Sexual sadism disorder

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Sexual sadism disorder
Other namesSexual sadism, sadistic sex, non-consensual sadomasochism
Specialty Psychology   OOjs UI icon edit-ltr-progressive.svg
Complications Sexual torture, rape
Differential diagnosis Rape, sexual coercion, sexual grooming, paraphilia, prostitution, sadomasochism, conduct disorder, torture, sexual bullying, sexual abuse, genital mutilation, pornography, child pornography, sexual addiction, pornography addiction

Sexual sadism disorder is the condition of experiencing great sexual arousal in response to the involuntary extreme pain, suffering or humiliation of other people. [1] Several other terms have been used to describe the condition, and it may overlap with other conditions that involve inflicting pain. It is distinct from situations in which consenting individuals use mild or simulated pain or humiliation for sexual excitement. [2] The words sadism and sadist are derived from the French writer and libertine Marquis de Sade, who wrote several novels depicting sexualized torture and violence.

Contents

Current terminology

Sexual sadism disorder is the term employed by the current version of the Diagnostic and Statistical Manual (DSM-5) of the American Psychiatric Association. [1] It refers to the "recurrent and intense sexual arousal from the physical or psychological suffering of another person, as manifested by fantasies, urges, or behaviors" (p. 696). It is classified as one of the paraphilias, called an "algolagnic disorder" (p. 685), which is one of the "anomalous activity preferences" (p. 685). The formal diagnosis of Sexual Sadism Disorder would apply if the individual has acted on these urges with a non-consenting person or if the urges cause significant distress to the individual.

Sadomasochism appears in the current version of the International Classification of Diseases (ICD-10) of the World Health Organization. [3] It refers to the "preference for sexual activity that involves bondage or the infliction of pain or humiliation" (p. 172), and divides sadomasochism into sadism and masochism according to whether the individual prefers to be the provider or recipient of it. The ICD-10 specifies that mild forms of sadomasochism "are commonly used to enhance otherwise normal sexual activity" (p. 172), and that the diagnosis would apply only if the behavior is preferred or required for sexual gratification. The condition is classified as one of the disorders of sexual preference, which includes the paraphilias (p. 170).

Paraphilic coercive disorder refers to the preference for non-consenting over consenting sexual partners. [4] It differs from sexual sadism disorder in that although the individual with this disorder may inflict pain or threats of pain in order to gain the compliance of the victim, the infliction of pain is not the individual's actual goal. The condition is typically described as a paraphilia and continues to undergo research, but does not appear in the current DSM or ICD. Alternate terms for the condition have included Biastophilia, [5] Coercive Paraphilic Disorder, [6] and Preferential Rape. [7]

BDSM or "bondage/discipline dominance/submission sadomasochism" is a colloquial term referring to the subculture of individuals who willingly engage in consenting forms of mild or simulated pain or humiliation. [8] It is not currently a diagnosable condition in either the DSM or ICD system. Alternative terms have included Bondage and Discipline (B&D),Domination and Submission (D&S), and Sadism and Masochism (S&M). In scientific research, this sexual preference has also been called the hyperdominance pattern of sexual behavior. [9] Unlike individuals with sexual sadism disorder or paraphilic coercive disorder, individuals with hyperdominance seek to provoke pleasure in their partner(s) with the pain/humiliation. [5]

Previous terminology

Sexual sadism is the term previously employed by the DSM-III-R, [10] DSM-IV, [11] and DSM-IV-TR, [12] where it was classified as a paraphilia. In these versions of the DSM, sexual sadism pertained only to the infliction of real (not simulated) suffering (p. 530). The condition was renamed sexual sadism disorder in DSM-5.

Sexual sadism was the term employed in the DSM-III, [13] classifying the condition as a paraphilia. The DSM-III noted that "the imagery in a Paraphilia, such as simulated bondage, may be playful and harmless and acted out with a mutually consenting partner….In more extreme form, paraphilic imagery is acted out with a nonconsenting partner, and is noxious and injurious to the partner" (p. 267). In DSM-III, sexual sadism could be diagnosed if:

  1. the person repeatedly and intentionally inflicted suffering on a nonconsenting person, to experience sexual excitement
  2. repeatedly or exclusively preferred simulated or mild suffering with a consenting sexual partner
  3. employs extensive, permanent, or potentially fatal suffering to achieve sexual excitement, regardless of the consent of the other person.

Sadism was the term employed by the DSM-II. [14] In that manual, the condition was classified as a sexual deviation, which was used to describe "individuals whose sexual interests are directed primarily toward…coitus performed under bizarre circumstances" (p. 44). The term "paraphilia" did not exist in the DSM-II, and diagnoses did not have specific criteria until DSM-III.

Sexual sadism was the phrase mentioned in DSM-I as one of the sexual deviations [15] (p. 39), but neither it (nor any of the other sexual deviations) received a specific label or diagnostic criteria. The term paraphilia did not exist in the DSM-II, and diagnoses did not have specific criteria until DSM-III.

Sadistic personality disorder does not actually refer to any sexual interest, and instead refers to the pervasive disregard for the well-being of other people. It is usually associated with a history of violence and criminality (which can include, but is not limited to sexual crimes).[ citation needed ]

Features

With paraphilic coercive disorder, the individual employs enough force to subdue a victim, but with sexual sadism disorder, the individual often continues to inflict harm regardless of the compliance of the victim, which sometimes escalates not only to the death of the victim, [16] but also to the mutilation of the body. What is experienced by the sadist as sexual does not always appear obviously sexual to non-sadists: sadistic rapes do not necessarily include penile penetration of the victim. In a survey of offenses, 77% of cases included sexual bondage, 73% included anal rape, 60% included blunt force trauma, 57% included vaginal rape, and 40% included penetration of the victim by a foreign object. [16] In 40% of cases, the offender kept a personal item of the victim as a souvenir. [16]

On personality testing, sadistic rapists apprehended by law enforcement have shown elevated traits of impulsivity, hypersexuality, callousness, and psychopathy. [17]

Although there appears to be a continuum of severity from mild (hyperdominance or BDSM) to moderate (paraphilic coercive disorder) to severe (sexual sadism disorder), it is not clear if they are genuinely related or only appear related superficially. [5]

Very little is known about how sexual sadism disorder develops. [1] Most of the people diagnosed with sexual sadism disorder come to the attention of authorities by committing sexually motivated crimes. [18] Surveys have also been conducted to include people who are interested in only mild and consensual forms of sexual pain/humiliation (BDSM). [18]

Most people with full-blown sexual sadism disorder are male, whereas the sex ratio of people interested in BDSM is closer to 2:1 male-to-female. [19] [20] [21]

People with sexual sadism disorder are at an elevated likelihood of having other paraphilic sexual interests. [1]

See also

Related Research Articles

<span class="mw-page-title-main">BDSM</span> Erotic practices involving domination and sadomasochism

BDSM is a variety of often erotic practices or roleplaying involving bondage, discipline, dominance and submission, sadomasochism, and other related interpersonal dynamics. Given the wide range of practices, some of which may be engaged in by people who do not consider themselves to be practising BDSM, inclusion in the BDSM community or subculture often is said to depend on self-identification and shared experience.

<span class="mw-page-title-main">Paraphilia</span> Atypical sexual attraction

A paraphilia is an experience of recurring or intense sexual arousal to atypical objects, places, situations, fantasies, behaviors, or individuals. It has also been defined as a sexual interest in anything other than a legally consenting human partner. Paraphilias are contrasted with normophilic ("normal") sexual interests, though the definition of what makes a sexual interest normal or atypical remains controversial.

<span class="mw-page-title-main">Sexual fetishism</span> Sexual arousal a person receives from an object or situation

Sexual fetishism or erotic fetishism is a sexual fixation on a nonliving object or body part. The object of interest is called the fetish; the person who has a fetish for that object is a fetishist. A sexual fetish may be regarded as a non-pathological aid to sexual excitement, or as a mental disorder if it causes significant psychosocial distress for the person or has detrimental effects on important areas of their life. Sexual arousal from a particular body part can be further classified as partialism.

Transvestic fetishism is a psychiatric diagnosis applied to men who are thought to have an excessive sexual or erotic interest in cross-dressing; this interest is often expressed in autoerotic behavior. It differs from cross-dressing for entertainment or other purposes that do not involve sexual arousal. Under the name transvestic disorder, it is categorized as a paraphilia in the DSM-5.

Frotteurism is a paraphilic interest in rubbing, usually one's pelvic area or erect penis, against a non-consenting person for sexual pleasure. It may involve touching any part of the body, including the genital area. A person who practices frotteuristic acts is known as a frotteur.

<span class="mw-page-title-main">Sadomasochism</span> Sexual practice

Sadism and masochism, known collectively as sadomasochism, are the derivation of pleasure from acts of respectively inflicting or receiving pain or humiliation. Practitioners of sadomasochism may seek sexual pleasure from their acts. While the terms sadist and masochist refer respectively to one who enjoys giving and receiving pain, some practitioners of sadomasochism may switch between activity and passivity.

<span class="mw-page-title-main">National Coalition for Sexual Freedom</span> Organization

The National Coalition for Sexual Freedom (NCSF) is an American sex-positive advocacy and educational organization founded in 1997. NCSF has over one hundred coalition partners, and over sixty supporting members. NCSF advocates on behalf of adults involved in alternative lifestyles with respect to sexuality and relationship composition, specifically for tolerance and non-discrimination of those so identified, as well as education for adults involved in such lifestyles. The organization's main office is in Baltimore, Maryland.

Sadist refers to:

The term chronophilia was used by psychologist John Money to describe varying forms of romantic preference and/or sexual fixation limited to individuals of particular age ranges. Some such fixations, specifically those towards prepubescents and those towards the elderly, constitute types of paraphilia. The term has not been widely adopted by sexologists, who instead use terms that refer to the specific age range in question. An arguable historical precursor was Richard von Krafft-Ebing's concept of "age fetishism". Importantly, chronophilia are technically not determined by age itself, but by human sexual maturity stages, such as body type, secondary sexual characteristics and other visible features, particularly as measured by the stages of the Tanner scale.

Biastophilia and its Latin-derived synonym raptophilia, also paraphilic rape, is a paraphilia in which sexual arousal is dependent on, or is responsive to, the act of assaulting an unconsenting person, especially a stranger. Some dictionaries consider the terms synonymous, while others distinguish raptophilia as the paraphilia in which sexual arousal is responsive to actually raping the victim.

<span class="mw-page-title-main">Dominance and submission</span> Erotic roleplay involving the submission of one person to another

Dominance and submission (D/s) is a set of behaviors, customs, and rituals involving the submission of one person to another in an erotic episode or lifestyle. It is a subset of BDSM. This form of sexual contact and pleasure has been shown to please a minority of people.

<span class="mw-page-title-main">Sadistic personality disorder</span> Former personality disorder involving sadism

Sadistic personality disorder was a proposed personality disorder defined by a pervasive pattern of sadistic and cruel behavior. People with this disorder were thought to have desired to control others. It was believed they accomplish this through the use of physical or emotional violence. This diagnosis appeared in an appendix of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R). The later versions of the DSM do not include it. It was removed as psychiatrists believed it would be used to legally excuse sadistic behavior.

Paraphilic infantilism, also known as autonepiophilia and adult baby, is a sexual fetish or non-sexual fetish that may involve role-playing a regression to an infant-like state. Paraphilic infantilism is a form of ageplay. People who practice paraphilic infantilism are often colloquially referred to as "adult babies", or "ABs".

<span class="mw-page-title-main">DSM-5</span> 2013 edition of the Diagnostic and Statistical Manual of Mental Disorders

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is the 2013 update to the Diagnostic and Statistical Manual of Mental Disorders, the taxonomic and diagnostic tool published by the American Psychiatric Association (APA). In 2022, a revised version (DSM-5-TR) was published. In the United States, the DSM serves as the principal authority for psychiatric diagnoses. Treatment recommendations, as well as payment by health care providers, are often determined by DSM classifications, so the appearance of a new version has practical importance. However, not all providers rely on the DSM-5 for planning treatment as the ICD's mental disorder diagnoses are used around the world and scientific studies often measure changes in symptom scale scores rather than changes in DSM-5 criteria to determine the real-world effects of mental health interventions. The DSM-5 is the only DSM to use an Arabic numeral instead of a Roman numeral in its title, as well as the only living document version of a DSM.

Sadism may refer to:

Diaper fetishism, nappy fetishism, or diaperism is a type of garment fetish in which a person derives pleasure from wearing or using a diaper. Though separate and distinct, diaper fetishism can also be used as a component of various other kinks, such as ageplay or paraphilic infantilism, which together form a spectrum of practices colloquially referred to as "adult baby/diaper lover" or "AB/DL".

Other specified paraphilic disorder is the term used by the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to refer to any of the many other paraphilic disorders that are not explicitly named in the manual. Along with unspecified paraphilic disorder, it replaced the DSM-IV-TR category paraphilia not otherwise specified (PNOS). In the revised DSM-5-TR published in 2022 no changes have been made regarding Other specified paraphilic disorder.

Sexual masochism disorder (SMD) is the condition of experiencing recurring and intense sexual arousal in response to enduring moderate or extreme pain, suffering, or humiliation. The Diagnostic and Statistical Manual (DSM-5) of the American Psychiatric Association indicates that a person may have a masochistic sexual interest but that the diagnosis of sexual masochism disorder would only apply to individuals who also report psychosocial difficulties because of it.

Homosexuality was classified as a mental disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM) beginning with the first edition, published in 1952 by the American Psychiatric Association (APA). This classification was challenged by gay rights activists during the gay liberation following the 1969 Stonewall riots, and in December 1973, the APA board of trustees voted to declassify homosexuality as a mental disorder. In 1974, the DSM was updated and homosexuality was replaced with a new diagnostic code for individuals distressed by their homosexuality, termed ego-dystonic sexual orientation. Distress over one's sexual orientation remained in the manual, under different names, until the DSM-5 in 2013.

References

  1. 1 2 3 4 Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, Virginia: American Psychiatric Association. 2013. ISBN   9780890425541.
  2. ↑ Freund, Kurt; Blanchard, Ray (Summer 1986). "The concept of courtship disorder". Journal of Sex & Marital Therapy . 12 (2). Abingdon, England: Routledge: 79–92. doi:10.1080/00926238608415397. PMID   3723606.
  3. ↑ "International statistical classification of diseases and related health problems". World Health Organization. 2007.
  4. ↑ Thornton, David (November 2009). "Evidence regarding the need for a diagnostic category for a coercive paraphilia". Archives of Sexual Behavior . 39 (2). New York City: Springer Science+Business Media: 411–418. ASIN   B005254JMI. doi:10.1007/s10508-009-9583-6. PMID   19941047. S2CID   17557633.
  5. 1 2 3 Cantor, James M.; Sutton, Katherine S. (2014). "Paraphilia, gender dysphoria, and hypersexuality". In Blaney, Paul H.; Millon, Theodore (eds.). Oxford Textbook of Psychopathology (3rd ed.). New York City: Oxford University Press. pp. 589–614.
  6. ↑ Quinsey, Vernon L. (October 2009). "Coersive paraphilic disorder". Archives of Sexual Behavior . 39 (2). Abingdon, England: Routledge: 405–410. doi:10.1007/s10508-009-9547-x. PMID   19795203. S2CID   23939195.
  7. ↑ Freund, Kurt; Seto, Michael C. (October 1998). "Preferential rape in the theory of courtship disorder". Archives of Sexual Behavior . 27 (5). New York City: Springer: 433–443. doi:10.1023/A:1018796312289. PMID   9795725. S2CID   29294017.
  8. ↑ Aggrawal, Anil (2009). Forensic and medico-legal aspects of sexual crimes and unusual sexual practices. New York City: Taylor & Francis. p. 145. ISBN   978-1420043082.
  9. ↑ Freund, K., Scher, H., & Hucker, S. (1983). The courtship disorders. Archives of Sexual Behavior, 12, 369-379.
  10. ↑ American Psychiatric Association. (1987). Diagnostic and Statistical Manual of Mental Disorders (3rd ed., revised). Washington, DC: Author.
  11. ↑ American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: Author.
  12. ↑ American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.). Washington, DC: Author.
  13. ↑ American Psychiatric Association. (1980). Diagnostic and Statistical Manual of Mental Disorders (3rd ed.). Washington, DC: Author.
  14. ↑ American Psychiatric Association. (1968). Diagnostic and Statistical Manual of Mental Disorders (2nd ed.). Washington, DC: Author.
  15. ↑ American Psychiatric Association. (1952). Diagnostic and Statistical Manual: Mental Disorders. Washington, DC: Author.
  16. 1 2 3 Dietz, Park E.; Hazelwood, Roy E.; Warren, Janet L. (February 1990). "The sexually sadistic criminal and his offenses". Bulletin of the American Academy of Psychiatry and the Law . 18 (2). Bloomfield, Connecticut: American Academy of Psychiatry and the Law: 163–178. PMID   2372577.
  17. ↑ Barbaree, Howard E.; Seto, Michael C.; Serin, Ralph C.; Amos, Nancy L.; Preston, Denise L. (March 1, 1994). "Comparisons between sexual and nonsexual rapist subtypes: Sexual arousal to rape, offense precursors, and offense characteristics". Criminal Justice and Behavior . 21 (1). Thousand Oaks, California: SAGE Publishing: 195–114. doi:10.1177/0093854894021001007. S2CID   143781842.
  18. 1 2 Krueger, Robert F. (April 2010). "The DSM diagnostic criteria for sexual sadism". Archives of Sexual Behavior . 39 (2). New York City: Springer Science+Business Media: 325–345. doi:10.1007/s10508-009-9586-3. PMID   19997774. S2CID   11495623.
  19. ↑ Hunt, Morton (1974). Sexual behavior in the 1970s. Chicago, Illinois: Playboy Press. ISBN   978-0872233935.
  20. ↑ Kinsey, Alred; Pomeroy, Wardell B.; Martin, Clyde E.; Gebhard, Paul H. (1953). Sexual behavior in the human female . Philadelphia, Pennsylvania: W. B. Saunders.
  21. ↑ Breslow, Norman; Evans, Linda; Langley, Jill (August 1985). "On the prevalence and roles of females in the sadomasochistic subculture: Report of an empirical study". Archives of Sexual Behavior . 14 (4). New York City: Springer Science+Business Media: 303–317. doi:10.1007/BF01550846. PMID   4051718. S2CID   31730499.
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