Sadism and masochism occupy a special place among the perversions, for the contrast of activity and passivity lying at their bases belong to the common traits of the sexual life. 2, p 1 T he topics of sex and violence are of almost universal interest. A Google search using the word sex produces 687-million hits. A search linking sex with synonyms for violence results in 274-million searchable links. A more specific review of the scientific literature was conducted using SUM search, which combines a metasearch strategy with contingency searching of major databases including PubMed and PsycLIT. In our review, the following key words were linked with the word sexual: violence, sadism, homicide, coercion, and predator. This search, limited to human subject research published in the English language within the last 10 years, The true prevalence of sexual sadism (and its variants) is unknown. However, all clinicians will knowingly or unknowingly encounter patients with this disorder. Regretfully, few programs offer adequate education in normal sexuality and even less provide training in the assessment and treatment of pathologic sexual interests. This review synthesizes current theories about possible etiologies of criminal sexual sadism and the resulting implications for diagnosis and treatment of this sexual disorder. Included is a review of theories of criminally sadistic sexual motivations, response patterns, and physiology, including possible neurophysiologic factors and more complex interactions. This review focuses primarily on published English-language scientific studies of sexual sadism. It should be noted that my use of the term sadism refers to nonconsensual sexual aggression.
Can J Psychiatry 2008;53(10):637-646Highlights · While some scientific evidence supports an interaction between sexual behaviours and aggression, the purported association between sex and violence in media reports is misleading. This is due to a focus on sensational cases, lack of consistency in diagnostic criteria, inconclusive study designs, overgeneralization, and reliance on opinion. · Sexual arousal from consensual interactions that include domination should be distinguished from nonconsensual sex acts. Nonconsensual sex may be opportunistic, disinhibited, or sexually motivated. Often motivations are mixed. · Future research needs to integrate studies to account for how neurophysiologic and neurohormonal events translate into psychologic experiences that in turn are modified by social variables within specific populations across the lifespan. · The frequency of reported sex crimes is decreasing. The efficacy of treatment for paraphilias of all types is improving. Further research into the relation between sex and violence will aid in decreasing sex crimes but more importantly will aid in understanding how to facilitate safe, healthy, and happy sexuality for everyone.resulted in 4211 journal article citations. These citations were combined with 148 journal articles identified by the key word sadomasochism, followed up by referral...