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Definition of Sadism:
Sadism involves gaining pleasure from seeing others undergo pain or discomfort. The Opponent-Process Theory explains the way in which individuals not only display, but also take enjoyment in committing sadistic acts. Individuals possessing sadistic personalities display recurrent cruel behavior and aggression. Sadism can also include the use of physical and emotional cruelty, purposefully manipulating others through the use of fear, and a preoccupation with violence.

While some sadistic individuals do gain pleasure in imposing pain and suffering upon others, sadism does not always involve the use of physical aggression or violence. More often, sadistic individuals express aggressive social behaviors and enjoy publicly humiliating others in order to achieve a sense of power over them.

Comorbidity with Other Personality Disorders:
Sadistic Personality Disorder is oftentimes found to occur in unison with other personality disorders. In fact, studies have found that Sadistic Personality Disorder is the personality disorder with the highest level of comorbidity to other types of psychopathologic disorders. However, sadism has also been found in patients who do not display other forms of psychopathic disorders. One personality disorder that is oftentimes found to occur alongside Sadistic Personality disorder are Conduct Disorders. In addition, anti-social and narcissistic personality disorders are sometimes found in individuals diagnosed with Sadistic Personality Disorder. Other disorders that are also oftentimes found to exist with Sadistic Personality Disorder include Bipolar Disorder, Panic Disorders, Depression, Borderline Personality Disorder, Histrionic Personality Disorder, Obsessive Compulsive Disorder, Self-Defeating Personality Disorder and Passive-Aggressive Personality Disorder. Studies have found other types of illnesses, such as alcoholism, to have a high rate of comorbidity with Sadistic Personality Disorder.

Because of its high level of comorbidity with other disorders, researches have had some level of difficulty distinguishing Sadistic Personality Disorder from other forms of personality disorder. While Sadistic Personality Disorder itself is no longer included in the DSM, partially for this reason, other types of disorders involving sadism, such as sexual sadism, are still found in the DSM.

Familial Patterns/Childhood Experiences and Sadistic Personality Disorder:
Sadistic Personality Disorder is found more often in males than in females. In addition, studies have suggested that there are familial patterns in the presence of sadistic personality types. Specifically, people with Sadistic Personality Disorder oftentimes have relatives who have some type of psychopathology as well.

DSM-III-R Criteria for Sadistic Personality Disorder
A. A pervasive pattern of cruel, demeaning and aggressive behavior, beginning by early adulthood, as indicated by the repeated occurrence of at least four of the following: (1) Has used physical cruelty or violence for the purpose of establishing dominance in a relationship (not merely to achieve some noninterpersonal goal, such as striking someone in order to rob him or her) (2) Humiliates or demeans people in the presence of others (3) Has treated or disciplined someone under his or her control unusually harshly (e.g., a child, student, prisoner, or patient) (4) Is amused by, or takes pleasure in, the psychological or physical suffering of others (including animals) (5) Has lied for the purpose of harming or inflicting pain on others (not merely to achieve some other goal) (6) Gets other people to do what he or she wants by frightening them (through intimidation or even terror) (7) Restricts the autonomy of people with whom he or she has close relationship (e.g., will not let spouse leave the house unaccompanied or permit teen-age daughter to attend social functions) (8) Is fascinated by violence, weapons, martial arts, injury, or torture B. The behavior in A has not been directed toward only on person (e.g., spouse, one child) and has not been solely for the purpose of sexual arousal (as in Sexual Sadism)

Removal From the DSM
Numerous theorists and clinicians introduced Sadistic Personality Disorder to the DSM in 1987 and it was placed in the DSM-III-R as a way to facilitate further systematic clinical study and research. It was proposed to be included because of adults who were possessing sadistic personality traits, but not being labeled even though their victims were being labeled with a self-defeating personality disorder. There were many concerns regarding confusion about which diagnoses were approved for clinical practice and which were not. SPD was removed from the DSM-IV because few studies have taken place regarding SPD since there haven’t been that many cases of people seeking treatment. For the most part, it is found that SPD is found in certain groups of people like sexual offenders and serial killers, so it isn’t considered a helpful diagnosis. Theorists like Theodore Millon wanted to generate further study on SPD so they proposed it to the DSM-IV Personality Disorder Work Group, but they rejected it. Since it was not included in the DSM-IV, it has been said that dimensional models of sadism might be more appropriate than SPD.

Characteristics of Sadistic Personalities
Characteristics of sadistic personalities are somewhat contradicting depending on the mood a sadist is in, because they are able to demonstrate empathy and compassion, but at the same time they find immense pleasure in humiliating, controlling and dominating others. Sadistic personalities are similar to paranoid, schizotypal, borderline, antisocial and negativistic personalities so they overlap in certain areas. It is a common belief that SPD has to be influenced by sexual arousal, but that is not its’ only defining trait. Most sadists view themselves as assertive, energetic and self-reliant, but also honest, strong and realistic. Sadistic personality disorder is mainly found in males and most sadists have had a history of sexual abuse, severe neglect or significant losses throughout their childhoods. Most sadists are very high-functioning members of society, but when confronted with significant separations or losses they are more likely to let their violent sides come out and do anything from verbally assaulting someone to physical violence. While they are able to connect to people, their primary way of relating to others is by causing them pain. When they cause pain they are unable to see the emotional distresses they cause and they also lack insight into the nature of their interpersonal difficulties. They use aggression to secure dominance and want all of their victims to be intimidated and to understand that the sadists are the cause of their suffering. When sadists attack their victims they find joy in controlling them and putting them in a place where they have to resign themselves to a position of weakness.

There are several personality traits that have been found to be present in a large number of individuals with Sadistic Personality Disorder. Most commonly, individuals who possess Sadistic Personality Disorder oftentimes display meaningful cruel and aggressive behavior. Because of the personality traits that oftentimes come along with Sadistic Personality Disorder, juveniles with this disorder are at a higher risk for juvenile delinquency. In addition, studies suggest that Sadistic Personality Disorder or sadistic tendencies have been found in a large number of young adults in inpatient psychiatric care as well as in adolescents who commit sexual homicide. However, sadistic personality traits have also been found among young adults who are not in psychiatric care. Other personality traits that have been found to be linked with Sadistic Personality Disorder include a tendency to act with “unprovoked aggression” as well as feelings of guilt.

Millon’s Subtypes
Theodore Millon identified four subtypes of sadists. Any individual sadist may exhibit none, one or more than one of the following:

Explosive Sadist
•	This type of sadistic personality is known for being unpredictably violent because they are disappointed and/or frustrated with their lives. When they are feeling humiliated or hopeless, they lose control and seek revenge for the mistreatment and deprecation to which they feel subjected. These violent behaviors are revealed through tantrums, fearsome attacks on others, especially family members, and uncontrollable rage. Generally, explosive sadists will suddenly feel threatened in a certain situation and shock others with their abrupt changes. Explosive sadists do not, “move about in a surly and truculent manner” so it is impossible to know when or what will set them off. While the violence that is released is almost always directed at someone, it mainly serves as an emotional release and a way to get out all the feelings they are holding inside themselves.

Tyrannical Sadist
•	This variety of sadistic personality is one of the more frightening and cruel of the subtypes because these sadists appear to relish the act of menacing and brutalizing others; forcing their victims to cower and submit seems to provide them with a special sense of satisfaction. This subtype of SPD is somewhat similar to that of the explosive sadist, but tyrannical sadists are more methodical in their actions. These sadists are not trying to release their frustration for their own emotional gain as explosive sadists are, but instead they are looking to employ violence as an intentionally utilized instrument to inspire terror and intimidation. Another significant difference between explosive sadists and tyrannical sadists is that tyrannical sadists pick their victims very carefully making sure that their choice is not going to fight back when they are attacked. Tyrannical sadists generally have low self-esteem and inner insecurities that they are desperately trying to hide from the world, so by overwhelming others they can feel superior to the people around them.

Enforcing Sadist
•	This category of sadist is arguably comparable to military sergeants, deans of universities or cops, because they are in a position where they feel they should be the ones controlling and punishing people who have broken rules or laws. Though they are trying to act for the common interest, there is speculation that there are deeper motives than just that. These sadists search for the rule-breakers in society and they exercise the most severe punishments they are able to give out. Most enforcing sadists are employed by society so their actions aren’t thought to be unjust and they have the freedom to prevail over and destroy others. They are supposed to remain just, but their personalities are not able to put limits on the emotions that drive their sadistically vicious behaviors. The more that these sadists dominate and punish others, the more pride and power they feel so their ego increases more and more.

Spineless Sadist
•	This sort of sadist is completely opposite of the other three types, because they are deeply insecure and act like cowards. They anticipate real danger, projecting their hostile fantasies, and they strike first, hoping thereby to forestall their antagonist and ask questions later. While these sadists are fearful of many things, when they experience panic they will counteract their enemies by doing the things that they fear. Spineless sadists use aggressive hostility to send the message to others that they aren’t intimidated or fearful. This allows them to control their inner feelings and help display the exact opposite of how they actually feel. Their behavior can be described as counterphobic, which allows them to master their personal fears, but it serves to divert and impress the public by a false sense of confidence and self-assurance. Spineless sadists also seek out scapegoats to gang up on, which allows them to assault the exact things that exist within themselves that they want to deny.