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Sexual Sadism

Sadism is the act of deriving pleasure, often sexual, from mistreating others and therefore these people find others whom they victimize with their behavior. Some of the severe activities involved in sexual sadism include burning, beating, stabbing, raping, and killing. Usually the thoughts and/or behaviors of sexual sadism begin in adolescence or early adulthood. The behaviors are not only chronic, but they usually increase in severity with time. Disorder characteristic are:

Repeatedly for at least 6 months, the patient experiences intense sexual desires, fantasies or behaviors concerning real acts of causing physical or psychological torment or otherwise humiliating another.
This causes clinically important distress or impairs work, social or personal functioning. The sadism may take the form of restraining, beating, torturing, mutilating or even killing another (especially when associated with anti-social personality disorder).

Associated Features:

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.


There is no identified cause but the age of onset is commonly by early adulthood. 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.


The course of paraphilia is usually chronic in nature and may require both the application of psychotherapeutic techniques and drug therapy.

Counseling and Psychotherapy [ See Therapy Section ]:

Cognitive, behavior, and psychoanalytic therapies are used to treat individuals with paraphilia's.

Pharmacotherapy [ See Psychopharmacology Section ] :

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.

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