Elsevier

Aggression and Violent Behavior

Volume 8, Issue 1, January–February 2003, Pages 1-22
Aggression and Violent Behavior

Sexual sadism in sexual offenders: An elusive diagnosis

https://doi.org/10.1016/S1359-1789(01)00052-0Get rights and content

Abstract

The present review considers the various conceptual and operational definitions of sexual sadism as this has been diagnosed among sexual offenders. The most persistent problem this review identified concerns the criteria of the fusion of sexual arousal with one or more of the various features of the offenders' actions or of the victims' responses. Not only do the definitions of sadism vary considerably in what it is that is thought to provoke sexual arousal, the operationalization of these definitions also varies. Furthermore, none of the operational definitions appears to satisfactorily or reliably measure sadism. In face of these discouraging observations we recommend abandoning the present diagnostic criteria and shifting to a dimensional approach to defining sadism.

Introduction

The first recorded case of a sadistic sexual offender appears to have been Gilles de Rais, a 15th century French nobleman (Hickey, 1991). He was said to have raped, tortured, and murdered hundreds of children. Reports over the centuries since that time reveal individual sexual offenders who display apparently sadistic features, including, of course, Donatien Alphonse Francois, the Comte de Sade, after whom the disorder was named (Hickey, 1991). However, it was not until Professor Richard von Krafft-Ebing (1886) wrote his comprehensive descriptions of sexual deviancy that sadism was accepted as topic for scientific study. Stekel's (1929) later book on sadism and masochism provided clear descriptions of the features of these two related disorders and this finally led to the popularization of the use of these terms in clinical practice. While there clearly are sadists who do not sexually offend, Breslow, 1989, Spengler, 1977, Weinberg, 1987, and who are of scientific and clinical interest in their own right, it is only those sadists who commit sexual crimes that are the focus of this paper.

There is now a very extensive literature on sadistic sexual offenders including numerous case reports Arieti & Schreiber, 1981, Guttmacher, 1963, Kozel et al., 1966, Rae, 1967, Schechter, 1990, Schlesinger, 1990 as well as reviews and research studies Brittain, 1970, Grubin, 1994a, Hickey, 1991, Holmes & DeBurger, 1988, Ressler et al., 1988, Revitch, 1957, Warren et al., 1996. Much of this literature also deals with sexual murderers, not all of whom are necessarily sadists (Grubin, 1994a), and serial murderers, not all of whom are sexual murderers (Ressler et al., 1988). Many studies, unfortunately, do not satisfactorily discriminate among these possibly different types of offenders, and some authors assume that serial killers are in fact serial sexual murderers (Myers, Reccoppa, Burton, & McElroy, 1993), while others conclude that serial sexual murderers are sadists (Giannangelo, 1996). This confused use of various terms makes it difficult to review this extensive literature and at times in this paper we will be obliged to drew inferences from studies that have not made these distinctions as clearly as we would like.

What we will attempt to do is first consider conceptual definitional issues, including diagnostic criteria, and then examine the operational bases on which the diagnosis of sexual sadism is made. Finally, we will draw implications for research and practice that we believe derive from our consideration of the literature.

Section snippets

Definitional issues

As noted above, we intend to discuss only those sadists who commit sexual offenses although of course actual diagnoses of sexual sadism are the same whether applied to offenders or not. Before we consider the various definitions of sexual sadism that have appeared in the literature, however, we must distinguish some related terms.

Implications for research and practice

This review suggests that the elusive nature of sexual sadism is a function of the need to determine that sexual arousal is fused with some aspect of the offender's behavior or the victim's response. If the offender denies either having recurrent sadistic sexual fantasies, or being sexually aroused by enacting sadistic behaviors, then the researcher or diagnostician must infer such fusion of sexual arousal and sadistic acts from sources independent of the offender. Since sexual offenders are

Conclusions

In conclusion then, after more than 100 years of research and clinical observations we seem no closer to a satisfactory, agreed upon, and reliable diagnosis of sadism than was true when Krafft-Ebing (1886) first described a series of cases he called sadistic. Our review of the evidence does not encourage confidence that things will improve in the future, so we recommend abandoning the diagnosis. Instead, we suggest that researchers rely on behavioral data to identify their subjects along

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