The main problem with the 'histronic behaviour' hypothesis, like the alternatives, is that it is unitary and simplistic, while the phenomena are complex and heterogeneous. When advanced as a sole and complete explanation, ''hysteria' is a vague and inadequate construct. ... "secondary gain and hysteria can occur as reactions to real events, real sociological problems, and real biomedical diseases, so the presence of these elements does not necessarily weigh in favour of Satanic ritual abuse's being entirely unreal. Ritual abuse cases need to be managed in such a way that hysteria, regression, grandiosity, and secondary gain are discouraged rather than fostered. However, it must be remembered that 'hysteria' and 'attention seeking' explanations generally function as justifications for not thinking about the complexities of the clinical problem.

Colin A. Ross