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, sometimes homicide
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 are 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.

Coercive sexual sadism disorder is the term used by the current version of the International Classification of Diseases (ICD-11) [3] . The diagnosis requires a pattern of sexual arousal that is directed at non-consenting persons. The patient must also have either acted on these thoughts or be markedly distressed by them. Consensual sadism and masochism are specifically excluded from the diagnosis. According to the respective working group, consensual arousal patterns as such do not represent mental disorders, and have been therefore deleted from the classifications of disorders. [4]

Paraphilic coercive disorder refers to the preference for non-consenting over consenting sexual partners. [5] 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, [6] Coercive Paraphilic Disorder, [7] and Preferential Rape. [8]

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. [9] 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. [10] 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. [6]

Previous terminology

Sadomasochism appeared in the previous version of the International Classification of Diseases (ICD-10) of the World Health Organization. [11] 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).

Sexual sadism is the term previously employed by the DSM-III-R, [12] DSM-IV, [13] and DSM-IV-TR, [14] 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, [15] 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. [16] 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 [17] (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, [18] 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. [18] In 40% of cases, the offender kept a personal item of the victim as a souvenir. [18]

On personality testing, sadistic rapists apprehended by law enforcement have shown elevated traits of impulsivity, hypersexuality, callousness, and psychopathy. [19]

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. [6]

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. [20] Surveys have also been conducted to include people who are interested in only mild and consensual forms of sexual pain/humiliation (BDSM). [20]

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. [21] [22] [23]

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, although the definition of what makes a sexual interest normal or atypical remains controversial.

<span class="mw-page-title-main">Urolagnia</span> Paraphilia associated with urine or urination

Urolagnia is a paraphilia in which sexual excitement is associated with the sight or thought of urine or urination. The term has origins in the Greek language. Golden shower is slang for the practice of urinating on another person for sexual pleasure, while watersports is the more inclusive term.

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 or S&M, is the derivation of pleasure from acts of respectively inflicting or receiving pain or humiliation. The term is named after the Marquis de Sade, a French author known for his violent and libertine works and lifestyle, and Leopold von Sacher-Masoch, an Austrian author who described masochistic tendencies in his works. Though sadomasochistic behaviours and desires do not necessarily need to be linked to sex, sadomasochism is also a definitive feature of consensual BDSM relationships.

<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.

Hebephilia is the strong, persistent sexual interest by adults in pubescent children who are in early adolescence, typically ages 11–14 and showing Tanner stages 2 to 3 of physical development. It differs from pedophilia, and from ephebophilia. While individuals with a sexual preference for adults may have some sexual interest in pubescent-aged individuals, researchers and clinical diagnoses have proposed that hebephilia is characterized by a sexual preference for pubescent rather than adult partners.

Chronophilia are forms of romantic preferences and/or sexual attractions limited to individuals of particular age ranges. Some such attractions, specifically those towards prepubescents and those towards the elderly, constitute types of paraphilia. The term was coined by John Money and 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.

Psychosexual disorder is a sexual problem that is psychological, rather than physiological in origin. "Psychosexual disorder" was a term used in Freudian psychology. The term "psychosexual disorder" has been used by the TAF for homosexuality as a reason to ban the LGBT people from military service.

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 is an obsolete term for a proposed personality disorder defined by a pervasive pattern of sadistic and cruel behavior. People who fitted this diagnosis were thought to have a desire to control others and to have accomplished this through use of physical or emotional violence. The diagnosis proposal appeared in the appendix of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R), however it was never put to use in clinical settings and later versions of the DSM had it removed. Among other reasons, psychiatrists believed it would be used to legally excuse sadistic behavior.

Self-defeating personality disorder was a proposed personality disorder. As a descriptor for "Other personality disorder" it was included in the DSM-III in 1980.. It was discussed in an appendix of the revised DSM-III-R in 1987, but was never formally admitted into the manual. The distinction was not seen as clinically valuable because of its significant overlap with other personality disorders. Both the DSM-III and DSM-III-R separated the condition from sexual masochism.

Paraphilic infantilism, also known as adult baby, is a form of ageplay that involves role-playing a regression to an infant-like state. Like other forms of adult play, depending on the context and desires of the people involved paraphilic infantilism may be expressed as a non-sexual fetish, kink, or simply as a comforting platonic activity. People who practice adult baby play are often colloquially referred to as "adult babies", or "ABs".

Diaper fetishism, or nappy fetishism, is a type of garment fetish in which a person derives pleasure from themselves or partners wearing or using a diaper. Diaper fetishism can be performed on its own or incorporated into other various kinks. These kinks may include paraphilic infantilism, omorashi, and BDSM. When combined with paraphilic infantilism, the fetish is often called adult baby/diaper lover or AB/DL for short.

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.

According to some classification systems, Sexual masochism disorder is the condition of experiencing recurring and intense sexual arousal in response to enduring moderate to 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

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  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 11th revision, Code 6D33". World Health Organization. 2024.
  4. ↑ Krueger, Richard B.; Reed, Geoffrey M.; First, Michael B.; Marais, Adele; Kismodi, Eszter; Briken, Peer (July 2017). "Proposals for Paraphilic Disorders in the International Classification of Diseases and Related Health Problems, Eleventh Revision (ICD-11)". Archives of Sexual Behavior. 46 (5): 1529–1545. doi:10.1007/s10508-017-0944-2. ISSN   0004-0002. PMC   5487931 . PMID   28210933.
  5. ↑ 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.
  6. 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.
  7. ↑ 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.
  8. ↑ 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.
  9. ↑ 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.
  10. ↑ Freund, K., Scher, H., & Hucker, S. (1983). The courtship disorders. Archives of Sexual Behavior, 12, 369-379.
  11. ↑ "International statistical classification of diseases and related health problems". World Health Organization. 2007.
  12. ↑ American Psychiatric Association. (1987). Diagnostic and Statistical Manual of Mental Disorders (3rd ed., revised). Washington, DC: Author.
  13. ↑ American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: Author.
  14. ↑ American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.). Washington, DC: Author.
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  16. ↑ American Psychiatric Association. (1968). Diagnostic and Statistical Manual of Mental Disorders (2nd ed.). Washington, DC: Author.
  17. ↑ American Psychiatric Association. (1952). Diagnostic and Statistical Manual: Mental Disorders. Washington, DC: Author.
  18. 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.
  19. ↑ 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.
  20. 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.
  21. ↑ Hunt, Morton (1974). Sexual behavior in the 1970s. Chicago, Illinois: Playboy Press. ISBN   978-0872233935.
  22. ↑ Kinsey, Alred; Pomeroy, Wardell B.; Martin, Clyde E.; Gebhard, Paul H. (1953). Sexual behavior in the human female . Philadelphia, Pennsylvania: W. B. Saunders.
  23. ↑ 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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