

    "Low affection" was defined as: low parental affection, low parental time spent with the child, poor parental communication with the child, poor home maintenance, low educational aspirations for the child, poor parental supervision, low paternal assistance to the child's mother, and poor paternal role fulfillment. "Harsh parenting" was defined as: harsh punishment, inconsistent maternal enforcement of rules, frequent loud arguments between the parents, difficulty controlling anger toward the child, possessiveness, use of guilt to control the child, and verbal abuse.


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    Setting Goals In Therapy

      Questions To Ask When Setting Goals

      In The Past Week:
      • WHO: was your problem?

      • EVENT: what did he/she do?

      • RESPONSE: how did you respond to that event?

      • OUTCOME: did your response help?

      • TRIGGER: what did you do that could have triggered this problem?

      • GOAL: what life skill(s) do you have to work on? (from checklist)

      Example Of Setting Goals In Interviewing A Person With Histrionic Personality Disorder

      In The Past Week:
      • WHO: was your problem?
        "My boyfriend."

      • EVENT: what did he/she do?
        "I was just talking to this guy at a party, and my boyfriend got all jealous."

      • RESPONSE: how did you respond to that event?
        "I stormed out of the party. I wish now that we hadn't made such a scene."

      • OUTCOME: did your response help?
        "No, I over-reacted. It wasn't worth upsetting everyone at the party."

      • TRIGGER: what did you do that could have triggered this problem?
        "My boyfriend knows that I like to flirt. I just got a little carried away that night."

      • GOAL: what life skill(s) do you have to work on? (from checklist)
        "I want to work on: (1) Sincerity ("being genuine - not overly theatrical or attention seeking"), and (2) Chastity ("avoidance of casual sex ["one night stands"] AND absence of intense desire for illicit sex")."


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    Improving Positive Behavior

    Philosophers for the past 2,500 years have taught that it is very beneficial to start the day with goal-setting, and end the day with a brief review.

    This habit of planning your day in the morning, and reviewing your day in the evening, is a time-proven technique for more successful living.

    Note: When each of the following videos finishes; you must exit YouTube (by manually closing the window) in order to return to this webpage.



    Morning Meditation (5-Minute Video)



    Afternoon Meditation (Learn How To Have Healthy Relationships)



    Evening Meditation (5-Minute Video)



    Life Satisfaction Scale (Video)



    Healthy Social Behavior Scale (Video)



    Mental Health Scale (Video)




    Click Here For More Self-Help



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      "In physical science a first essential step in the direction of learning any subject is to find principles of numerical reckoning and practicable methods for measuring some quality connected with it. I often say that when you can measure what you are speaking about and express it in numbers you know something about it; but when you cannot measure it, when you cannot express it in numbers, your knowledge is of a meagre and unsatisfactory kind: it may be the beginning of knowledge, but you have scarcely, in your thoughts, advanced to the stage of science, whatever the matter may be."

      Lord Kelvin (1824 – 1907)


    • The best summary on bad research is given by Laura Arnold in this TEDx lecture. If you read nothing else about research, you owe it to yourself to watch this short video - it is excellent!

    • Canadian researchers who commit scientific fraud are protected by privacy laws: There are criminals in every community - even in the scientific research community (especially if a lot of money is at stake). Criminal researchers can hide their fraud behind outdated privacy laws.

    • The power of asking "what if?"

    • The active placebo effect: 2300 years ago, the Greek Stoic philosophers taught that it is not the objective event, but our subjective judgment about the event, that determines our behavior. The active placebo effect bears witness to this ancient wisdom.

    • Criteria For High Quality Research Studies

    • It is troubling that a recent study found that two-thirds of important psychological research studies couldn't be replicated. High quality research must meet the following criteria:

      • Randomized Controlled Trial:
        Ask: Was the trial randomized? Was the randomization procedure described and was it appropriate? The best research design is to have research subjects randomly assigned to an experimental or control group. It is essential that confounding factors be controlled for by having a control group or comparator condition (no intervention, placebo, care as usual etc.).

      • Representative Sample:
        Ask: Do the research subjects represent a normal cross-section of the population being studied? Many psychological research studies using university students are flawed because their subjects are not representative of the normal population since they are all W.E.I.R.D. (White, Educated, Intelligent, Rich, and living in a Democracy).

      • Single Blind Trial:
        Ask: Was the treatment allocation concealed? It is essential that the research subjects are kept "blind" as to whether they are in the experimental or control group (in order to control for any placebo effects).

      • Double Blind Trial (Better Than Single Blind Trial):
        Ask: Were blind outcome assessments conducted? In a double blind study, neither the research subjects nor the outcome assessors know if the research subject is in the experimental or control group. This controls for both the placebo effect and assessor bias.

      • Baseline Comparability:
        Ask: Were groups similar at baseline on prognostic indicators? The experimental and control groups must be shown to be comparable at the beginning of the study.

      • Confounding Factors:
        Ask: Were there factors, that weren't controlled for, that could have seriously distorted the study's results? For example, research studies on the effectiveness of mindfulness cognitive therapy in preventing depressive relapse forgot to control for whether the research subjects were also simultaneously receiving antidepressant medication or other psychological treatments for depression.

      • Intervention Integrity:
        Ask: Was the research study protocal strictly followed? The research subjects must be shown to be compliant (e.g., taking their pills, attending therapy) and the therapists must be shown to be reliably delivering the intervention (e.g., staying on the research protocol).

      • Statistical analysis:
        Ask: Was a statistical power calculation described? The study should discuss its statistical power analysis; that is whether the study size is large enough to statistically detect a difference between the experimental and control group (should it occur) and usually this requires at least 50 research subjects in the study.

        Ask: Are the results both statistically significant and clinically significant? The results should be both statistically significant (with a p-value <0.05) and clinically significant using some measure of Effect Size such as Standardized Mean Difference (e.g., Cohen's d >= 0.33). The summary statistics should report what percentage of the total variance of the dependent variable (e.g., outcome) can be explained by the independent variable (e.g., intervention). In clinical studies, the study should report the number needed to treat for an additional beneficial outcome (NNTB), and the number needed to treat for an additional harmful outcome (NNTH).

          Number Needed To Benefit (NNTB): This is defined as the number of patients that need to be treated for one of them to benefit compared with a control in a clinical trial. (It is defined as the inverse of the absolute risk reduction.) Note: Statistically, the NNTB depends on which control group is used for comparison - e.g., active treatment vs. placebo treatment, or active treatment vs. no treatment.

          Number Needed To Harm (NNTH): This is defined as the number of patients that need to be treated for one of them to be harmed compared with a control in a clinical trial. (It is defined as the inverse of the absolute increase in risk of harm.)

          Tomlinson found “an NNTB of 5 or less was probably associated with a meaningful health benefit,” while “an NNTB of 15 or more was quite certain to be associated with at most a small net health benefit.”

        Ask: Does the researcher accept full responsibility for the study's statistical analysis? The researcher should not just hand over the study's raw data to a corporation (that may have $1,000 million invested in the study) to do the statistical analysis.

      • Completeness of follow-up data:
        Ask: Was the number of withdrawals or dropouts in each group mentioned, and were reasons given for these withdrawals or dropouts? Less than 20% of the research subjects should drop out of the study. The intervention effect should persist over an adequate length of time.

      • Handling of missing data:
        Ask: Was the statistical analysis conducted on the intention-to-treat sample? There must be use of intention-to-treat analysis (as opposed to a completers-only analysis). In this way, all of the research subjects that started the study are included in the final statistical analysis. A completers-only analysis would disregard those research subjects that dropped out.

      • Replication of Findings:
        Ask: Can other researchers replicate this study's results? The research study's methodology should be clearly described so that the study can be easily replicated. The researcher's raw data should be available to other researchers to review (in order to detect errors or fraud).

      • Fraud:
        Ask: Is there a suspicion of fraud? In a research study, examine the independent and dependent variables that are always measured as a positive whole number (e.g., a variable measured on a 5-point Likert-type scale ranging from "1 = definitely false to 5 = definitely true" etc.). For each of these variables, look at their sample size (n), mean (M) and standard deviation (SD) before they undergo statistical analysis. There is a high suspicion of fraud in a study's statistics:

        • If the M is mathematically impossible (online calculator): This is one of the easiest ways to mathematically detect fraud. The mean (M) is defined as "the sum (Sum) of the values of each observation divided by the total number (n) of observations". So: M = Sum/n. Thus: (Sum) = (M) multiplied by (n). We know that, if a variable is always measured as a positive whole number, the sum of these observations always has to be a whole number. For these variables to test for fraud: calculate (M) multiplied by (n). This calculates the Sum which MUST be a positive whole number. If the calculated Sum isn't a positive whole number; the reported mean (M) is mathematically impossible - thus the researcher either cooked the data or made a mistake. A recent study of 260 research papers published in highly reputable psychological journals found that 1 in 2 of these research papers reported at least one impossible value, and 1 in 5 of these research papers reported multiple impossible values. When the authors of the 21 worst offending research papers were asked for their raw data (so that its reliability could be checked) - 57% angrily refused. Yet such release of raw data to other researchers is required by most scientific journals. (Here is an example of a research paper filled with mathematically impossible means.)

        • If the SD is mathematically impossible (online calculator): When researchers fraudulently "cook" their data, they may accidently give their data a mean and standard deviation that is mathematically impossible.

        • If the SD/M is very small (i.e., the variable's standard deviation is very small compared to the mean suggesting data smoothing).

        • If the SD's are almost identical (i.e., the variables have different means but almost identical standard deviations).

        • If the 4th digit of the values of the variables aren't uniformly distributed - since each should occur 10% of the time (Benford's Law).

        • If the researcher is legally prevented from publishing negative findings about a drug or therapy because that would violate the "nondisclosure of trade secrets" clause in the research contract (i.e., it is a "trade secret" that the drug or therapy is ineffective - hence this can not be "disclosed"). Approximately half of all registered clinical trials fail to publish their results.

        • If the researcher refuses to release his raw data to fellow researchers (so that they can check its validity). In order to be published in most scientific journals, a researcher must promise to share his raw data with fellow researchers. Thus a researcher's refusal to do so is almost a sure indicator of fraud.

        • If the research study's data contradicts the study's own conclusions - surprisingly, this often occurs.

    • Calling Bullshit In The Age of Big Data - "Bullshit is language, statistical figures, data graphics, and other forms of presentation intended to persuade by impressing and overwhelming a reader or listener, with a blatant disregard for truth and logical coherence." Reading the syllabus of this university course should be required reading for every student of mental health. This syllabus is absolutely fantastic!

    • Statistical Methods in Psychology Journals: Guidelines and Explanations - American Psychologist 1999

    • Not All Scientific Studies Are Created Equal - video

    • The efficacy of psychological, educational, and behavioral treatment

    • Estimating the reproducibility of psychological science

    • Psychologists grapple with validity of research

    • Industry sponsorship and research outcome (Review) - Cochrane Library

    • 'We've been deceived': Many clinical trial results are never published - (text and video)

    • Junk science misleading doctors and researchers

    • Junk science under spotlight after controversial firm buys Canadian journals

    • Medicine with a side of mysticism: Top hospitals promote unproven therapies - Are some doctors becoming modern witchdoctors?

    • When Evidence Says No, But Doctors Say Yes


    • Cochrane Reviews (the best evidence-based, standardized reviews available)

    Research Topics

    Histrionic Personality Disorder - Latest Research (2016-2017)


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    Comment by Phillip Long MD (Psychiatrist and Editor):


    It's A Wonder We're Still Alive

    The Man Who Saved The World

    The world barely avoided being annihilated in 1983. On 26 September 1983, the nuclear early warning system of the Soviet Union erroneously reported an incoming attack against Russia by American intercontinental missiles. Russia has a "launch on warning" policy whereby it launches its missiles against America on the first warning of an incoming American missile attack.

    Fortunately this missile attack warning was correctly identified as a false alarm by Stanislav Petrov, lieutenant colonel of the Soviet Air Defence Forces. Petrov's decision to disregard the erroneous radar warnings is credited with having prevented a retaliatory nuclear attack on the United States and its NATO allies that could have resulted in large-scale nuclear war.

    Stanislav Petrov had the courage to disobey his military orders (to "launch on warning") because of his personal knowledge and convictions. He knew that launching a large-scale nuclear war would annihilate humanity, and he knew that the Russian early warning system could not be trusted.

    9 Times the World Was at the Brink of Nuclear War — and Pulled Back

    Due to human error, there have been nine times that the world was at the brink of nuclear war — but pulled back. Accidental false alerts which could trigger a nuclear war are not a rare occurrence. Given how incompetent our nuclear "launch on warning" system is - it is a miracle that we haven't already annihilated all life on earth.



    The 2 Men Who Could End The World

    America and Russia possess 93% of the world's nuclear weapons. Thus Valdimir Putin and President Trump are the only two people on earth who could single-handedly start a nuclear World War III and thus annihilate all life on our planet.

    The problem now is that the leaders of Russia and America have severe personality flaws that make them incapable of appreciating the enormity of harm that they may cause.

    Both Vladimir Putin and President Trump have Antisocial, Narcissistic, and Paranoid Personality Disorders.

    Why is the mental health of Vladimir Putin or President Trump important?

    The world's fate is now in the hands of two leaders who have the following severe personality flaws:

    Antisocial Personality Disorder

    Narcissistic Personality Disorder

    • Arrogance:
      Being boastful or excessively proud; offensive display of superiority or self-importance.

    • Manipulation:
      Exploiting, conning, or taking unfair advantage of others.

    • Callousness:
      Lack of guilt or remorse about causing others harm; indifference to the suffering of others.

    • Attention Seeking:
      Trying to be the center of attention; being overly dramatic or flamboyant.

    Paranoid Personality Disorder

    • Suspiciousness:
      Suspecting, without sufficient basis, that others are harming or deceiving him.

    • Bearing grudges:
      Blaming others; seeking revenge

    • Being Hot-Headed:
      Easily angered; quick to take offense; unable to take criticism, blame or rejection.


    Tony Schwartz wrote "The Art of the Deal" for Donald Trump, and spent 18 months in Donald Trump's office observing him in order to write this Donald Trump biography. In 2016, immediately before the presidential election, Tony Schwartz gave a scathing lecture entitled "The Truth About Trump" at Oxford University. Every American who voted for President Trump should watch this Oxford lecture video.

    Jan. 29, 2017: Alexandre Bissonnette, a white, 27-year-old, French-Canadian male far right extremist shot 25 Muslims in the back while they were at prayer in their mosque in Quebec City, Canada. Six were killed, 5 were hospitalized in critical condition, and the other wounded required only brief hospitalization. All of Canada mourned this barbaric act of senseless hatred against Muslims. Canadians are now asking how can the flood of far right anti-Muslim hatred coming into Canada from other countries be stopped? Take a good look at where the far right anti-Muslim hatred is taking us. [Racism can be untaught: How getting beat up taught a new Canadian not to be racist]

    P.S. In the past 2 years, Canada has accepted more than 40,000 Syrian refugees. Not one of these Syrian refugees has attempted a terrorist attack in Canada or America.

    A Counterargument To President Trump's Xenophobia:
    (Interview with Jack Ma, a Chinese businessman worth US$ 35 billion) "In the past 30 years, America has had 13 wars spending US$ 14.2 trillion. What if they spent a fraction of that money building up [America's] infrastructure, and helping white collar and blue collar workers? ... You are supposed to spend money on your own people. The money has gone to Wall Street. And what happened? In 2008, the financial crisis wiped out US$ 19.2 trillion in USA alone, and destroyed 34 million jobs globally. What if that money wasn't spent on Wall Street? What if that money was spent on middle America and the rest of the United States developing the industry there? So it's not the other countries stealing jobs from America, it is your strategy [over-spending on war and on Wall Street]. You did not distribute your money in the proper way."


    How The Rich Neglect The Poor

    Having Money Makes You Ruder And Less Empathetic

    Certain individuals have amassed great power and wealth. These fabulously rich individuals totally neglect the poor and the starving, and care only about accumulating more wealth, fame and power - even if it means oppressing half of humanity. They, and the corporations they control, do everything in their power to avoid paying their fair share of taxes. Although they may give millions to charity, many of their corporations avoid paying billions in taxes every year.





    The 62 Richest People Are As Wealthy As The Poorest Half Of The World

    The richest 1% now own a staggering portion of the world's wealth

    The top 0.1% of American households hold the same amount of wealth as the bottom 90%

    What the 1% Don't Want You to Know


    Which Behavioral Dimensions Are Involved?

    Research has shown that there are 5 major dimensions (the "Big 5 Factors") of personality disorders and other mental disorders. There are two free online personality tests that assess your personality in terms of the "Big 5 dimensions of personality". Although not computerized online, the Big Five Inventory (BFI) is a 44-item test often used in personality research.

    This website uses these 5 major dimensions of human behavior to describe all mental disorders. (This website adds one more dimension, "Physical Health", but our discussion will focus on the first 5 major dimensions.)

    These major dimensions of human behavior seem to represent the major dimensions whereby our early evolutionary ancestors chose their hunting companions or spouse. To maximize their chance for survival, our ancestors wanted companions who were agreeable, conscientious, intelligent, sociable, emotionally stable, and physically healthy.

    What Are The 5 Major Dimensions of Histrionic Personality Disorder?

    THE POSITIVE SIDE OF THE "BIG 5" PERSONALITY DIMENSIONS THE NEGATIVE SIDE OF THE "BIG 5" PERSONALITY DIMENSIONS THIS DISORDER
    Agreeableness Antagonism       Agreeableness
    Conscientiousness Disinhibition       Conscientiousness
    Intellect Decreased Intellect       Intellect
    Sociability (Extraversion) Detachment       Attention Seeking (Excessive Sociability)
    Emotional Stability Negative Emotion      Negative Emotion



    The 5 Major Dimensions of Mental Illness

    The Big 5 Factors or dimensions of mental illness each has a healthy side and an unhealthy side. Thus the Big 5 Factors are: (1) Agreeableness vs. Antagonism, (2) Conscientiousness vs. Disinhibition, (3) Intellect vs. Decreased Intellect, (4) Sociability (Extraversion) vs. Detachment (Introversion), and (5) Emotional Stability vs. Negative Emotion.

    The Following Will Only Discuss The Dimension of Mental Illness That Is Abnormal In This Disorder

    The problems that are diagnostic of this disorder are highlighted in   Pink  . Other problems that are often seen in this disorder are highlighted in   Yellow  .



    Treatment Goals for Attention Seeking In Histrionic Personality Disorder

    SOCIABILITY (EXTRAVERSION) vs. DETACHMENT
    .
    SOCIABILITY
    .
    Description: Sociability (Extraversion) is synonymous with being enthusiastic and assertive. Assertiveness encompasses traits relating to leadership, dominance, and drive. Enthusiasm encompasses both sociability and the tendency to experience and express positive emotion. Extraverts tend to engage in social interaction; they are enthusiastic, risk-taking, talkative and assertive. The Extraversion dimension measures the behaviors that are central to the concept of SOCIABILITY - seeking and enjoying companionship. High sociability is associated with better: longevity, leadership, job [sales] performance. (This dimension appears to measure the behaviors that differentiate approach from avoidance.)
    Descriptors: Sociable, gregarious, reward-seeking, talkative.
    Language Characteristics: Many topics, higher verbal output, think out loud, pleasure talk, agreement, compliment, positive emotion words, sympathetic, concerned about hearer (but not empathetic), simple constructions, few unfilled pauses, few negations, few tentative words, informal language, many swear words, exaggeration (e.g. "I'm really smart" ), many words related to humans (e.g. "man", "pal"). poor vocabulary.
    Research: Higher scores on Sociability (extraversion) are associated with greater happiness and broader social connections. *MRI research found that Sociability (extraversion) was associated with increased volume of medial orbitofrontal cortex, a region involved in processing reward information.
    "I'm talkative"
    "I'm not reserved."
    "I'm full of energy."
    "I generate a lot of enthusiasm."
    "I'm not quiet."
    "I have an assertive personality."
    "I'm not shy or inhibited."
    "I am outgoing and sociable."
    "I make friends easily."
    "I warm up quickly to others."
    "I show my feelings when I'm happy."
    "I have a lot of fun."
    "I laugh a lot."
    "I take charge."
    "I have a strong personality."
    "I know how to captivate people."
    "I see myself as a good leader."
    "I can talk others into doing things."
    "I am the first to act."
    .
    Attention Seeking (Excessive Emotionality)
    .
    "I like to draw attention to myself."
    "I crave attention."
    "I do things to make sure people notice me."
    "I do things so that people just have to admire me."
    "My behavior is often bold and grabs peoples' attention."
    .
    DETACHMENT
    .
    Description: Detachment is synonymous with being reserved and quiet.
    Descriptors: Withdrawn, anhedonic (pleasureless), intimacy avoiding, detached, shy, passive, solitary, moody
    Language Characteristics: Single topic, doesn't think out loud, problem talk, dissatisfaction, negative emotion words, not sympathetic, elaborated sentence constructions, many unfilled pauses, formal language, many negations, many tentative words (e.g. maybe, guess), few swear words, little exaggeration, few words related to humans, rich vocabulary.
    .
    * Social Withdrawal:
    "I don’t like to get too close to people."
    "I don't deal with people unless I have to."
    "I'm not interested in making friends."
    "I don’t like spending time with others."
    "I say as little as possible when dealing with people."
    "I keep to myself."
    "I am hard to get to know."
    "I reveal little about myself."
    "I do not have an assertive personality."
    "I lack the talent for influencing people."
    "I wait for others to lead the way."
    "I hold back my opinions."
    .
    * Intimacy Avoidance:
    "I steer clear of romantic relationships."
    "I prefer to keep romance out of my life."
    "I prefer being alone to having a close romantic partner."
    "I'm just not very interested in having sexual relationships."
    "II break off relationships if they start to get close."
    .
    * Loss of Interest or Pleasure:
    "I often feel like nothing I do really matters."
    "I almost never enjoy life."
    "Nothing seems to make me feel good."
    "Nothing seems to interest me very much."
    "I almost never feel happy about my day-to-day activities."
    "I rarely get enthusiastic about anything."
    "I don't get as much pleasure out of things as others seem to."
    .
    * Restricted Emotions:
    "I don't show emotions strongly."
    "I don't get emotional."
    "I never show emotions to others."
    "I don't have very long-lasting emotional reactions to things."
    "People tell me it's difficult to know what I'm feeling."
    "I am not a very enthusiastic person."
    .
    ("Sociability vs. Detachment" modified from "PID-5" by Kreuger RF, Derringer J, Markon KE, Watson D, Skodol AE and Between facets and domains: 10 aspects of the Big Five)
    *MRI Research: Testing predictions from personality neuroscience. Brain structure and the big five.



    The Blueprint For Virtue Is Built Into Your DNA

    More than 2,300 years ago, the ancient Greek philosopher, Aristotle (384–322 BC), said: "What is the essence of life? To serve others and to do good." Aristotle taught that "doing good" was synonymous with living a life of virtue. He believed these virtues were in keeping with the laws of nature.

    Aristotle and other ancient Greek philosophers believed that the main virtues were justice, self-control/moderation, wisdom, sociability, courage, and physical health.

    Psychological research now has shown that these virtues do predict success and good health. It can be argued that these virtues represent basic evolutionary principles that are evident at every level of our existence: physiological, psychological, and social.

    DNA, The Basis of Life

    First let's examine the chemical basis of life - the DNA molecule.



    • The DNA molecule is the foundation of all life on earth. DNA is a double helix molecule that is like a spiral ladder with rungs. Each rung on this ladder consists of 2 base pairs; altogether there are 4 bases used by DNA. These four bases are abbreviated A, T, C, and G. These 4 bases form the "4 letter chemical code" in DNA which stores all the chemical information necessary for life.

    • The DNA molecule's spiral ladder has millions of rungs (base pairs). Part of DNA's chemical code is read by messenger RNA (which takes it out of the cell nucleus to the nearby ribosomes who use this code to create proteins). All the DNA chemical code in our 46 chromosomes is estimated to be about 3.2 billion base pairs long.

    • Proteins are built as chains of amino acids, which then fold into unique three-dimensional shapes that have different functions. Proteins compose structural and motor elements in the cell, and they serve as the catalysts for virtually every biochemical reaction that occurs in living things.

    DNA Replication



    • The mutual attraction between opposite bases (G-C and A-T) allows for DNA replication, since the DNA molecule can divide lengthwise into two halves. Then each half can attract the necessary opposite bases to create a complementary new strand of DNA.

    • This chemical replication only works because of the mutual attraction between opposite base pairs.

    Virtues Manifested at The Physiological, Psychological, and Social Levels

    • Justice:

    • In terms of survival, it is better that members of a species cooperate. With one's own species, cooperation requires that an individual neither harms nor allows harm (which is the definition of justice). Justice requires mutually beneficial interaction in which no party gains an unfair advantage. It ensures service to the common good - not just good for the privileged few. [Golden Rule: "The commandments, 'You shall not commit adultery,' 'You shall not murder,' 'You shall not steal,' 'You shall not covet,' and whatever other command there may be, are summed up in this one command: 'Love your neighbor as yourself.' Love does no harm to a neighbor. Therefore love is the fulfillment of the law." (Romans 13: 9-10) "Do to others what you would want them to do to you." (Luke 6:31)].

      • Physiological Level:

        [Evolutionary Principle] The Most Adaptable Survive

        Evolution isn't survival of the fittest; it is survival of the most adaptable.


        In evolution, it is not the strongest or smartest organism that survives - it is the organism that can best adapt to its changing environment.

        [Evolutionary Principle] Live In Harmony

        An organism must be able to flourish in harmony with its environment.


        For example, all the cells in a healthy body grow in harmony. Cancer represents the harmful breakdown in these harmonious cellular relationships. Cancer results from mutated DNA that is self-destructive because it causes uncontrollable growth which kills the organism and itself.

        [Evolutionary Principle] No Species Escapes Extinction

        Nothing lives forever; nearly all species that ever lived are now extinct. They did not survive the sudden climate changes that caused mass extinctions of nearly all life on earth. Fortunately, a few species did survive the last mass extinction.


        There have been five mass extinction events in Earth's history. In the worst one, 250 million years ago, 96 percent of marine species and 70 percent of land species died off. Humans almost went extinct 60,000 years ago when only approximately 1,000 humans survived a global drought. Nowadays, many scientists are predicting that we're on track for a sixth mass extinction due to human destruction of the environment. This human-caused mass extinction of life on earth is the greatest injustice that humanity has ever created.

      • Psychological Level:

        Justice means neither harming nor allowing harm.

        Injustice is more than just being deceitful (e.g., lying, stealing, cheating). Justice requires that we neither harm nor allow harm to others and our environment. Justice is the public manifestation of love.

      • Social Level:

        Social injustice occurs when one group unfairly harms another. Social justice requires that we treat others the way we want them to treat us.

        Evolution doesn't care if we are beautiful, strong, intelligent, or happy. Evolution only cares if we can flourish by living in harmony with others and our environment.

        Injustice occurs when groups or nations harmfully violate the rights of others. Once there is a breakdown in the rule of law, it is just a matter of time until the group or nation degenerates into corruption and a violent struggle for power.

        Humanity's survival now depends upon whether love, brotherhood, and peace can overcome hate, nationalism, and war.

    • Self-Control:

    • To survive, all organisms have homeostatic mechanisms that strive to balance their functioning at an optimal level between excess and deficiency. Some organisms have strong homeostatic mechanisms; hence their functioning is highly regulated and orderly. Other organisms have weak homeostatic mechanisms; hence their functioning is weakly regulated and disorderly or chaotic. [Golden Mean: The Greek poet Hesiod (c.700 bc) said that "moderation is best in all things'. Ancient Greek philosophers taught that self-control or moderation is about finding the Golden Mean or balance between two extremes, excess and deficiency.]

      • Physiological Level:

        [Evolutionary Principle] Maintain Stability By Self-Regulation (Homeostasis)

        Life involves constant change, and all organisms evolve ways to moderate these changes to maintain their stability (i.e., homeostasis). The goal of this homeostasis is to maintain optimal conditions for life (i.e., to avoid deficiency or excess).


        For example, DNA is self-controlling; it moderates its functioning by turning itself on or off depending upon its environment. Thus, by moderating its own functioning, DNA can better survive environmental change. However, there is a limit to how much change organisms can withstand (e.g., a fish out of water).

        [Evolutionary Principle] Certain Vices Shorten Life

        Certain excesses (smoking, obesity, and alcohol) damage DNA; hence must be seen as vices.


        "A major cause of aging is 'oxidative stress.' It is the damage to DNA, proteins, and lipids (fats) caused by oxidants, which are highly reactive substances containing oxygen. These oxidants are produced normally when we breathe, and also result from inflammation, infection, and consumption of alcohol and cigarettes. In one study, scientists exposed worms to two substances that neutralize oxidants, and the worms' lifespan increased an average 44%.

        Another factor in aging is 'glycation.' It happens when glucose, the main sugar we use as energy, binds to some of our DNA, proteins, and lipids, leaving them unable to do their jobs. The problem becomes worse as we get older, causing body tissues to malfunction, resulting in disease and death. Glycation may explain why studies in laboratory animals indicate that restricting calorie intake extends lifespan." [reference]

      • Psychological Level:

        Self-control and moderation in all things (i.e., good behavioral homeostasis) is the core feature of conscientiousness.

        Conscientious individuals have good homeostatic control of their behavior - it is neither excessively inhibited nor disinhibited. They are careful, responsible, hard-working, cautious, focused, and organized. In contrast, individuals lacking conscientiousness are careless, irresponsible, impulsive, easily distracted, and disorganized.

      • Social Level:

        Vices (behavioral excesses or deficiencies) must be controlled or they will destroy a group or nation.

        When a group or nation is overcome by its excesses (e.g. alcoholism, drug abuse, or corruption) or deficiencies (e.g. injustice or massive poverty); it withers and dies.

    • Wisdom:

    • Learning requires attention, reasoning, and memory. Of the 21 different hominids that have existed; 20 are now extinct. Only our species, homo sapiens, has survived. It appears evolution has favored our species, compared to the extinct hominids, because of our superior adaptability and ability to learn. [Our Attention May Blind Us: The biggest problem with learning is that our selective attention may blind us to much of what we see. We create our own reality - seeing only what we are interested in seeing. Thus we are blinded by our desires and biases.].

      • Physiological Level:

        [Evolutionary Principle] Experiment To Improve Adaptation

        Evolution creates better adapted organisms by using mutation and natural selection.


        The sugar-phosphate backbone of DNA preserves the specific order of the rungs on the DNA ladder. Chance mutation causes deletion (or multiplication) of these rungs. Sometimes the rung of one DNA molecule breaks off and attaches itself to another DNA molecule. Natural selection then determines if the mutated DNA survives better than the original DNA. If so, this mutated DNA creates a more adaptable organism. Without this constant experimentation and evaluation (mutation and natural selection), evolution would stop.

        [Evolutionary Principle] Replicate Experiments

        Evolution uses the scientific experimental method to discover the truth.


        Evolution is constantly experimenting - comparing the adaptive success of new DNA mutations against the success of their original DNA. As in science, evolution requires that the findings of its experiments be repeatedly replicated. This requirement for repeated replication of success eliminates unstable mutant DNA which can't successfully replicate its initial adaptive success.

        [Evolutionary Principle] Share Information

        Organisms survive because they genetically share adaptive information from one generation to the next.


        For example, all the information needed to create an elephant is coded in its 56 chromosomes. This also includes all the elephant's instinctual behaviors. That's an incredible amount of adaptive information passed by DNA from one generation to the next.

        [Evolutionary Principle] Have Contingency Plans

        In evolution, most of the information stored in DNA is contingency plans.


        Only a tiny amount of the information stored in DNA's base pairs tells how to make proteins. Far more of the information stored in DNA determines when and where these proteins are to be produced. Thus, DNA stores more information on contingency plans for "when" and "where" to do a task (e.g., produce protein) than it stores information on "how" to do it.

        [Evolutionary Principle] Use A Standardized Language To Share Information

        Every living cell stores all of the adaptive information that evolution has taught it by using the same "4 letter chemical code" (4 base pairs repeated billions of times) in its DNA.


        Without using this universal, standardized language to store information, evolution could not pass on adaptive information within the body or between generations.

        [Evolutionary Principle] Chance Directs Evolution

        Evolution is not guided by any plan; the direction it takes is determined solely by chance events.


        In evolution, there is no evidence of a grand plan, and that everything happened for a reason according to this universal plan. Instead, each organism's evolution was solely determined by random DNA mutation and natural selection.

        For example, our hominid lineage diverged from the ape lineage 7 to 8 million years ago. There were 21 hominid species - and 20 became extinct. Thus evolution tried 21 different experiments in creating hominids, and all proved to be evolutionary dead-ends - except our species, Homo sapiens. Our species has existed for about 100,000 years, and now we could be on the verge of extinction due to nuclear war or climate change.


      • [Evolutionary Principle] Expect Unexpected Consequences

        Making a small change in a complex system will often cause major unintended consequences.


        For example, when nature causes a DNA mutation or humans engineer a genetic modification, the unintended consequence can be: (1) a positive unexpected benefit (e.g. a recent spontaneous mutation in crayfish has produced a "super crayfish" that clones itself), or (2) a negative unexpected detriment (e.g. Monsanto genetically engineered its plants to make them resistant to the most used herbicide, Roundup [glyphosate], in order to help their plants survive during weed spraying. Monsanto's plants did become resistant to this herbicide, but this promoted the development of the same resistance in several weed species and insects. Now millions of acres of U.S. farmland have been destroyed by these pesticide resistent "superweeds" and insects.)

        [Evolutionary Principle] Nature Constantly Changes

        Everything in nature cycles and eventually dies.


        DNA has a built-in time bomb (shortening of its telomeres with each reproduction) that causes it to age. Old DNA doesn't divide: thus all organisms eventually die.

        Cancer occurs when DNA fails to age and keeps dividing until the resulting unchecked cell growth destroys the organism. Thus, nature prevents continuous growth; hence "no tree grows to heaven". Similarly, the competing forces in nature ensure that nothing remains the same - everything cycles.


      • Psychological Level:

        Humans are rational animals that evolution has given the ability to reason and learn. Wise, open-minded individuals that ask "why?" consistently outperform close-minded individuals that never question "why?". The hallmark of open-minded individuals is their curiosity and willingness to logically experiment and make mistakes in order to learn.

        Throughout human history, open-minded, inventive, quick learning individuals prospered better than close-minded, uncreative, and slow learning individuals. Open-minded individuals are more likely to gather relevant information and create contingency plans before they act.

        Wise individuals that keep a record of their progress (in diaries, business records, etc.) outperform those individuals that don't keep such records.

        Such records allow individuals to look back over the years to analyze their successes and failures. Otherwise, without these backup records, individuals must rely on their notoriously faulty memories. The most efficient record keeping involves using: (1) standardized language to avoid confusion, and (2) mathematically quantified data.

      • Social Level:

        War is the greatest threat to civilization and the accumulation of knowledge. Those that start wars never foresee war's unexpected consequences.

        History's Dark Ages occur when wars cause a collapse of civilization. The worst Dark Age occurred at the end of the Bronze Age around 1200 BC. For 40-50 years, war destroyed all the ancient Mediterranean civilizations (except Egypt's, which came close to collapsing). Almost every significant city in the eastern Mediterranean world was destroyed. These cultures (except Egypt) lost their literacy, political organization, and ability to build cities or conduct international trade. Their people barely survived and were forced to return to simple, small village life.

    • Sociability:

    • In a social species, social networking is vital for survival since it permits cooperation and sharing of information. Single celled organisms banded together to form multicellular organisms because of the additional survival benefits that such multicellular cooperation bestowed upon them.

      • Physiological Level:

        [Evolutionary Principle] Combine Forces

        Sharing of genetic diversity speeds up evolution.


        The genetic sharing of DNA during sexual reproduction increases genetic diversity, which speeds up evolution. Even single-celled organisms, like bacteria, survive better in diverse communal groups (where they can exchange their DNA), rather than surviving as solitary organisms.

      • Psychological Level:

        Sociability increases one's chances for survival.

        Individual humans are too weak to survive solo; human survival requires that individuals cooperate for mutual benefit. Socially outgoing individuals, compared to solitary individuals, are more likely to acquire adaptive information from others in a social group. Also socially outgoing individuals belong to more social networks; hence are more likely to receive social support in times of need.

      • Social Level:

        Like all social species, humans form dominance hierarchies ("pecking orders").

        Humans survive better living in social groups. These groups permit specialization of labor which dramatically increases the group's productivity - hence its chances for survival.

        All social species, including humans, organize their social groups in terms of dominance hierarchies ("pecking orders"). Such dominance hierarchies unequally distribute power and wealth within the group. For humans, a child on the bottom of our dominance hierarchy is often chronically hungry, unsafe, or neglected.

        Nature establishes social dominance hierarchies as a cruel survival strategy which maximizes the adaptive advantages for those at the top of the dominance hierarchy at the expense of those at the bottom. This is often a matter of life and death because, when the social group is stressed by famine or disease, it is those at the bottom of a social dominance hierarchy who are most likely to starve or die.

        Social groups and nations that freely share adaptive information are the most likely to succeed.

        Nations that freely share information democratically support freedom of speech and of the press, universal education, social equality, social mobility, and social mixing of their members. This social sharing and mixing strengthens the social cohesiveness of these groups and improves their quality of life.

    • Courage:

    • An organism's primary objective is to stay alive; hence it must be able to differentiate safety from danger. Courage, like everything else, must be exercised in moderation. Too little courage results in cowardice, and too much courage results in foolish recklessness. [Fight-Flight-Freeze-Fantasize: There are three main coping strategies that all animals use: (1) "Fight" or angry attack, (2) "Flight" or fearful retreat, and (3) "Freeze" or depressive immobilization. Humans uniquely have a fourth main coping strategy, "Fantasize", in which they respond to stress by creating comforting delusions or false beliefs which are strongly held against all evidence to the contrary.]

      • Physiological Level:

        [Evolutionary Principle] Remain Stable

        The DNA molecule is extremely stable.


        During evolution, natural disasters have caused repeated near-total mass extinctions of all life on earth; yet life has always recovered. Now DNA life forms have spread to virtually every corner of our planet, and humans have spread to every continent.

      • Psychological Level:

        Courage involves remaining calm and emotionally stable in the face of adversity.

        Courage doesn't mean rushing headlong into danger. The courageous person will assess the situation, and take the appropriate "fight/flight/freeze/fantasize" response that best solves the problem. There is no one response that is always right. Individuals must remain calm and emotionally stable while facing adversity - otherwise strong emotion can severely impair their problem-solving ability.

      • Social Level:

        Leaders must instill courage in their followers in order to maintain morale.

        Once a group loses its courage, and its morale is broken, it quickly becomes dysfunctional.

    • Physical Health:

    • In order to stay alive; an organism must maintain its physical health.

      • Physiological Level:

        [Evolutionary Principle] Evolution's Only Goal Is Survival

        Evolution selects for traits that help organisms survive, but doesn’t necessarily find optimal solutions.


        The goal of evolution is to create living organisms - even if they aren't perfect. Thus, evolution has produced many types of organisms - some are in a gray area between living and nonliving (e.g., viruses), the majority are single-celled (e.g., bacteria), and a few are multicellular (e.g., most animals and plants). It is an error to believe that the sole purpose of evolution is to create more complex or intelligent organisms. In terms of global biomass, single-celled organisms far outweigh multicellular organisms. So, in that sense, evolution has favored single-celled, unintelligent organisms.

        [Evolutionary Principle] Avoid Extremes

        Nature hates extremes and rewards moderation.


        The optimal conditions for DNA survival are usually the midpoint between deficiency and excess. For example, DNA thrives at the temperature of liquid water, but is destroyed when water freezes or boils. Organisms flourish when they maintain their functioning in the midpoint between deficiency and excess. Nature punishes those organisms that slip into conditions of deficiency or excess.

      • Psychological Level:

        Our physical vices are leading causes of disability and death.

        Usually virtue is physically helpful; whereas vice is physically harmful. The modern vices of cigarette smoking, alcohol and drug abuse, sedentary lifestyle, obesity, and unsafe sex are leading causes of physical disability and death. Chronic users of cigarettes lose 13% of their expected lifespan, chronic users of alcohol lose 29%, chronic users of cocaine lose 44%, chronic users of methadone lose 49%, chronic users of heroin lose 52%, and chronic users of methamphetamine lose 53% of their expected lifespan.

      • Social Level:

        Leading global risks:

        The leading global risks for mortality in the world are high blood pressure (responsible for 13% of deaths globally), tobacco use (9%), high blood glucose (6%), physical inactivity (6%), and overweight and obesity (5%).

        The leading global risks for burden of disease as measured in disability-adjusted life years (DALYs) are underweight (6% of global DALYs) and unsafe sex (5%), followed by alcohol use (5%) and unsafe water, sanitation, and hygiene (4%).

        Globally, it appears that "modernization" increases addiction, sedentary lifestyle, obesity, unsafe sex, environmental destruction, and disastrous climate change. Thus, our modern civilization may severely impair our future evolution, or lead to our own extinction. [The Second Law of Thermodynamics: In physics, this law states that, in order to create order in one part of a system, more disorder (entropy) is automatically created in another part of the system. This law would predict that, in order to create and maintain our civilization, we will automatically create greater disorder and chaos in our environment. This is a chilling prediction given what is currently happening with climate change.]


    The "Big 5 Factors" of Personality as Shown In Dogs

    The same "Big 5 Factors" of personality found in humans can be found in dogs. This makes sense because dogs, like humans, are a social species.



    AGREEABLENESS VS. ANTAGONISM
    .
    Agreeableness ("Friend")
    .
    Dog is friendly towards unfamiliar people.
    Dog is friendly towards other dogs.
    When off leash, dog comes immediately when called.
    Dog willingly shares toys with other dogs.
    Dog leaves food or objects alone when told to do so.
    .
    Antagonism ("Foe")
    .
    Dog is dominant over other dogs.
    Dog is assertive with other dogs (e.g., if in a home with other dogs, when greeting).
    Dog behaves aggressively towards unfamiliar people.
    Dog shows aggression when nervous or fearful.
    Dog aggressively guards coveted items (e.g., stolen item, treats, food bowl).
    Dog is quick to sneak out through open doors, gates.

    CONSCIENTIOUSNESS VS. DISINHIBITION
    .
    Conscientiousness ("Self-Controlled")
    .
    Dog works at tasks (e.g., getting treats out of a dispenser, shredding toys) until entirely finished.
    Dog works hard all day herding or pulling a sleigh (if a "working dog" on the farm or in the snow). *
    Dog is curious.
    .
    Disinhibition ("Disinhibited")
    .
    Dog is boisterous.
    Dog seeks constant activity.
    Dog is very excitable around other dogs.

    INTELLECT VS. DECREASED INTELLECT
    .
    Open To Experience ("Open-Minded")
    .
    Dog is able to focus on a task in a distracting situation (e.g., loud or busy places, around other dogs).
    .
    Closed To Experience ("Closed-Minded")
    .
    Dog is slow to respond to corrections.
    Dog ignores commands.
    Dog is slow to learn new tricks or tasks.

    SOCIABILITY (EXTRAVERSION) VS. DETACHMENT
    .
    Sociability ("Approach")
    .
    Dog is attention seeking (e.g., nuzzling, pawing or jumping up on family members looking for attention and physical contact).*
    Dog seeks companionship from people.
    Dog is affectionate.
    .
    Detachment ("Avoidance")
    .
    Dog is aloof.
    Dog gets bored in play quickly.
    Dog is lethargic.

    EMOTIONAL STABILITY VS. NEGATIVE EMOTION
    .
    Emotional Stability ("Safety")
    .
    Dog tends to be calm.
    Dog is relaxed when greeting people.
    Dog is confident.
    Dog adapts easily to new situations and environments.
    .
    Negative Emotion ("Danger")
    .
    Dog is anxious.
    Dog is shy.
    Dog behaves fearfully towards unfamiliar people.
    Dog exhibits fearful behaviors when restrained.
    Dog avoids other dogs.
    Dog behaves fearfully towards other dogs.
    Dog behaves submissively (e.g., rolls over, avoids eye contact, licks lips) when greeting other dogs.
    .
    Modified from Jones, A. C. (2009). Development and validation of a dog personality questionnaire. Ph.D. Thesis. University of Texas, Austin.

    * New items added by Phillip W. Long MD


    Personality Difference Between Dogs and Humans

    Dogs and humans are strikingly similar on 4 of the "Big 5 Factors" of personality. However, dogs and humans are quite different on the "Conscientiousness" factor - because the canine brain is designed for hunting, not building. That's why dogs don't build dog houses.

    The Brain and the "Big-5 Factors" of Personality In A Social Species

    The "Big-5 Factors" of personality represent basic brain functions in social species. For example, when a male approaches a female, the female must: (1) decide whether the male is friend or foe ["Agreeableness"], (2) decide if this represents safety or danger ["Emotional Stability"], (3) decide whether to approach or avoid him ["Sociability"], (4) decide whether to be self-controlled or disinhibited ["Conscientiousness"], and (5) learn from this experience ["Openness to Experience"].

    The "Big-5 Factors" of Human and Cat Personality

    Cats are a social species, but less social than dogs. Nevertheless, cats also show the "Big 5 Factors" of personality.




    The "Big 5" Dimensions of Personality and Personality Disorders

    The following diagram shows the relationship between the "Big 5" dimensions of personality and personality disorders. This diagram is based on the research of Sam Gosling, Jason Rentfrow, and Bill Swann, Gerard Saucier, Colin G. DeYoung, and Douglas Samuel and Thomas Widiger.


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    Histrionic Personality Disorder Scores High On Extraversion

    In personality testing, individuals with Histrionic Personality Disorder often have a High Extraversion test score.


    HIGH EXTRAVERSION NORMAL EXTRAVERSION LOW EXTRAVERSION (DETACHMENT)
    Inappropriately Seductive Intimacy Intimacy Avoidance
    Inappropriately seductive or provocative sexual behavior Wanting close, intimate relationships Avoidance of close relationships and intimate sexual relationships
    Attention Seeking Friendliness Social Withdrawal
    Trying to be the center of attention; being overly dramatic or flamboyant Friendly; interested in social contacts and activities; tendency to approach people Reserved, distant, preference for being alone; tendency to avoid people
    Theatrical Self-Dramatization Demonstrativeness Lack of Emotion
    Drama Queen; theatrically blows everything out of proportion Expressing one's feelings easily, openly or unreservedly (especially love or affection) Being unemotional, even in normally emotionally arousing situations
    Internet Mental Health: Extraversion Scale

    Avoidant Personality Disorder Scores Low On Extraversion

    The personality dimension of extraversion appears to measure how sociable and enthusiastic individuals are (e.g., Histrionic Personality Disorder) vs. how quiet and seclusive they are (e.g., Avoidant Personality Disorder).

    Primate Evolution

    There appears to be three different ways in which primates have evolved socially:

    • The chimpanzees have evolved to be socially antagonistic, competitive, callous, and manipulative. Chimpanzees are the only primates (apart from humans) that wage organized war. Thus chimpanzee social behavior most closely mirrors the antagonistic behavior of the antisocial-narcissistic-borderline-histrionic cluster of personality disorders.

    • In contrast, the bonobos have evolved to be socially anxious, peaceful, cooperative, and loving. Thus bonobo social behavior most closely mirrors the negative emotion (anxious) behavior of the avoidant-dependent cluster of personality disorders.

    • Another separate evolutionary path was followed by the orangutans. They evolved to become solitary hermits. Thus orangutan social behavior most closely mirrors the detached behavior of the paranoid-schizoid-schizotypal cluster of personality disorders.


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