THUR, Oct 7 \ 17.00-19.00 \ Sexual Sadism

042
SEXUAL SADISM IN SEXUAL OFFENDERS

William Marshall, Ph.D., FRSC
Rockwood Psychological Services, Kingston, Ontario, Canada
bill@rockwoodpsyc.com

First, the concept of sexual sadism will be reviewed. The general body of literature reveals that most researchers either replace DSM criteria with their own, or add their own criteria to that of DSM. This produces inconsistency of diagnoses across studies making it difficult to draw general inferences.
In an attempt to understand the application of the diagnosis of sexual sadism, two studies were undertaken. The first study examined the actual clinical application of the diagnosis by comparing sexual offenders given the diagnosis by forensic psychiatrists versus those offenders assessed by these psychiatrists but deemed not to be sexual sadists. This study was followed by asking 15 internationally-renowned forensic psychiatrists to apply the diagnosis where relevant to 12 very detailed case descriptions. The results of both studies will be described and recommendations will be made for further research and for clinical practice.

043
TREATMENT AND RISK MANAGEMENT APPROACHES WITH SEXUAL SADISTS AND MURDERERS

Lawrence Ellerby, Ph.D., C. Psych
Forensic Psychological Services, Manitoba, Canada
ellerbyl@mts.net

Much of the literature on sexual sadists and murders focuses on identifying characteristics of these offenders, offender typologies and exploring the dynamics of the offending behaviour (Homes & Homes, 1996; Ressler, Burgess & Douglas, 1988). There is little information available on clinical practice with this population and, at this time, we likely do not know what constitutes best practice for addressing the treatment needs and risk factors of sexual sadists and murders. Although some identify similar treatment strategies as are used in general sexual offender treatment (Hollin, 1997), it is suggested that there are approaches and issues that are specific to this sub-group of sexual offenders. This presentation will focus on discussing lessons learned through clinical experience with sexual sadists and murders and strategies developed to facilitate risk management with this challenging and difficult client group. Issues discussed will include identifying potentially promising clinical approaches to working with sexual sadists and murders as well as a discussion of a multi-systems approach to managing these cases.

044
“SADOMASOCHISTIC" SEX CRIMES: A CONTRADICTION IN TERMS

Charles Moser, Ph.D., M.D.
Professor of Sexology, Institute for Advanced Study of Human Sexuality, San Francisco, USA
docx2@ix.netcom.com

Science requires precision and precision starts with clear and unambiguous definitions. The colloquial and professional uses of terms "sadism," "masochism," and "sadomasochism" include the description of a sexual interest, descriptions of personality types, types of sexual psychopathology (paraphilias), and an obsession or compulsion to sexually offend. This confusion is common among professionals and hinders our understanding of the differences between those who commit sex offenses and those who do not. This presentation will distinguish each of these uses of the terms and contrast the types of individuals associated with each of these meanings. The problems with the Diagnostic and Statistical Manual of the American Psychiatric Association, Fourth Edition, Text Revision, will be used to illustrate how the confusion engendered by the imprecise definitions affects our clinical judgments. How to distinguish each subtype and differences in treatment approaches to each subtype will be discussed. New terminology will be suggested.