Table 1

Criteria Sets for Sexual Sadism From the DSM and ICD-10

Criteria from DSM-III7
    (1) On a nonconsenting partner, the individual has repeatedly and intentionally inflicted psychological or physical suffering in order to achieve sexual excitement.
    (2) With a consenting partner, a repeatedly or exclusive mode of achieving sexual excitement combines humiliation with simulated or mildly injurious bodily suffering.
    (3) On a consenting partner, bodily injury that is extensive, permanent, or possibly mortal is inflicted in order to achieve sexual excitement.
Criteria from DSM-IIIR8
    A. Over a period of at least six months, recurrent intense sexual urges and sexually arousing fantasies involving acts (real, not simulated) in which the psychological or physical suffering (including humiliation) of the victim is sexually exciting to the person.
    B. The person has acted on these urges, or is markedly distressed by them.
Criteria from DSM-IV9
    A. Over a period of at least six months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving acts (real, not simulated) in which the psychological or physical suffering (including humiliation) of the victim is sexually exciting to the person.
    B. The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Criteria from DSM-IV-TR10
    A. Over a period of at least six months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving acts (real, not simulated) in which the psychological or physical suffering (including humiliation) of the victim is sexually exciting to the person.
    B. The person has acted on these urges with a nonconsenting person, or the sexual urges, or behaviors cause marked distress or interpersonal difficulty.
Criteria from ICD-1018
    A preference for sexual activity which involves the infliction of pain or humiliation. If the subject prefers to be the recipient of such stimulation this is called masochism. If the provider, sadism.