“Sexual Sadism: Avoiding Its Misuse in Sexually Violent Predator Evaluations”

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), Task Force has recently rejected the proposal to include coercive paraphilia as an official diagnosis, reaffirming that rape is a crime and not a mental disorder. [wow.rly] We hope this will discourage what has been the inappropriate practice of giving rapists the made-up diagnosis of paraphilia, NOS, nonconsent, to facilitate their psychiatric commitment under sexually violent predator (SVP) statutes. Losing the paraphilia, NOS, option has tempted some SVP evaluators to overdiagnose sexual sadism, which is an official DSM mental disorder. (…) Rape and sexual sadism have in common violence, cruelty, and a callous indifference on the part of the perpetrator to the suffering of the victim, but they differ markedly in motivation. Rapists use violence to enforce the victim’s cooperation, to express aggression, or both. In contrast, in sexual sadism, the violence, domination, and infliction of pain and humiliation are a preferred or necessary precondition for sexual arousal. Only a small proportion of rapists qualify for the diagnosis of sexual sadism.  

"Discourage an inappropriate practice"…?  Is that what we now call misdiagnosis and ethics violations by state licensed clinicians?  B/c  general pop some clinicians NOS, still need criteria spelled out and clarified. Of course, does that even matter since the “tempting” motivation (speaking of) is to curtail the diagnosis to make it fit the jurisdictional standards of psychiatric commitment.  Who runs this monkey clown show anyway? S’great.

Sexual Sadism: Avoiding Its Misuse in Sexually Violent Predator Evaluations

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), Task Force has recently rejected the proposal to include coercive paraphilia as an official diagnosis, reaffirming that rape is a crime and not a mental disorder. [wow.rly] We hope this will discourage what has been the inappropriate practice of giving rapists the made-up diagnosis of paraphilia, NOS, nonconsent, to facilitate their psychiatric commitment under sexually violent predator (SVP) statutes. Losing the paraphilia, NOS, option has tempted some SVP evaluators to overdiagnose sexual sadism, which is an official DSM mental disorder. (…) Rape and sexual sadism have in common violence, cruelty, and a callous indifference on the part of the perpetrator to the suffering of the victim, but they differ markedly in motivation. Rapists use violence to enforce the victim’s cooperation, to express aggression, or both. In contrast, in sexual sadism, the violence, domination, and infliction of pain and humiliation are a preferred or necessary precondition for sexual arousal. Only a small proportion of rapists qualify for the diagnosis of sexual sadism.  

"Discourage an inappropriate practice"…?  Is that what we now call misdiagnosis and ethics violations by state licensed clinicians?  B/c  general pop some clinicians NOS, still need criteria spelled out and clarified. Of course, does that even matter since the “tempting” motivation (speaking of) is to curtail the diagnosis to make it fit the jurisdictional standards of psychiatric commitment.  Who runs this monkey clown show anyway? S’great.

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