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Sadistic personality disorder was a personality disorder diagnosis involving sadism which appeared only in an appendix of the revised third edition of the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R). The later versions of the DSM (DSM-IV, DSM-IV-TR and DSM-5) do not include it, so it is no longer considered a valid diagnostic category. Yet some still study the disorder.
Sadism is a behavioral disorder characterized by callous, vicious, manipulative, and degrading behavior expressed towards other people. To date, the exact cause of sadism is not known. However, many theories have been given to explain the possible reasons underlying the development of a sadistic personality in an individual.
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.[clarification needed] Individuals possessing sadistic personalities display recurrent cruel behavior and aggression. Sadism can also include the use of 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.[not in citation given]
Sadistic Personality Disorder is often 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.[dubious ] However, sadism has also been found in patients who do not display other forms of psychopathic disorders. One personality disorder that is often found to occur alongside sadistic personality disorder is conduct disorder, not an adult disorder but one of childhood and adolescence. In addition, anti-social and narcissistic personality disorders are sometimes found in individuals diagnosed with sadistic personality disorder. Other disorders that are also often 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 behavior. 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 as paraphilias.
Most of these theories commonly point out the fact that sadism is mainly dependent on the upbringing of an individual. Although biological and environmental aspects are also known to contribute to the development of this behavioral disorder, less evidence is available about hereditary patterns or genetic causes.
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 often have relatives who have some type of psychopathology as well.[not in citation given]
Unfavorable experiences during childhood or in early stages of sexual development are believed[who?] to be one of the major contributing factors in the development of a sadistic personality in an individual. It has also been observed that sadism or a sadistic personality can also develop in an individual through conditioning. For instance, continual connection of a particular stimulus with sexual enjoyment or of happiness with the anguish of others can cause sadism or sadomasochism.
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 possessed sadistic personality traits but were not being labeled, even though their victims were being labeled with a self-defeating personality disorder.[page needed] 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 there have been so few studies of it, since not many people have sought treatment. For the most part, SPD is found in certain groups of people like sexual offenders and serial killers, so it is not considered a helpful diagnosis. Theorists like Theodore Millon wanted to generate further study on SPD, and so proposed it to the DSM-IV Personality Disorder Work Group, who rejected it. Since it was not included in the DSM-IV or DSM-5, it has been said that dimensional models of sadism might be more appropriate than SPD.
Sexual sadism disorder is considered a paraphilia and is listed as such in DSM-5. It is defined as "recurrent and intense sexual arousal from the physical or psychological suffering of another person, as manifested by fantasies, urges, or behaviors."
Theodore Millon identified four subtypes of sadists. Any individual sadist may exhibit none, one, or more than one of the following:
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.[page needed] 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.[page needed] 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 sadists are among the more frightening and cruel of the subtypes by appearing to relish menacing and brutalizing others; forcing their victims to cower and submit seems to provide them with a special sense of satisfaction.[page needed] This subtype of SPD somewhat resembles the explosive sadist but more methodically use violence to terrorize and intimidate rather than release their frustration.[page needed] Moreover, tyrannical sadists very carefully select their victims, ensuring that their choice will not resist, and they generally have low self-esteem and insecurities that they hide from others; by overwhelming others they can feel superior to them.[page needed]
Enforcing sadists can be found among military sergeants, deans of universities, prison overseers, police officers or other authoritative functions because they are in a position where they feel they should be the ones controlling and punishing people who have broken rules, regulations, or laws. Though they believe themselves to act in the common interest, they have deeper motives: these sadists generally seek rule-breakers in their domain of authority--or in society in general--and exercise the most severe punishments. Enforcing sadists who are police or prison staff are rarely perceived to be unjust and therefore have great freedom to dominate, victimize, or destroy others at will. Their personalities cannot appropriately respond to the emotions that drive their sadistically vicious behaviors. As these sadists dominate and punish others, so increases satisfaction and power they feel, reinforcing their self-perception of righteousness and increasing their ego. This intoxication can unleash their behavior and blind them to reality, usually without attracting any negative attention because they act within their legal authority to exert power and normally behave in everyday situations.
Spineless sadists are opposite the other three by being deeply insecure and acting 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, thus allowing themselves to control their inner feelings and help display the opposite. Their behavior can be counterphobic, allowing them to master their fears, but serves to divert and impress others with a false sense of confidence and self-assurance. Spineless sadists also seek out scapegoats to gang up on, enabling themselves to assault what they want to deny in themselves.
There is renewed interest in studying sadism as a non-disordered personality trait.  Everyday sadism joins with subclinical psychopathy, narcissism, and Machiavellianism to form the so-called "Dark Tetrad" of personality.