Because of their underlying feelings of dependency, histrionics are likely to experience separation anxieties or, as an expression of their fears of emptiness, agoraphobia (check Anxiety). Conversion symptoms or hypochondriasis might also be a means of dramatically expressing their needs (check Somatoform), and their need for stimulus seeking may result in substance abuse (check Alcohol Dependence and Drug Dependence). Possible associated elevations on personality scales include Dependent (see section on Dependent), Narcissistic, Passive-Aggressive (Negativistic), Antisocial, and Compulsive. Elevations on Somatoform might indicate conversions. An associated Narcissistic elevation, along with Histrionic, frequently occurs with and is quite consistent with Histrionic in that it exaggerates many of the self-centered qualities of the histrionics. They are also likely to emphasize how charming and capable they are and to belittle those who do not partake in reinforcing their own sense of selfimportance. Their descriptions of their competence and exploits are often exaggerated. They continually indicate how they are special and worthy of more attention and praise than others. An associated elevation on Passive-Aggressive (Negativistic) is problematic in that the histrionics do not like to accept their own negative emotions, such as anger and resentment. As a result of this conflict, they are moody, unpredictable, and emotionally reactive. They might overtly criticize or show disdain for others or, in contrast, express these feelings in a more indirect way, such as through obstructionism. Their attempts to repress and overcontrol their anger and resentment may sometimes culminate in explosive outbursts, followed by guilt and apologies. Similarly, an elevation on Antisocial creates conflict for these persons. They are highly dependent on others, but they also realize that their anger, disaffiliation, and resentment are likely to distance the very people whom they so much need. They might begin a relationship by being charming, friendly, and engaging, but eventually their antisocial feelings become expressed in resentment, mistrust, and even anger. In extreme cases, they might fluctuate between overcontrol and occasional extreme emotional or even physical outbursts. They may also seek to cope with this conflict through passive-aggressive strategies. Their world is perceived as a competitive, potentially dangerous place, and, given these perceptions, they have similarly become competitive, tough realists who believe that this is the only means of coping. Elevations on Compulsive, along with Histrionic, also present a conflicted relationship because part of the person wants to be unrestrained and emotional whereas another part believes in the importance of emotional overcontrol. These clients are likely to seek approval through being orderly, efficient, dependable, and by dressing correctly. Often, they have difficulty integrating these two modes of adapting and may become tense and moody.