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Sadistic personality disorder
Illustration showing the pleasure that sadistic people often have from hurting someone
Specialty	Psychiatry, clinical psychology
Symptoms	Cruelty, manipulation using fear, preoccupation with violence
Complications	Substance use disorder, marital, occupational and legal difficulties
Usual onset	Adolescence
Causes	Unclear
Risk factors	Childhood abuse
Diagnostic method	Based on symptoms
Differential diagnosis	Antisocial personality disorder and Sexual sadism disorder

Sadistic personality disorder is an obsolete term for a proposed personality disorder defined by a pervasive pattern of sadistic and cruel behavior. People who fitted this diagnosis were thought to have a desire to control others and to have accomplished this through use of physical or emotional violence. The diagnosis proposal appeared in the appendix of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R),^[1] however it was never put to use in clinical settings and later versions of the DSM (DSM-IV, DSM-IV-TR, and DSM-5) had it removed. Among other reasons, psychiatrists believed it would be used to legally excuse sadistic behavior.

Sadistic personality disorder was thought to have been frequently comorbid with other personality disorders, primarily other types of psychopathological disorders.^[2] In contrast, sadism has also been found in patients who do not display any or other forms of psychopathic disorders.^[3] Conduct disorder in childhood, and Alcohol use disorder were thought to have been frequently comorbid with Sadistic personality disorder.^[2][4] Researchers had difficulty distinguishing sadistic personality disorder from the other personality disorders due to high levels of comorbidity, hence another reason why it was eventually removed.^[2]

According to the DSM-III-R, the diagnostic criteria were defined by a pervasive pattern of sadistic and cruel behavior that began in early adulthood. It was defined by four of the following.

• Has used physical cruelty or violence for the purpose of establishing dominance in a relationship (not merely to achieve some noninterpersonal goal, such as striking someone in order to rob him/her).
• Humiliates or demeans people in the presence of others.
• Has treated or disciplined someone under his/her control unusually harshly.
• Is amused by, or takes pleasure in, the psychological or physical suffering of others (including animals).
• Has lied for the purpose of harming or inflicting pain on others (not merely to achieve some other goal).
• Gets other people to do what he/she wants by frightening them (through intimidation or even terror).
• Restricts the autonomy of people with whom he or she has a close relationship, e.g., will not let spouse leave the house unaccompanied or permit teenage daughter to attend social functions.
• Is fascinated by violence, weapons, injury, or torture.

This behavior couldn’t have been better explained by sexual sadism disorder and it had to have been directed towards more than one person.^[5]: 371

Theodore Millon claimed there were four subtypes of sadism, which he termed enforcing sadism, explosive sadism, spineless sadism, and tyrannical sadism.^{[6][7][8][9][10]}

Sadistic personality disorder was developed as forensic psychiatrists had noticed many patients with sadistic behavior. It was introduced 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.^[11] It was removed from the DSM for numerous reasons, including the fact it could be used to legally excuse sadistic acts. Sadistic personality disorder also shared a high rate of comorbidity with other disorders, implying that it was not a distinct disorder on its own.^[12][13] Millon writes that "Physically abusive, sadistic personalities are most often male, and it was felt that any such diagnosis might have the paradoxical effect of legally excusing cruel behavior."^[14] Researchers were also concerned about the stigmatizing nature of the disorder, and that it put patients at higher risk of abuse from prison guards.^[15][16] 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.^[6]

There is renewed interest in studying sadism as a personality trait.^[17][18] Sadism joins with subclinical psychopathy, narcissism, and Machiavellianism to form the so-called "dark tetrad’ of personality.^[17][19]

• Antisocial personality disorder, a personality disorder characterized by a long term pattern of disregard for, or violation of, the rights of others
• Bullying
• Evil Genes
• Malignant narcissism
• Psychopathy
• Sadism and masochism
• Schadenfreude
• Self-defeating personality disorder (masochistic personality disorder)
• Sexual sadism disorder
• Zoosadism
• Sociopathy

• Blaney, P. H., Millon, T. (2009). Oxford Textbook of Psychopathology. New York: Oxford University Press.
• Davis, R., Millon, T. (2000). Personality Disorders in Modern Life. Canada: John Wiley & Sons, Inc.
• Livesley, J. (1995). The DSM-IV Personality Disorders. New York, NY: Guilford Press.
• Million, T. (1996). Disorders of Personality DSM-IV and Beyond. New York: Wiley-Interscience Publication.
• Myers W.C.; Burket R.C.; Husted D.S. (2006). "Sadistic personality disorder and comorbid mental illness in adolescent psychiatric inpatients". Journal of the American Academy of Psychiatry and the Law Online. 34 (1): 61–71. PMID 16585236. Archived from the original on 2013-04-15.
• Pacana, G. (2011, March 2). Sadists and sadistic personality disorder.
• Reich J (1992). "Prevalence and characteristics of sadistic personality disorder in an outpatient veterans population". Psychiatry Research. 48 (3): 267–276. doi:10.1016/0165-1781(93)90077-t. PMID 8272448. S2CID 24066628.

• "Provisional Psychological Profile of Washington, D.C.-Area Sniper" provides some theoretical descriptions of the sadistic personality, which, in addition to being a "white man", were traits concluded by the author to describe the D.C. sniper attacks shooter.