Both involve a need for attention and admiration, but narcissistic PD centers on grandiosity and a fragile, inflated self-image, while histrionic PD centers more broadly on emotionality and discomfort when not the center of attention.
Both are personality disorders with a pervasive, longstanding pattern traceable to early adulthood.
Both are stable, enduring patterns.
Histrionic PD features rapidly shifting, shallow emotion and impressionistic speech; narcissistic PD features a grandiose sense of self-importance, need for excessive admiration, and lack of empathy.
Both strain relationships, though for different reasons -- perceived superficiality and intensity in histrionic PD, versus entitlement and lack of empathy in narcissistic PD.
If attention-seeking is not accompanied by grandiosity or a fragile, inflated self-image, histrionic PD is favored; if grandiosity and need for admiration tied to self-image are central, narcissistic PD is favored.
Assessing whether the core driver is a general need to be noticed and emotionally expressive (histrionic) versus a specific need for admiration tied to a grandiose self-concept (narcissistic) is central.
Both can appear self-centered from the outside, making the distinct underlying psychological driver easy to conflate without careful assessment.
A person who dramatically recounts emotional stories and feels uncomfortable when attention shifts elsewhere fits histrionic PD; a person who expects special treatment, lacks empathy, and reacts to criticism with disproportionate anger fits narcissistic PD.
| Feature | Histrionic Personality Disorder | Narcissistic Personality Disorder |
|---|---|---|
| Core driver | Discomfort when not the center of attention | Grandiosity and need for admiration tied to self-image |
| Empathy | Generally present, though self-focused in expression | Characteristically reduced |
| Emotional style | Rapidly shifting, dramatic, shallow | Entitled, reactive to criticism |
A pervasive pattern of excessive emotionality and attention-seeking, including discomfort when not the center of attention, rapidly shifting and shallow emotional expression, and a tendency to view relationships as more intimate than they actually are.
A pervasive pattern of grandiosity, need for admiration, and lack of empathy, present since early adulthood across a variety of contexts.