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PubMed1978

Sadism and masochism: sociological perspectives.

This paper represents an initial attempt to provide theoretical structure for the sociological study of sadomasochism. Sadomasochistic behavior, like human behavior in general, is most fully understood within a social context. To understand "what is going on" within an S&M episode, one must know something about the culture of the group and how it defines and categorized people and behavior. This is where frame analysis is helpful. Frames are central components of the culture of the group, through which its members interpret the world. To a great extent the frame itself is structured by the language of the groups, which serves to explain to its members what is happening and to justify their desires, motives, and behavior. Frames tell people what is and what is not proper, acceptable, and possible with their world. They define and categorize for their members situations, settings, scenes, identities, roles, and relationships. When people join sadomasochistic groups, or any other kind of group, they are taught not only frames, but also the conceptual tools or "keys" for defining, applying, transforming, and limiting them. Frame analysis helps make sense of findings that might otherwise be difficult to explain. For example, the apparently puzzling existence in the S&M subculture of "dominant" women and "submissive" men when the larger society to which these individuals also belong prescribes aggressiveness for males and passivity for females may be explained in terms of makebelieve, fantasy, and the theatrical frame. Lack of generalization into the larger world of roles and relationships developed within the sadomasochistic subworld is explained in terms of how behavior is "keyed". A number of areas that have not been fully developed here could be profitably explored. For example, although we have attended to the structuring and limiting of S&M frames, we have not explored misframings, miskeyings, breaking frame, and other errors and their consequences for interactants. Hollander, for instance, provides an example in which an S&M episode was miskeyed with disastrous results. Another issue for further exploration involves the ways in which the language of S&M structures the relations between participants in the world by building in notions of activity and passivity and tying these to particular roles in the interaction. The specific identities of people as "dominant" or "submissive", the ways in which they arrive at a recognition of these self-identities, and the stability of these orientations await investigation.

Culture↗
PubMedDate not supplied

[Clinical variants of sexual sadism].

Clinical variants of sadistic sexual craving (obtrusive, compulsive, and ego-syntonic) are described, based on examinations of subjects who repeatedly committed murders. Some approaches to formation of these states and their time course are shown. A clinical case is described.

Adolescent↗
PubMed2006

The motivation behind serial sexual homicide: is it sex, power, and control, or anger?

Controversy exists in the literature and society regarding what motivates serial sexual killers to commit their crimes. Hypotheses range from the seeking of sexual gratification to the achievement of power and control to the expression of anger. The authors provide theoretical, empirical, evolutionary, and physiological support for the argument that serial sexual murderers above all commit their crimes in pursuit of sadistic pleasure. The seeking of power and control over victims is believed to serve the two secondary purposes of heightening sexual arousal and ensuring victim presence for the crime. Anger is not considered a key component of these offenders' motivation due to its inhibitory physiological effect on sexual functioning. On the contrary, criminal investigations into serial sexual killings consistently reveal erotically charged crimes, with sexual motivation expressed either overtly or symbolically. Although anger may be correlated with serial sexual homicide offenders, as it is with criminal offenders in general, it is not causative. The authors further believe serial sexual murderers should be considered sex offenders. A significant proportion of them appear to have paraphilic disorders within the spectrum of sexual sadism. "sexual sadism, homicidal type" is proposed as a diagnostic subtype of sexual sadism applicable to many of these offenders, and a suggested modification of DSM criteria is presented.

Anger↗
PubMed2006

Psychiatric disorders in single and multiple sexual murderers.

BACKGROUND: Sexual homicides - and particularly offenders with multiple victims - receive much attention in the general public as well as among forensic experts. The aim of this study was to assess psychiatric disorders in a large sample of sexual murderers and to identify disorders related to multiple sexual homicides. SAMPLING AND METHODS: Psychiatric court reports from 20 German forensic psychiatrists on 166 men who had committed a sexual homicide were evaluated for psychiatric disorders according to DSM-IV, including standardized instruments for personality disorders (criteria from the Structured Clinical Interview) and psychopathy (Psychopathy Checklist-Revised). Offenders with a single sexual homicide victim (n = 130) were compared to those with multiple victims (n = 36). RESULTS: High lifetime prevalence rates were found for substance abuse or dependence, paraphilias (especially sexual sadism), sexual dysfunctions and personality disorders (especially antisocial, borderline, sadistic and schizoid). In the multiple sexual murderer group sexual sadism, voyeurism, sadistic, antisocial and schizoid personality disorders were more frequent than in the single-victim group; none of the multiple offenders was diagnosed with a mood disorder. CONCLUSIONS AND LIMITATIONS: Multiple sexual murderers are characterized by disorders in three major psychopathological domains: sexual as well as 'character' sadism, antisociality and schizoid personality. A thorough diagnostic evaluation of Axis I as well as Axis II disorders should be part of risk assessments in sexual homicide perpetrators. Although the study was a retrospective investigation on psychiatric court reports, the size of the sample and consistency with results from previous studies give confidence that the identified group differences are unlikely to be due to methodological limitations.

Adolescent↗
PubMed1999

[Sexual homicide--a data collection from psychiatric records].

After an analysis of the concerning literature we conceptualized a questionnaire with 124 items, which describes the most common characteristics of sexual murderers. The relevance of these characteristics was examined on the basis of psychiatric records. The hypothesis was, that persons who murdered more than once show these characteristics more evidently than single murderers. We compared 20 psychiatric records about single sexual murderers with those about 10 repetitive sexual murderers. Planned offenses, chronic isolation, narcism and tendency to perversity were found more often in persons that murdered more than once. Especially the psychosocial factors were found less often than in the angloamerican literature. More pronounced were the differences between a group of sadistic murderers compared with nonsadistic murderers, using criteria for sadism extracted from Kafft-Ebings first description (1892), Schorsch and Becker (1977), MacCulloch et al. (1983) and Ressler et al. (1988). A case example illustrates the importance of an elaborated concept of sadism and its relation to personality disorder.

Adult↗
PubMed1999

Childhood antisocial behaviors as predictors of psychotic symptoms and DSM-III-R borderline criteria among inpatients with borderline personality disorder.

Structured clinical interviews of 107 female inpatients diagnosed with borderline personality disorder (BPD) were used to determine whether antisocial personality disorder (APD) diagnostic criteria evident prior to age 15 could be used to predict current Axis I and Axis II psychopathology. Diagnostic information was gathered using the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II) and the Structured Clinical Interview for DSM-III-R-Patient Version (SCID-P). Childhood APD criteria were subjected to principal-components analysis, and three factors--rule-breaking, assault, and sadism--emerged. The severity of the childhood APD criteria was related to psychotic symptoms, as well as to the unstable relationships and labile affect BPD criteria and the current overall severity of BPD criteria. Sadism predicted psychotic symptoms and BPD severity, while rule-breaking predicted unstable relationships and BPD severity. Childhood APD severity also had a larger effect on BPD severity than on psychotic symptoms. Possible explanations for these findings are explored and discussed.

Adult↗
PubMed1995

Offender and offense characteristics of sexual sadists: a comparative study.

This paper compares the offender and offense characteristics of 30 sexually sadistic criminals studied by Dietz et al. with those of 29 sexually sadistic criminals and 28 nonsadistic sexual offenders from the Royal Ottawa Hospital. We examined whether the characteristics noted by Dietz et al. would be found among a less violent group of sadistic offenders and also to what extent these characteristics were specific to sexual sadism. Results suggest some offender and offense characteristic are specific to sexual sadism and that others appear to be common to sexually aggressive offenders more generally. In addition, there were a number of characteristics found exclusively among the most violent offenders described by Dietz et al. An explanation of these results in terms of a biopsychosocial understanding of sexual sadistic offenders is provided.

Cause of Death↗
PubMed1998

Homicidal sex offenders: psychological, phallometric, and diagnostic features.

Homicidal sex offenders represent an understudied population in the forensic literature. Forty-eight homicidal sex offenders assessed between 1982 and 1992 were studied in relation to a comparison group of incest offenders. Historical features, commonly used psychological inventories, criminal histories, phallometric assessments, and DSM diagnoses were collected on each group. The homicidal sex offenders, compared with the incest offenders, self-reported that they had more frequently been removed from their homes during childhood and had more violence and forensic psychiatric contact in their histories. On the self-report psychological inventories, the homicidal sex offenders portrayed themselves as functioning significantly better in the areas of sexuality (Derogatis Sexual Functioning Inventory) and aggression/hostility (Buss-Durkee Hostility Inventory). However, on the Psychopathy Checklist-Revised (PCL-R), researchers rated the homiciders significantly more psychopathic than the incest offenders on Factor 1 (personality traits) and Factor 2 (antisocial history). Police records revealed the homicidal subjects also had been charged or convicted of more violent and nonviolent nonsexual offenses. The phallometric assessments indicated that the homicidal sex offenders demonstrated higher levels of response to pedophilic stimuli and were significantly more aroused to stimuli depicting assaultive acts to children, relative to the incest offenders. Despite the homiciders' self-reports of fairly good psychological functioning, DSM-III diagnoses reliably discriminated between the groups. A large number of homicidal sex offenders were diagnosed as suffering from psychosis, antisocial personality disorder, paraphilias, sexual sadism, sexual sadism with pedophilia, and substance abuse. Seventy-five percent of the homicidal sex offenders had three or more diagnoses compared with six percent of the incest offenders. The article addresses the role of "hard" versus "soft" measures in the assessment and treatment of violent sex offenders. In addition, the usefulness of phallometric assessments and the PCL-R and its subscales are considered.

Adolescent↗
PubMedDate not supplied

[The study assessed the prevalence of TPS and its associations with psychopathy in a population of forensic violent patients in a Belgian security hospital].

The population was composed of 76 male patients (mean age=36.14). All of them having committed a violent offence indexed in their institutional file: (1) sexual offences on children; (2) rapes of adult women; (3) homicide offence; and (4) assaults and batteries. TPS was defined by the following 8 diagnostic criteria as described in DSM III-R: 1) has used physical cruelty or violence for the purpose of establishing dominance in a relationship; 2) humiliates or demeans people in the presence of others; 3) has treated or disciplined someone under his or her control unusually harshly; 4) is amused by, or takes pleasure in, the psychological or physical suffering of others; 5) has lied for the purpose of harming or inflicting pain on others 6) gets other people to do what he or she wants by frightening them 7) restricts the autonomy of people with whom he or she has a close relationship; 8) is fascinated by violence, weapons, martial arts, injury, or torture. These criteria were assessed from (a) clinical and institutional files and (b) clinical collateral informations. TPS assessment was conducted by two -trainees in clinical psychology (kappa=0.87; n=20). The assessment of psychopathy was conducted according to the guidelines of the Hare psychopathy checklist manual (PCL-R, 1991, 2003): coding of clinical and institutional files and semi-structural clinical interviews. The PCL-R is mainly composed by 2 factors: factor 1 "Emotional detachment" describing the core psychological component of psychopathy, and factor 2 "Chronically antisocial factor" reflecting behavioral instability and antisocial life style. The total cut-off score for the inclusion of the diagnosis was 25. The prevalence of TPS in the population was 25% (n=19) and is congruent with the large range described in the literature (0.5 to 33%). The most frequent criteria were 6 (gets other people to do what he or she wants by frightening them), 1 (has used using physical cruelty or violence for the purpose of establishing dominance in a relationship) and 3 (has treated or disciplined someone under his or her control unusually harshly). The most sensible criteria were: 7 (restricts the autonomy of people with whom he or she has a close relationship), 8 (major interest for violence) and 4 (pleasure in the psychological or physical suffering of others). The most specific criteria were: 3 (has treated or disciplined someone under his or her control unusually harshly), 6 (gets other people to do what her or she wants by frightening them), 4 (takes pleasure in the psychological or physical suffering of others) and 1 (has used physical -cruelty or violence for the purpose of establishing dominance in a relationship). As concerns psychopathy, the mean of factor 1, factor 2 and the PCL-R total scores were 7.40, 9.08 and 18.67. Thus, 38% of patients were considered as "low psychopaths", 36% were considered as "moderate psychopaths" and 26% were considered as "high psychopaths". In spite of few significant positive correlations between some TPS and PCL-R criteria, TPS diagnosis was not significantly correlated with factors 1, factor 2, nor with total score of the PCL-R. The mean psychopathy total score did not differ between sadistic and non-sadistic patients. Moreover, a two ways ANOVA comparing PCL-R factors 1 and 2 did not reveal any differences between sadism and non-sadism. Again, these comparisons did not support hypothesis of a strong association between TPS and psychopathy.

Adult↗
PubMed1980

Therapeutic sex drive reduction.

Sex drive reducing therapies are employed in those cases of anomalous erotic preferences in which the patient's sexual behaviour is dangerous (certain forms of sadism, or a preference for forcing intercourse or similar interaction) or while not really dangerous, is utterly unacceptable to the community (pedophilia and pedohebephilia) or is an embarrassment to the patient himself (exhibitionism). Three sex drive reducing therapies are in use, all designed for male patients, (1) pharmacological reduction of circulating testosterone, (2) orchidectomy, (3) deletion of certain brain structures by stereotaxic surgery. The main indication for pharmacological sex drive reduction is exhibitionism but here it should be used only temporarily, as a first emergency measure, and after that only intermittently, during periods when the patient can not manage his urges by techniques he should be taught by a behaviour therapist. In cases of unmanageable and dangerous sadism, orchidectomy is the method of choice--and the same would appear to be true for particular cases of pedohebephilia. Brain surgery in this realm is not yet based on sufficient knowledge and should be thoroughly studied on infrahuman primates, before use with humans could be seriously considered.

Animals↗
PubMed2005

The role of psychopathy and sexuality in a female serial killer.

The case of Aileen Wuornos, executed in Florida for the serial killing of seven men, is studied to determine her degree of psychopathy and the presence or absence of sexuality or sexual sadism as a motivation or gratification for her crimes. The authors, one of whom evaluated the subject shortly before her death, determined that she evidenced a psychopathic personality (PCL-R score 32). She also met DSM-IV-TR criteria for Antisocial Personality Disorder and Borderline Personality Disorder. While her killings ostensibly were carried out during routine acts of prostitution, there was ambiguous evidence that her crimes were sexually motivated or gratifying. Her articulated motivation was robbery and elimination of the witness/victim. After carefully considering all available data, the authors concluded there was no convincing evidence of sexual sadism in either her personal history or her method of committing serial murder, and it remains unclear whether sexual gratification was to some degree a motivating factor in her commission of these offenses. The confluence of early childhood attachment disruptions, severe psychopathy, other personality disorder pathology, and a traumagenic abuse history likely contributed to her having serially murdered seven victims.

Adult↗
PubMed1981

Anality: a theory of erotism and characterology.

The psychogenesis of anality is in the psychosexual events of the second year of life. An analysis of that phase of development centers on the biological determinants of psychological development, specifically on the erotization of the excretory functions. The social structures interfering with this process are examined. The interrelationship of feces, child, and penis are analyzed within the context of the total libidinal spectrum of development and object relations. Bipolarity is seen as an integral facet of the anal character, manifested in the retentive-eliminative continuum and in the aggressive-erotic divergences. These trends are examined in detail vis-à-vis the ultimate ossification of the anal adult. In this context, the percept of anal-sadism is introduced and alternate interpretations of the phenomenon are suggested. Various characteristics frequently associated with anal characterology are discussed and an attempt is made to demarcate the status (as integral or peripheral) of these traits. Sociocultural contingencies of anality are also considered, particularly with regard to Western institutions. The major pathological maladaptions related to anality are detailed. These include the obsessions and rigid superego development, paranoia, and homosexuality. The status of anality is then evaluated from the ego-psychological perspective, and interpersonal and societal factors are considered. What emerges is a unitary construct of anality which incorporates both erotism and characterology.

Defense Mechanisms↗
PubMed2000

[Treatment of paraphilia and sexually aggressive impulsive behavior with the LHRH-agonist leuprolide acetate].

Up to now there are no published results of therapy of paraphilia (Pedophilia, Sadism) and sexual aggressive impulsiveness with LHRH-(luteinizing hormone-releasing hormone) Agonists in the Germanspeaking countries. In this report we describe 11 patients which were treated with the LHRH-Agonist Leuprolide Acetate in a period of 12 months. The patients showed no tendency of sexual aggressive behaviour and reported an evident reduction of penile erection, ejaculation, masturbation, sexual deviant impulsiveness and fantasies. One patient died from suicide. In combination with other treatments LHRH-Agonists seem to be a very promising alternative to cyproterone acetate and its possible carcinogene effects.

Adult↗