Sadistic Personality Disorder and Comorbid Mental Illness in Adolescent Psychiatric Inpatients

Wade C. Myers; Roger C. Burket; David S. Husted

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Table 1

DSM-III-R Diagnostic Criteria for Sadistic Personality Disorder

A. A pervasive pattern of cruel, demeaning and aggressive behavior, beginning by early adulthood, as indicated by the repeated occurrence of at least four of the following:

(1) Has used physical cruelty or violence for the purpose of establishing dominance in a relationship (not merely to achieve some noninterpersonal goal, such as striking someone in order to rob him or her)

(2) Humiliates or demeans people in the presence of others

(3) Has treated or disciplined someone under his or her control unusually harshly (e.g., a child, student, prisoner, or patient)

(4) Is amused by, or takes pleasure in, the psychological or physical suffering of others (including animals)

(5) Has lied for the purpose of harming or inflicting pain on others (not merely to achieve some other goal)

(6) Gets other people to do what he or she wants by frightening them (through intimidation or even terror)

(7) Restricts the autonomy of people with whom he or she has a close relationship (e.g., will not let spouse leave the house unaccompanied or permit teen-age daughter to attend social functions)

(8) Is fascinated by violence, weapons, martial arts, injury, or torture

B. The behavior in A has not been directed toward only one person (e.g., spouse, one child) and has not been solely for the purpose of sexual arousal (as in Sexual Sadism).

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Table 2

Demographic Characteristics

	Sadistic Group (n = 18)	Nonsadistic Group (n = 38)	Significance
Gender (male/female)	6/12	13/25	χ2 = 0.00419255, df = 1
			p = 0.948373
Age (average in years)	15.17 ± 0.79	15.26 ± 0.92	T = 0.3569685, df = 54
			p = 0.722900
Race (white/African American)	16/2	34/4	p = 1.000^*
SES (classes IV–V)	11 (61%)	22 (58%)	χ² = 0.0522078, df = 1
			p = 0.819265
Full-Scale IQ (average)	95.1 ± 15.9	100.4 ± 14.1	T = 1.260882, df = 54
			p = 0.210300

* Fisher exact test (two-tailed).

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Table 3

Common Axis-I Disorders in the Sadistic and Nonsadistic Groups

	Sadistic Group (n = 18)	Nonsadistic Group (n = 38)	Significance
ADHD	4 (22)	6 (16)	p = 0.711^*
Conduct Disorder	12 (67)	13 (34)	χ² = 5.2064, df = 1
			p = 0.022504
ODD	2 (11)	8 (21)	p = 0.474^*
Substance Abuse	11 (61)	9 (24)	χ² = 7.45211, df = 1
			p = 0.006336
Major Depression	13 (72)	16 (42)	χ² = 4.43716, df = 1
			p = 0.035165
Dysthymia	5 (28)	11 (29)	p = 1.000^*
Any Affective Disorder	15 (83)	22 (58)	p = 0.076^*
Overanxious Disorder	4 (22)	9 (24)	p = 1.000^*
PTSD	3 (17)	4 (11)	p = 0.669^*
Phobia	5 (25)	6 (16)	p = 0.305^*
Separation Anxiety Disorder	3 (17)	2 (5)	p = 0.314^*
Panic Disorder	2 (11)	3 (8)	p = 0.652^*
OCD	3 (17)	3 (8)	p = 0.374^*
Any Anxiety Disorder	9 (50)	15 (39)	p = 0.774^*

* Fisher exact test (two-tailed). Data are number of patients (percentage of total group).

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Table 4

Personality Disorders in the Sadistic and Nonsadistic Groups

	Sadistic Group (n = 18)	Nonsadistic Group (n = 38)	Significance
Paranoid	6 (33)	6 (16)	p = 0.171^*
Histrionic	9 (50)	9 (24)	χ2 = 3.878116, df = 1
			p = 0.048920
Borderline	11 (61)	5 (13)	χ² = 13.76257, df = 1
			p = 0.000207
Narcissistic	5 (28)	3 (8)	p = 0.095^*
Obsessive-Compulsive	6 (33)	4 (18)	p = 0.060^*
Passive-Aggressive	14 (78)	17 (45)	p = 0.024^*
Dependent	6 (33)	5 (13)	p = 0.146^*
Avoidant	4 (22)	4 (11)	p = 0.254^*
Mixed	1 (6)	0 (0)	p = 0.321^*
Self-Defeating	9 (50)	7 (18)	χ2 = 5.968421, df = 1
			p = 0.014564