Pervasive pattern of behavior which characterizd by cruel, manipulative, demeaning and possibly aggressive behavior towards others. The behaviour usually begins in childhood and is consistent thereafter. It is evident in social, personal and occupational situations to varying degrees. The SPD takes pleasure in the humiliation, control and domination of others.
It is well recognized that not all those who engage in cruelty, torture, etc. are sexually aroused while engaging in such behaviour (Dietz et al., 1990; Hazelwood, Dietz & Warren, 1992). Recent interest has been shown in the possibility of including a sadistic personality disorder in the Diagnostic and Statistical Manual (Fiester & Gay, 1991; Simons, 1987). Several previous authors, mainly psychoanalysts, had documented the essential features of a sadistic personality disorder (Fenichel, 1945; Kernberg, 1970; Schad-Somers, 1982). The criteria suggested in DSM-IIIR included "a pervasive pattern of cruel, demeaning and aggressive behaviour directed towards other people beginning in early adulthood" (p. 371). There was considerable overlap with personality disorders, in particular, antisocial and narcissistic subtypes (Spitzer et al., 1991). However, there appeared to be insufficient evidence to support the inclusion of sadistic personality disorder as a separate diagnostic category in the DSM-IV.
© Stephen Hucker, MB,BS, FRCP(C), FRCPsych, 2004, 2005
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