Sexual sadism is infliction of physical or psychological suffering (eg, humiliation, terror) on another

person to stimulate sexual excitement and orgasm.

Sexual sadism disorder (SSD) is a mental health-related issue in which a person is sexually aroused by
inflicting physical or emotional pain on another person.

Sexual sadism disorder is sexual sadism that causes clinically significant distress or functional
impairment or is acted on with a nonconsenting person.

Someone with SSD has strong urges to engage in activities that bring about these situations. The urges
rise to the level of a disorder when they cause significant psychological, emotional, or physical distress in
the person experiencing them or are acted out with a non-consenting person.

Sexual sadism disorder should be distinguished from mild sadistic sexual activity, which is very common
among consenting adults. When the behavior is acted on only with consenting partners and does not
cause distress or actual harm, sadistic acts or urges do not meet the criteria for sexual sadism disorder.

The behaviors associated with SSD are also not synonymous with sexual assault or other criminal sexual
offenses. Although the symptoms of SSD are often criminal acts when acted out upon a non-consenting
person, studies have shown that fewer than 10% of sex offenders can be diagnosed with SSD. That is not
to say that SSD can’t be associated with dangerous criminal behavior; as many as 75% of people
convicted of sexually-motivated homicide may have SSD.

Symptoms of Sexual Sadism Disorder

Common symptoms of sexual sadism disorder include:

1. Sexual arousal, fantasies, or urges involving the infliction of pain, humiliation, or emotional distress

2. Acting on the urges

3. The behavior, urges, or fantasies cause distress or impair a person’s ability to function at home,
school, or work

4. The behavior involves non-consenting people.

Causes Sexual Sadism Disorder?

The cause of sexual sadism disorder is unknown, but different factors likely trigger it in different cases.
Scientists believe that physical, medical, and psychological factors may all play a role in producing the
disorder’s behavior.

Studies have suggested some factors that appear to be associated with SSD, but it is unclear whether
these factors cause the disorder. Some factors are not consistently associated with the disorder, and
some may be a symptom of the disorder rather than a cause. Some of these factors include:

1. A desire for feelings of power, especially in those who feel powerless in their daily lives
2. High testosterone levels

3. Consumption of sadistic pornography

4. Other mental health-related issues (e.g., antisocial personality disorder)

Note: Though studies have been carried out to identify link between Genetics and SSD, there has been
no conclusive investigations.

Diagnosis of Sexual Sadism Disorder

1. Ruling out any medical conditions causing the symptoms

2. Physical examination to rule out any physical condition causing symptoms

3. Psychiatric evaluation by professional to evaluate patient's mood, mental state and mental health
history

4. After medical causes are ruled out, medical professionals can consider whether the patient meets the
diagnostic criteria for sexual masochism disorder. These criteria include:

1. The patient is consistently aroused by fantasies, urges, or acts that involve inflicting or witnessing
extreme pain, torture, or humiliation for sexual arousal.

2. The symptoms cause significant impairment in social situations, at work, or elsewhere.

3. The person acts on the urges with a non-consenting person.

4. The symptoms have been present for at least six months.

Treatment of Sexual Sadism Disorder

People with sexual sadism disorder typically will not seek out treatment on their own, and they will
often deny that they are experiencing symptoms of the disorder. In many cases, treatment does not
begin until a person has illegally acted on their urges and has been arrested.

Treatment of sexual sadism behavior may include both psychotherapy and medications. Common
treatment options include:

1. Cognitive-Behavioral Therapy:

Teaches a person to recognize the situations that trigger their masochistic urges and develop new,
healthy ways to cope with those situations.

2. Group therapy or support groups

3. Relaxation therapy

4. Antidepressant medications, typically serotonin reuptake inhibitors (SSRIs)

5. Antiandrogen drugs, such as gonadotropin-releasing hormone (GnRH) agonists and depot
medroxyprogesterone acetate, work to lower testosterone levels and decrease sexual urges.