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What is Sexual Sadism? Is classified as one of the paraphilias because of the specific sexual component. Sexual sadism refers to the derivation of sexual pleasure from the infliction of pain, suffering and/or humiliation upon another person. The pain and suffering of the victim, which may be both physical and psychological, is pivotal to the sexual arousal and pleasure. The ICD-10 (World Health Organization, 1992) defines sadism as "preference for sexual activity that involves bondage or infliction of pain or humiliation." The term "sadism" derives from French medical literature of the early 19th century in connection with the writings of the Marquis de Sade whose novels depict scenes of torture, cruelty and killing for erotic purposes.

Prevalence The prevalence of sexual sadism is difficult to gauge accurately, given that most individuals who practice in these activities do not self report although several studies have been conducted over the several decades: Kinsey et al (1953): determined that 3-12% of women and 10- 20% of men admitted to responding sexually to sadomasochistic narratives Crepault and Couture (1980): found a 14.9% incidence of fantasies of humiliating a woman and 10.7% of beating up a woman when they surveyed a group of men in the general population
Causes:

Arndt, Foehl and Good (1985) found that 33% of women and 50% of men had sexual fantasies
There are several different theories about the origins of sexual sadism. Psychodynamic Theories Freud's views on sadism and masochism changed over the course of his professional life, making it sometimes difficult to trace the evolution of his thought. Initially, he conceptualized the association of aggressiveness with sexuality as a combination of "mental impulses" but later he suggested a possible explanation was the child's witnessing the "primal scene", coming to view his parents having intercourse as an act of ill treatment or subjugation. In 1920, he suggested that, rather than deriving from the pleasure principle, sadism derived from the "death instinct". This theory does not explain why some develop sadism while others do not, however, or why the aggression is reflected as sadism in some and as masochism in others. Sadger (1926) proposed that children developed a tendency to sadism when their caretakers both bring sexual pleasure and deny it when initiating toilet training or preventing masturbation. Friedberg (1956) suggested that teething is the root of sadism. Official Criteria:

of tying up their partner. Note: It is not clear whether these represent sustained, preferred activities or part of a repertoire of activities that may be carried out from time to time. Hunt (1974) found that 5% of men and 2% of women reported they obtained sexual gratification from inflicting pain If commercially available pornography can be used as an indicator of levels of sexual sadism in the general public, research has shown that 10 - 20% of pornographic magazines feature bondage and discipline themes

Current diagnostic criterion from the DSM-IV-TR requires the following criteria be met:

1. Recurrent, intense sexually arousing fantasies, sexual urges, or behaviours involving acts (real, not simulated) in which the psychological or physical suffering (including humiliation) of the victim is sexually exciting for the person, have been present for at least 6 months.

2. The fantasies, sexual urges, or behaviours cause clinically significant stress or impairment in social, occupational or other important areas of function.

While the criteria may appear to imply that the impairment must be perceived by the person in question to be applied, this is not the case. Ie. sadistic behaviour resulting in harming someone would be interpreted as an impairment of function.

Demography: Sexual sadism is found predominately in males and usually onsets with puberty although sadistic behaviour may be evident earlier in children. In all male cases, it becomes evident by early adulthood. Sexual sadism may begin with fantasies and, in some cases, these may never be acted upon or, be acted out in the more mild forms of consensual relationships. In non-consensual cases, the behavior usually continues and often escalates over time as the perpetrator experiences a need for increased violence in order to stimulate the sexual response. Paradoxically, while sexual sadism is more common in men, there appears to be a

Manifestation

1.

Lust-murder. Here he included cases in which there was a connection between sexual arousal and killing which may extend to anthropaphagy or cannibalism (eating body parts of the victim). Among examples he included "Jack the Ripper" and similar types of homicide

Treatment Options
An individual with sexual sadism may never come to the attention of the criminal justice system or the mental health system, the two systems where treatment would be initiated if viable. If the individual practices mild forms of sexual sadism within a consensual sexual relationship may never seek help or treatment for it, for example. Of those who come to the attention of the criminal justice system, the sexual sadism has usually manifested itself in dangerous activity that has harmed others. The same may or may not be true of those presenting to medical or mental health facilities. As with sexual behaviour in general, sexual sadism is difficult to modify with behavioural techniques and treatments. Pharmacological treatments may be of some benefit, depending upon the individual. In such cases, treatment would be long-term. In some cases, treatment has included surgical castration and steroatactic neurosurgery. Indicators of a poor prognosis include: early age of onset; no feelings of guilt or remorse for sadistic behavior; high frequency of engaging in sadistic behavior; poor sexual and social relationships. 6. 7. 8. 2. 3. 4. 5.

Mutilation of corpses or necrophilia Injury to females (stabbing, flagellation etc.,) Defilement of women Other kinds of assaults on women - symbolic sadism in which, for example, the perpetrator cuts the hair of his victim rather than harming them directly Ideal sadism or sadistic fantasies alone without acts Sadism with other objects, for example, whipping of boys Sadistic acts with animals Those eight basic types can be roughly categorized into two main groups of Sexual sadism: Mild sadism in a consensual sexual relationship (eg. S&M) and the major category involving injury or worse, usually in a non-consensual relationship. In both, the element of pain to the victim is the sexual stimulus

Frotteurism refers to a paraphilic interest in rubbing, usually one's

pelvis or erect penis, against a non-consenting person for sexual gratification. It may involve touching any part of the body including the genital area. A person who practices frotteurism is known as a frotteur. The majority of frotteurs are male and the majority of victims are female,although female on male, female on female, and male on male frotteurs exist. Adult on child frotteurism can be an early stage in child sexual abuse. This activity is often done in circumstances where the victim cannot easily respond, in a public place such as a crowded train or concert. Usually, such nonconsensual sexual contact is viewed as a criminal offense: a form of sexual assault albeit often classified as a misdemeanor with minor legal penalties. Conviction may result in a sentence or psychiatric treatment.
As with most paraphilias, frotteurism is usually concurrent with.

Prevalence:

Men with adolescence to decrease twenties. Paraphilias

Frotteurism usually begins in and the abnormal behavior tends when the man reaches his late are primarily male disorders.

Signs and Symptoms:

Most paraphilic fantasies begin in late childhood or adolescence and continue throughout adult life. Intensity and occurrence of the fantasies are variable, and they usually decrease as people get older.

Over a period of at least 6 months, recurrent, intense, or arousing sexual urges or fantasies, that involve touching and rubbing against a nonconsenting person.

The person has acted on these sexual urges or fantasies, or they cause the person significant distress, to a degree they are disruptive to everyday functioning.

Differential Diagnosis: Some disorders have similar or even the same symptoms. The clinician, therefore, in his/her diagnostic attempt has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis. Mental Retardation ,Substance Intoxication ,Manic Episode ,Schizophrenia

Treatment of Frotteurism Cognitive, behavior, and psychoanalytic therapies are used to treat individuals with paraphilias. Some prescription medicines have been used to help decrease the compulsive thinking associated with the paraphilias. Hormones are prescribed occasionally for individuals who experience intrusive sexual thoughts, urges, or abnormally frequent sexual behaviors. Almost always the treatment must be long-term if it is to be effective.

The prognosis for complete recovery is generally considered to be guarded.