August 12, 2010

Sexual sadism diagnosis not predictive

In another blow to the controverial sexual paraphilia diagnoses, a group of prominent researchers has found that the diagnosis of sexual sadism is not related to sex offender recidivism. Unlike some of the made-up paraphilias being used in court to justify civil commitment of sex offenders, sexual sadism is actually listed in the American Psychiatric Association's current Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), and it is planned for inclusion in the upcoming fifth edition as well.

The longitudinal study followed almost 600 convicted sex offenders for up to 20 years. The researchers found that a sexual sadism diagnosis did not predict any type of recidivism. This was in contrast to sexual arousal to violence as measured phallometrically, which was associated with future violence, including sexual violence.

The study replicates and extends what the authors call "accumulating evidence of specific problems with the reliability of paraphilia diagnoses, including sexual sadism."
[O]ur results raise questions about the clinical utility of the DSM diagnosis of sexual sadism. This appears to be a problem for other paraphilia diagnoses as well [including pedophilia].
The findings are relevant to the upcoming fifth edition of the DSM, the authors note, because the proposed criteria for sexual sadism are "very similar" to the criteria in current and previous editions.

The study, "Comparing indicators of sexual sadism as predictors of recidivism among adult male sexual offenders," by Drew Kingston, Michael Seto, Philip Firestone, and John Bradford, appears in the Journal of Consulting and Clinical Psychology.

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