Convergent Validity of Three Measures of Sexual Sadism: Value of a Dimensional Measure

Sadistic Sexual Crimes Against Children: Comparing the Manifestation of Sexual Sadism and Crime-Commission Process

Individuals who commit sexual offenses against children have been shown to be distinctive from adult offenders across both individual and crime characteristics. However, an examination of the literature shows that there are gaps in the research related to whether sadism manifests differently between those who target child compared to adult victims. The current study therefore aimed to explore the differences in the characteristics, crime-commission process, and the dimensions of sadism between sadistic crimes of children (n = 101) compared to those of adults (n = 433). Sexual sadism was assessed with the Sexual Sadism Scale (SeSaS) and binary logistic regression analysis and multidimensional scale analysis (MDS) were performed to examine differences between these two groups. Our results showed that sadistic fantasies manifested into four dimensions for both adult and child victims. In terms of differences, sadistic sexual offenses involving children appear to be reflective of deviant fantasies related to overlapping paraphilias (e.g., sadism and pedophilia). Conversely, sadistic crimes involving adult victims involve a crime-commission process that involves a greater degree of structure to control their adult victim and decrease their risk of identification. Implications for clinical assessment and police investigations are discussed.

Validating the Screening Scale of Pedophilic Crime Scene Behavior

The Screening Scale of Pedophilic Crime Scene Behavior (SSPC) is a seven-item structured rating scale assessing pedophilic sexual arousal. In the current study, we cross-validated the scale's convergent validity using multiple measures of sexual interest in children (clinical diagnosis of pedophilia, the high fixation/low social competence type of the MTC:CM4, and phallometric assessment of sexual interests toward children) in two independent samples (USA and Canada). In both samples and in relation to all three criteria, the SSPC showed acceptable (phallometry) to excellent (clinical assessment) diagnostic accuracy. Furthermore, the SSPC showed incremental validity in relation to the Screening Scale for Pedophilic Interest and at times outperformed it in convergent validity analyses. The current study also provides psychometric information that can help users choose an appropriate SSPC cutoff score.

Manifestations of sexual sadism in child sexual assault and the associated victim, offender, and offense characteristics: A latent class analysis

BACKGROUND

Although sadistic child sexual abuse (SCSA) is rare, existing typologies of child sexual abuse have identified the existence of sadistic subtypes in child molestation, as well in the sexual homicide of children. Nonetheless, no study has sought to determine whether there is heterogeneity in the manifestation of sexual sadism between sadistic child abusers.

OBJECTIVE

The present study seeks to examine how SCSA manifests differently between offenders, and whether these differences are associated with specific victim, offender, and offense characteristics.

PARTICIPANTS AND SETTING

The current sample includes adult males (N = 101) who were involved in a child sexual assault and scored at least a 4 on the Severe Sexual Sadism Scale (SeSas). All offenses take place in France between 1990 and 2018.

METHODS

Latent class analysis was used to analyze the sample for heterogeneity. Bivariate analyses were conducted to identify external variables associated with each of the latent classes.

RESULTS

Three distinct latent classes were found: the sadistic kidnapper; the sadistic torturer; and the sadistic ritualist. External validity testing also revealed distinctive characteristics associated with each class.

CONCLUSIONS

SCSA involves a heterogenous population with distinctive sadistic behavioral manifestations that vary in severity and relate to differences in crime-commission processes and offender characteristics. These findings offer important insights for crime prevention and correctional practice.

Sexual Sadism Disorder and Coercive Paraphilic Disorder: A Scoping Review

BACKGROUND

Valid and reliable diagnostic criteria are essential in forensic psychiatry and sexual medicine due to the severe implications of potential misdiagnoses. One challenge in this field is the poor operationalization of sexual sadism disorder (SSD) and coercive paraphilic disorder (CP+) definitions.

AIM

The aim of this scoping literature review is to provide a comprehensive overview of the key conceptual differences between SSD and CP+, as well as consider pragmatic and clinically useful approaches to their diagnostic formulation.

METHODS

Arksey and O'Malley's methodological framework was followed. A literature search of Medline, PsychInfo, Web of Science, and Cumulative Index to Nursing and Allied Health Literature electronic databases was conducted. Publications in English describing the construct and/or operational definition of SSD or CP+ were included. Full-text studies were reviewed by 2 authors and data was charted and synthesized qualitatively.

RESULTS

The initial search provided 1,271 records, after which 120 full-text papers were considered for eligibility and 48 studies were ultimately included. The most common sources of definitions for SSD and CP+ were the Diagnostic and Statistical Manual of Mental Disorders (n = 53) and the International Classification of Disease (n = 12). There was more variation of terms used for CP+ than SSD. Both CP+ and SSD are critiqued by reviewed literature for having low validity, reliability, and consistency, as well as being conflated with sexual crime. SSD is better described due to having diagnostic criteria and validated diagnostic tools.

CLINICAL IMPLICATIONS

Currently, clinicians rely mostly on the DSM to diagnose SSD or CP+. As applications of SSD and CP+ definitions vary, interpretations may not be generalizable between clinicians. Furthermore, specific diagnoses may be practically unhelpful and unreliable. It may therefore be beneficial for treatment to be determined by risk of harm. In addition to these concerns, the stigma associated with SSD and CP+ may also impact treatment.

STRENGTHS & LIMITATIONS

Strengths of this study include duplicate review and charting to increase methodological rigor, transparent reporting to minimize publication bias, and encompassing a comprehensive scope. Limitations include the weaknesses of low strength of reviewed literature and risk of publication bias.

CONCLUSION

Despite their significant implications, the definitions of SSD and CP+ are inconsistent and lack reliability. Future research is necessary to develop stronger diagnostic criteria and tools. Liu A, Zhang E, Leroux EJ et al. Sexual Sadism Disorder and Coercive Paraphilic Disorder: A Scoping Review. J Sex Med 2022;000:1-11.

Emotional intelligence in incarcerated sexual offenders with sexual sadism

Emotional intelligence (EI) is defined by the ability to perceive, manage, and reason about emotions in oneself and others. Studies have reported deficits in EI abilities among certain antisocial populations such as individuals with psychopathy, and enhanced performance among sexual offenders. Despite EI's relevance to offending behaviour, the association between EI and paraphilic offending has been under-studied. We examined the association between EI, sexual offending, and sexual sadism in 80 incarcerated men with sexual offenses and 207 incarcerated men with non-sexual offences. EI was assessed using the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT). Sadism was measured using the Severe Sexual Sadism Scale (SeSaS). Results showed that SeSaS scores were positively associated with Strategic EI (the ability to understand and manage emotions), but were not significantly related to Experiential EI. This may reflect core characteristics of sexual sadism including domination and manipulation, challenging the prevalent notion that higher EI is invariably positive.

"We Boil at Different Degrees": Factors Associated With Severity of Attack in Sexual Killing

Degree of injury, as measured by the Homicide Injury Scale (HIS), was examined to advance understanding of the dynamics of sexual killing. A total of 350 nonserial, male sexual killers were included, and the different ways that the sexual element of their offenses and the act of killing were connected was accounted for by determining that cases were either directly sexual (the sexual element and killing were closely bound), or indirectly sexual (killing was not a source of sexual stimulation). The two groups, direct and indirect sexual killers, were each subjected to multiple linear regression analyses to examine the group-specific relationship between level of injury and predictor variables previously found to be associated with increased severity of attack. No differences in the mean total HIS scores between the indirect and the direct cases were found, suggesting a comparable emotional intensity between the groups. However, given that the groups differed in terms of the functional role of fatal violence, severity of attack could not be sufficiently explained as driven by anger. In line with this hypothesis, different predictors appeared to be associated with increased degree of injury sustained by victims of indirect compared with direct sexual killers. As such, situational components appear to play a role in the behavior of indirect sexual killers, whereas the behavior of direct perpetrators tends to be linked with the enactment of existing deviant fantasies. The role of anger in sexual homicide is discussed further, and overall, it is argued that irrespective of whether violence was initially driven by anger, evidence of sexual arousal to severe violence must be scrutinized within sexual homicide research as well as in psycholegal contexts.

Sexual Sadism Among Sex Offenders in Switzerland

The Sexual Sadism Scale (SeSaS) was developed to assist in the diagnosis of sexual sadism, and it revealed adequate psychometric properties in prior research. This study cross validated the SeSaS in Switzerland using a sample of 179 male sex offenders. Specifically, the SeSaS conformed to a Mokken model of double monotonicity (scalability coefficient [H] = .46, coefficient of reproducibility [CR] = .89), indicating that it measures a unidimensional construct of sexual sadism with hierarchically ordered items. The reliability of the scale was acceptable to high (ρ = .80, λ₂ = .75, κ = .88). In addition, the SeSaS was strongly associated with sexual sadism diagnoses based on mental health manuals (r_pb = .60, odds ratio [OR] = 13.02, area under the curve [AUC] = 1) but not with recidivism. The results suggest that the use of the SeSaS may improve the validity and reliability of sexual sadism diagnoses, therefore playing a role in the assessment and management of sex offenders.

Coercive Sexual Sadism: a Systematic Qualitative Review

PURPOSE OF REVIEW

Coercive sexual sadism can be distinguished from consensual BDSM (bondage discipline/dominance submission/sadism masochism) role-play and from everyday sadism, a personality trait. The purpose of this paper is to provide a systematic qualitative review of the pertinent literature on coercive sexual sadism from the last three years.

RECENT FINDINGS

Clinical assessment of sexual sadism can be made more objective through behavioral checklists based on crime scene actions. The latent structure of sexual sadism is likely dimensional, placing the disorder at the upper end of a continuum of sexually aggressive behavior. Sexual sadism does not seem to increase the risk of violent offense recidivism (including sexual contact offenses) above and beyond the risk implied by established risk factors of delinquency. Coercive sexual sadism denotes a disposition for sexually aggressive behavior. Whether this disposition is put into practice is likely due to other trait and state variables. Treatment studies are completely lacking in the recent literature.

Sexual Sadism and Psychopathy in Sexual Homicide Offenders: An Exploration of Their Associates in a Clinical Sample

Sexual sadism and psychopathy are often considered synonymous with sexual homicide, but there is limited research on their associates in sexual homicide offenders. Associates of dimensional measures of sexual sadism (Sexual Sadism Scale; SeSaS) and psychopathy (Psychopathy Check List-Revised [PCL-R] total, Factor 1, and Factor 2) were examined in 51 male Scottish cases. Over a third were DSM-IV (Diagnostic and Statistical Manual of Mental Disorders-IV) sexual sadists, just under a third screened in with the SeSaS, and a quarter were "Hare psychopaths." Sexual sadism and PCL-R measures were moderately associated. Sexual sadism predicted control, sexual deviance, and unusual behaviour at crime scenes; attempted homicide and having a co-accused; and multiple sexual homicides and previous sexual offending. PCL-R Factor 1 predicted violent, exploitative, and evading detection behaviours at crime scenes; completed homicide; and previous violent offending. PCL-R Factor 2 predicted impulsive behaviours at crime scenes, substance misuse, and previous general offending. Psychopathy and sexual sadism play key roles in sexual homicide, interact with each other, and determine different aspects of offences and offenders.

Sadistic Offender or Sexual Sadism? Taxometric Evidence for a Dimensional Structure of Sexual Sadism

Severe sexual sadism is a disorder of sexual preferences that focuses on humiliation and domination of the victim, sometimes causing grievous injury or death. Because offenders with high levels of sadism represent a risk to both reoffend and cause considerable harm should they reoffend, a diagnosis of sexual sadism has serious implications. The actual diagnosis of sexual sadism is fraught with problems (i.e., low reliability and validity) and exhibits poor consistency across assessments and studies (Levenson, 2004; Marshall, Kennedy, & Yates, 2002a). Various authors have proposed that sadism should be reconceptualized and have suggested that a dimensional approach may be more effective than a classificatory one for diagnosing sexual sadism (e.g., Marshall & Kennedy, 2003; Nietschke, Osterheider, & Mokros, 2009b). The dimension versus taxon question also impacts debates about the etiology and treatment of sadism. We assessed the taxonicity of sexual sadism by conducting a taxometric analysis of the scores of 474 sex offenders from penitentiary settings on the MTC Sexual Sadism Scale, using Meehl's taxometric methods (Meehl & Yonce, 1994; Waller & Meehl, 1998). Findings indicated that sexual sadism presents a clear underlying dimensional structure. These results are consistent with earlier research supporting a dimensional assessment of sexual sadism and indicate that the diagnosis of sexual sadism should be reconceptualized. The theoretical and clinical implications of these findings are discussed.

MTC Sadism Scale: Toward a Dimensional Assessment of Severe Sexual Sadism With Behavioral Markers

Sadism was initially described as the experience of sexual pleasure produced by acts of cruelty and bodily punishment. Sadism was conceptualized as if sadists were fundamentally different from nonsadists. Recent studies have suggested that sadism is distributed as a dimension rather than as a category. The aim of the current study was to assess the psychometric properties the MTC Sexual Sadism Scale. Our analyses were conducted on a sample of 486 sexual offenders assessed at a correctional institution in Massachusetts. In summary, the results indicate that the MTC Sexual Sadism Scale possesses good psychometric properties for the dimensional assessment of severe sexual sadism with behavioral markers. Moreover, the scale captures a wide range of intensity of sadism among sexual offenders. These results are consistent with prior research and support the current consensus to move toward a dimensional interpretation of sadism. Implications both for clinical assessment and for research on the development of sadism are discussed.