Sadistic Personality Disorder: Signs, Traits, & Treatment

What Is Sadistic Personality Disorder?

Originally, SPD was used to describe individuals who took sexual pleasure in causing pain to others. The term was expanded, however, to include those who simply took overall satisfaction and pleasure in the suffering of others.¹  Sadists take pleasure in the infliction of physical, emotional, and psychological pain and intentionally cause harm in order to give themselves personal satisfaction.

Sadistic Personality Traits

The ways in which an individual exhibits traits of SPD can vary, but the primary focus of their behavior is to cause suffering for others or to be in a place to witness others’ suffering.

Common traits of SPD include:

• Hostility: Feelings of negativity, ill will, or aggression towards others.
• Lack of empathy: While most people identify with others’ pain and seek to alleviate it, sadistic individuals take pleasure in others’ suffering.
• Inability to feel remorse: Guilt about wrongdoing is experienced by the majority of people, but sadists do not feel guilty or regret for the harm they cause.
• Viciousness: Sadists go for the jugular when given the chance. They don’t hold back in their criticism, sarcasm, or physical attacks on others even when given the chance or encouraged to do so by others around them.
• Fascination with violence: Sadists revel in playing video games that allow them to physically harm others and enjoy violence in movies, sports, and media much more than the average person does.
• Lack of responsibility: Sadists do not take responsibility for the harm that they bring to others.

Sensitivity to Criticism & Vulnerability

Individuals with SPD are extremely sensitive to criticism from others. For them, holding power over others or controlling others is their primary motivation. When they receive criticism, it takes away the power they need. Being vulnerable with others is also avoided as they believe that revealing intimate pieces of information or their feelings is tantamount to yielding power to another.

Their need for control keeps them from allowing anyone to truly get close to them. For them, control and power are the drivers behind their rigid personal boundaries. If someone tries to get too close, they may use force to ensure that person is kept in their place. Using force and violence to maintain their boundaries doesn’t cause them guilt, only pleasure at the opportunity to do so.

Signs & Symptoms of Sadistic Personality Disorder

The most defining characteristic of a sadistic person is the pleasure they take in others’ pain. One manifestation of this is “everyday sadism,” seen in subclinical sadists who engage in behaviors like trolling or bullying. While there are differences in severity, some signs of everyday sadism overlap with those of Sadistic Personality Disorder.

Traits of SPD typically emerge in adolescence or early adulthood, though signs may appear earlier. While many are horrified by extreme cases of sadism, sadistic individuals often take pleasure in such stories, reflecting their enjoyment of others’ suffering.

Common warning signs of a sadistic personality include:

• Harming animals or others: Intentionally causing pain or distress to another living creature.
• Fascination with violence or death: An obsession with violent crimes or individuals who commit them.
• Inappropriate humor: Laughing at others’ pain or humiliation, viewing it as a source of amusement.
• Looking for reasons to harm others: Sadists go out of their way and will invest energy into the opportunity to inflict pain.⁵
• Lacking affective empathy: Empathy implies feeling another person’s feelings in such a way as to identify with those feelings. Those with SPS may recognize how another person feels, but when they recognize suffering, they feel a sense of pleasure rather than pain.
• Lacking concern for others’ welfare: Altruism is considered a survival mechanism in that by helping others, we are increasing the likelihood that others will help us when we need it. Sadists do not have the drive to invest in another’s welfare and do not show the desire to help others in need.
• Mocking the weak: Taking pleasure in the vulnerability or weakness of others, often as a means of asserting control.
• Watching and sharing violent content: Deriving enjoyment from videos of others being harmed, and sharing such content with others.
• Encouraging others to hurt people: Motivating others to engage in causing emotional or physical harm to others.

Diagnosis Criteria of Sadistic Personality Disorder

Sadistic Personality Disorder (SPD) was last included in the DSM in its DSM-III-R edition.⁴ The traits used to diagnose SPD differed from those of other personality disorders characterized by cruelty and aggression. Clinically significant sadistic behaviors typically emerge by early adulthood, marking the onset of this disorder’s patterns of conduct.

An SPD diagnosis requires a consistent pattern of at least four of the following behaviors:

• Uses physical cruelty and/or violence to dominate others
• Intentionally humiliates or demeans others publicly
• Exerts extreme discipline for others under their control
• Finds pleasure from witnessing pain of others, both humans and animals
• Uses lies to inflict pain on others
• Intimidates and frightens others to get them to do what they want them to do
• Limits others’ autonomy through the exertion of extreme control
• Experiences fascination and an obsession with physical harm/violence

Possible Causes of Sadistic Personality Disorder

There is no single cause for Sadistic Personality Disorder, but several factors are believed to contribute. Traumatic or disruptive events during a child’s formative years, such as abusive caregiving, exposure to violence, or experiences of extreme humiliation, may play a significant role in the development of sadistic traits. Additionally, genetic or neurobiological factors might influence the way these behaviors manifest.

Sadistic Personality Disorder may be caused by:

• Abusive caregivers: When children are abused by those they depend on for care, it can create confusion, leading some to equate abuse and humiliation with a sense of connection.
• Physical abuse by others: Experiencing physical abuse is a strong predictor of sadistic behavior.⁶ As children recognize that inflicting pain gives power to the abuser, they may later use violence as a way to regain lost power.
• Exposure to violence: Children who are exposed to violence may learn to derive pleasure from others’ pain, modeling such behaviors as a means of gaining power or pleasure. Social learning can be a powerful tool and when children are learning that pain leads to someone else’s pleasure, they may model their own behavior on that.
• Neurochemical disruption in the brain: The brain’s chemistry may be altered in a way that rewards sadistic behaviors, causing individuals to feel pleasure when witnessing suffering.
• Engagement in vicarious violence: Participation in violent video games or witnessing acts of violence can condition children to associate pleasure with power, further reinforcing sadistic tendencies.
• Extreme poverty: Children who experience extreme scarcities in adequate food or other resources may internalize humiliation, leading them to assert power and take pleasure in others’ suffering as they felt others did with them.
• Frequent personal failures: A lack of self-efficacy or failure to achieve personal goals can lead to sadistic behavior as individuals attempt to gain power through the humiliation or pain of others.
• Being bullied: Children who are bullied may develop a need to inflict pain on others as a way to regain power, using torment as a coping mechanism for their own past suffering. By inflicting hurt on others, they feel that this will give them the power that they lacked when they were younger.

Differentiation From Other Disorders

Sadistic Personality Disorder  shares several traits with other personality disorders, particularly those characterized by power-seeking and manipulative behaviors. Like many personality disorders, SPD involves persistent patterns of behavior that disrupt societal norms and interpersonal relationships. However, the key distinction of SPD lies in the emotional satisfaction derived from causing pain to others, a trait that differentiates it from other disorders.

Antisocial Personality Disorder

The key traits of Antisocial Personality Disorder (APD) involve a willingness to exploit others for personal gain, a lack of remorse, an inability to manage anger, and a disregard for social norms. Individuals with APD often have a history of behavioral issues, particularly conduct problems from childhood or adolescence, which is not necessarily true for those with SPD. While individuals with SPD may also exploit others and show no regret for the pain they cause, the primary motivation for those with SPD is to derive satisfaction from the suffering of others, rather than exploiting others for material gain.¹

Sexual Sadism Disorder

Sexual Sadism Disorder (SSD) shares similarities with SPD in that both disorders involve deriving pleasure from inflicting pain on others. However, SSD is driven by the desire to fulfill sexual needs, whereas SPD is primarily motivated by a general sense of power and emotional gratification. While both involve harming others for satisfaction, the focus of SSD is on sexual gratification through harm, while for SPD, the pleasure comes from emotional control and causing suffering.

Sadistic Personality Disorder Treatment

Treating any personality disorder presents significant challenges, particularly because individuals with these conditions often do not recognize the need for treatment. For those with SPD, the most difficult aspect is convincing them that they need help, as their satisfaction comes from causing others pain. Motivation for seeking treatment may arise from external factors, such as legal trouble or relationship loss, but a person with SPD may still resist treatment or find pleasure in being noncompliant.

Proper diagnosis is essential for determining the most effective treatment plan, as SPD shares features with other disorders like Antisocial Personality Disorder (APD) and Sexual Sadism Disorder (SSD). Once SPD is identified, treatment typically involves a combination of psychotropic medications and long-term psychotherapy.

Psychotherapy

Common treatments for Sadistic Personality Disorder include:

• Behavior Therapy (BT): This therapy helps individuals recognize how their sadistic behaviors harm others and guides them in reshaping these patterns.
• Cognitive Behavioral Therapy:  Cognitive behavioral therapy (CBT) encourages individuals to explore the connection between their thoughts and actions, aiming to change maladaptive thinking and promote healthier responses to external events.
• Dialectical Behavioral Therapy (DBT): Dialectical behavior therapy (DBT) is effective for those with SPD by focusing on mindfulness and teaching emotional regulation skills.

While there are ways that therapy can support changes in thought patterns and behavior, clients must be willing to stick with the treatment protocol and follow through on homework assignments and practice sessions as they learn the necessary skills to reduce their sadistic behaviors.

In regard to empathy and those with SPD, it is important to bear in mind that while sadistic people do not care about others’ feelings, they do cognitively recognize them. Psychotherapy may help these individuals learn to respond to another’s suffering with concern and care rather than pleasure.

Medications

Due to the lack of knowledge about the specific cause of SPD, there is not one specific psychopharmacological treatment that works to cure it. Taking medications that help with depression may have some efficacy for individuals with SPD who also have symptoms of depression; the same is true of medications designed to minimize anxiety. When individuals with SPD are better able to manage anxiety or stress, this may help minimize the disruption caused by the disorder.

How to Find Professional Help

If you or someone you know exhibits symptoms of SPD, finding effective assistance can be of great benefit. Speaking to your medical doctor for a referral to someone who specializes in personality disorders is one avenue in seeking professional help. You might want to explore an online therapist directory where you can search for specializations and treatment modalities, or work with an online psychiatrist for diagnosis and medication management.

Make sure you know what’s important when finding a therapist when you begin your search. In addition, you will want to review your healthcare policy so that you are aware of the coverage regarding therapy platforms that accept your insurance; some practitioners provide sliding scales to those who have limited or no mental healthcare coverage.

In My Experience

In my experience, awareness of a personality disorder is the first step to improving one’s outcome. Unfortunately, the presence of everyday sadism seems more visible now that individuals can express their sadistic tendencies through increasingly violent video games, online sharing of sadistic acts, and other avenues. Recognizing when your own thoughts or feelings in response to another’s suffering are reflecting your own pleasure in another’s pain is important and a key to addressing these feelings before they lead to more dangerous behaviors. Cognitive behavioral therapy and dialectical behavior therapy are both effective treatments in changing response to unsettling or triggering events. By seeking help, or encouraging someone to seek help, when sadistic impulses first become a problem is the best way to ensure that treatment is successful.