Sexual sadism continues to be a diagnosis fraught with controversy concerning its reliability and validity. The current study examined the offense behavior of 39 civilly committed sexual offenders diagnosed with sexual sadism compared to a group of similarly committed individual diagnoses with Paraphilia Not Otherwise Specified (NOS)— Nonconsent. In addition, offense elements common across studies of sadism were identified. Specifically, offense behaviors including victim abduction and confinement, beating the victim during a sexual assault, and using restraints were indicative of sexual sadism across studies. In addition, this study found the use of noncontingent threats as well as gestures of mutuality to be more common among sadists. Results overall suggest that sadistic acts may be more characterized by humiliation of the victim through the exercise of power and control than by the use of violence. Differential diagnosis between Sexual Sadism and Paraphilia NOS—Nonconsent, may be aided by close inspection of offense behavior.
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