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Bennett T. The Marginalization of Kink: Kinkphobia, Vanilla-Normativity and Kink-Normativity. JOURNAL OF HOMOSEXUALITY 2024:1-21. [PMID: 39028679 DOI: 10.1080/00918369.2024.2381520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/21/2024]
Abstract
A recent wave of academic research has highlighted the wide-ranging and negative impacts that stigma against kink has on kinksters. As scholarship continues to explore prejudice and discrimination around kink, this article argues that fresh insight can be found by drawing on adjacent work around other stigmatized sexualities. Over the previous decades, scholars in sexuality studies and queer studies have developed a powerful conceptual framework of "phobias" and "normativities" for thinking about the marginalization of sexual differences. This framework has its origins in the concepts of homophobia, heteronormativity and homonormativity, but its naming conventions and analytical insights have since been extended to address reproduction, romantic love, monogamy, gender identity, etc. This article argues that this conceptual framework should be expanded once again, this time to encompass kink. Building on the nascent use of this conceptual framework within kink scholarship, this article defines and expands on the concepts of kinkphobia and vanilla-normativity, and introduces the new concept of kink-normativity. This article demonstrates how these concepts can help us better talk about and think through the marginalization of kink.
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Affiliation(s)
- Theodore Bennett
- Sexology, School of Population Health, Curtin University, Perth, Western Australia, Australia
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Liang W, Zhang Y. The correlation between sadomasochists' experience and their sadomasochistic behaviors and fantasies: A qualitative analysis of interviews. Psych J 2024; 13:295-321. [PMID: 38105564 PMCID: PMC10990812 DOI: 10.1002/pchj.706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 09/29/2023] [Indexed: 12/19/2023]
Abstract
Lacking a comprehensive understanding of sadomasochism makes difficulties in judicial dispositions, clinical interventions, and mental health services. This study explores the correlation between sadomasochists' growth experience and their sadomasochistic behaviors and fantasies. We interviewed 51 sadomasochists from a Chinese subcultural website, coded and analyzed the interview records, conducted correlation and cluster analyses on the reference points of the nodes of impressive experience and sadomasochistic behaviors and fantasies, and constructed the model of Experience-Behaviors and Fantasies. We found that sadomasochists' typical impressive experiences are family parenting and sexual experience; sadomasochistic behaviors and fantasies can be classified into five categories: spirit, punishment, sex, canine, and excretion; and sadomasochistic behaviors and fantasies are partially correlated with sadomasochists' impressive experiences, indicating psychoanalytic theory is the leading theory for the driving processes of sadomasochism, while behaviorist and Gestalt theories also contribute.
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Affiliation(s)
- Wanying Liang
- Key Laboratory of Mental HealthInstitute of Psychology, Chinese Academy of SciencesBeijingChina
- Department of PsychologyUniversity of Chinese Academy of SciencesBeijingChina
| | - Yuqing Zhang
- Key Laboratory of Mental HealthInstitute of Psychology, Chinese Academy of SciencesBeijingChina
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Schuerwegen A, Huys W, Wuyts E, Goethals K, Coppens V, Davis JM, Tarleton HL, Sagarin BJ, Morrens M. BDSM in North America, Europe, and Oceania: A Large-Scale International Survey Gauging BDSM Interests and Activities. JOURNAL OF SEX RESEARCH 2023:1-11. [PMID: 37647344 DOI: 10.1080/00224499.2023.2241451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
BDSM bondage and discipline, dominance and submission, and sadism and masochism is a widespread and highly prevalent yet stigmatized practice of intimacy and sexuality. In recent years, international interest in BDSM research has grown, mainly resulting in prevalence studies in various countries. To date, however, no research has investigated international and intercontinental differences in the nature of BDSM interests and fantasies, BDSM roles and practicing contexts among BDSM practitioners. In order to explore international discrepancies in BDSM identity, fantasies, and activities among self-identified BDSM practitioners, a group of FetLife (a social network website for BDSM and kink interested individuals) members (N = 1,112) originating from North America (n = 458), Europe (n = 566), Oceania (n = 46), and Other (n = 42) completed the survey. Europeans reported an earlier age of onset of fantasizing about BDSM than did North Americans. More North Americans indicated practicing BDSM in a public context than did Europeans and Oceanians. These differences could in part be explained by different cultural backgrounds, higher levels of religiosity, and current stigmas toward non-traditional sexual interests. Future research should focus on clarifying whether cultural mechanisms underlie these dissimilarities.
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Affiliation(s)
- Alana Schuerwegen
- University Forensic Centre, Department of Psychiatry, Antwerp University Hospital
| | - Wim Huys
- University Forensic Centre, Department of Psychiatry, Antwerp University Hospital
- Collaborative Antwerp Psychiatric Research Institute, Faculty of Medicine and Health Sciences, University of Antwerp
| | - Elise Wuyts
- Collaborative Antwerp Psychiatric Research Institute, Faculty of Medicine and Health Sciences, University of Antwerp
| | - Kris Goethals
- University Forensic Centre, Department of Psychiatry, Antwerp University Hospital
- Collaborative Antwerp Psychiatric Research Institute, Faculty of Medicine and Health Sciences, University of Antwerp
| | - Violette Coppens
- Collaborative Antwerp Psychiatric Research Institute, Faculty of Medicine and Health Sciences, University of Antwerp
- Scientific Initiative for Neuropsychiatric and Psychopharmacolgical Studies, University Psychiatric Centre Duffel
| | | | | | | | - Manuel Morrens
- Collaborative Antwerp Psychiatric Research Institute, Faculty of Medicine and Health Sciences, University of Antwerp
- Scientific Initiative for Neuropsychiatric and Psychopharmacolgical Studies, University Psychiatric Centre Duffel
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Brown A, Barker ED, Rahman Q. Psychological and Developmental Correlates of Paraphilic and Normophilic Sexual Interests. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2023; 35:428-464. [PMID: 36063449 DOI: 10.1177/10790632221120013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
The classification of sexual fantasies and behaviors (here referred to as 'sexual interests') has historically been divided into 'paraphilic' and 'normophilic'. However, studies on paraphilic interests are often limited to clinical or forensic samples and normophilic interests are rarely assessed in tandem. Previous research has found mixed results for psychological and other correlates of sexual interests, potentially due to inconsistency in operationalism and measurement of fantasies and behaviors. The aim of the current study was to quantify correlates of sexual interests via the Sexual Fantasies and Behaviors Inventory, containing factors related to general fantasies/behaviors, normophilia, power dynamics, sadomasochism, and courtship paraphilias, using a large (N = 4280) non-clinical sample. Psychological, developmental, sexual, and demographic correlates were investigated via bivariate correlations, mean difference testing, and multiple regression. Sexual interest domains were largely unrelated to psychopathology and developmental factors. Sociosexuality and more accepting attitudes towards sadomasochism was generally related to more arousal to/engagement in normophilic and paraphilic domains. More autism spectrum disorder traits were related to decreased normophilic interests. Psychopathic traits, sexual sensation seeking, and sexual compulsivity were related to paraphilia dimensions, especially courtship paraphilias and domination/sadism; the former was also associated with negative attitudes about establishing consent. Men, non-monogamous, and non-heterosexual participants indicated greater sexual fantasies and behaviors compared to women (except in the case of submission and masochism), monogamous, and heterosexual participants, respectively.
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Affiliation(s)
- Ashley Brown
- Psychology Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Edward D Barker
- Psychology Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Qazi Rahman
- Psychology Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
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Paarnio M, Sandman N, Källström M, Johansson A, Jern P. The Prevalence of BDSM in Finland and the Association between BDSM Interest and Personality Traits. JOURNAL OF SEX RESEARCH 2023; 60:443-451. [PMID: 34994669 DOI: 10.1080/00224499.2021.2015745] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
According to previous research, interest in BDSM (Bondage-Discipline, Dominance-Submission and Sadomasochism) activities is high in several European countries and various BDSM practices are not uncommon. There is a limited amount of research on the personalities of BDSM practitioners, but in previous research practitioners have been found to have better overall well-being and to be more educated than the general population. The current study explored the prevalence of BDSM interest and practice in a Finnish sample (n = 8,137, age range 18-60, M = 30.14, SD = 8.08) and investigated the association between BDSM interest and personality measured with the six-factor personality measure HEXACO. A total of 38% of the sample was interested in BDSM sex and non-heterosexual individuals displayed almost twice as much interest and at most 83% more participation in BDSM than heterosexual individuals. Younger participants (18-28 years old) displayed almost three times as much interest than older participants. There were some associations between BDSM interest and personality factors, but the effect sizes of these associations were modest. The study shows that BDSM interest is quite common among the Finnish population.
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Affiliation(s)
- Markus Paarnio
- Department of Psychology and Speech-language Pathology, University of Turku
- Department of Psychology, University of Jyväskylä, Finland
| | - Nils Sandman
- Department of Psychology and Speech-language Pathology, University of Turku
| | - Marianne Källström
- Department of Psychology, Faculty of Arts, Psychology and Theology, Åbo Akademi University
| | - Ada Johansson
- Department of Psychology, Faculty of Arts, Psychology and Theology, Åbo Akademi University
| | - Patrick Jern
- Department of Psychology, Faculty of Arts, Psychology and Theology, Åbo Akademi University
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Current biopsychosocial science on understanding kink. Curr Opin Psychol 2022; 48:101473. [PMID: 36274435 DOI: 10.1016/j.copsyc.2022.101473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/19/2022] [Accepted: 09/21/2022] [Indexed: 01/28/2023]
Abstract
The field of kink (or BDSM) studies has grown significantly in recent years, with several areas of study being initiated. This paper summarizes the current state of kink research, including prevalence rates; marginalization and stigma; key biological, psychological, and social research findings; clinical issues; and recommendations for further research. Theoretical frameworks, such as minority stress, serious leisure, sexual orientation, personal growth, and sensation-seeking theories appear to be useful frameworks outside of approaches that assume psychopathology as an etiological factor. Studies find the following results: higher levels of sensation-seeking; kink activities generating states of flow and transient hypofrontality; notable levels of gender, sexual orientation, and relationship style diversity in kink samples; and higher levels of minority stress-related suicidality.
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Brown SL, Seymour NE, Mitchell SM, Moscardini EH, Roush JF, Tucker RP, Cukrowicz KC. Interpersonal Risk Factors, Sexual and Gender Minority Status, and Suicidal Ideation: Is BDSM Disclosure Protective? ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:1091-1101. [PMID: 35044597 PMCID: PMC8891054 DOI: 10.1007/s10508-021-02186-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 10/08/2021] [Accepted: 10/09/2021] [Indexed: 06/14/2023]
Abstract
Suicidal ideation is elevated among individuals who engage in BDSM practices and those with sexual and gender minority (SGM) identities. There is limited research on the intersectionality of these identities and how they relate to suicidal ideation, especially within a theoretical framework of suicide risk, such as the interpersonal theory of suicide. Thus, we tested the indirect relation between BDSM disclosure and suicidal ideation through thwarted belongingness and perceived burdensomeness, as well as the moderating role of SGM identity on these indirect associations. Participants were 125 (Mage = 28.27 years; 64% cisgender men) individuals recruited via online BDSM-related forums who endorsed BDSM involvement and recent suicidal ideation. Results indicated significant moderated mediation, such that BDSM disclosure was indirectly negatively related to suicidal ideation through lower thwarted belongingness, but not perceived burdensomeness, among SGM individuals. This was due to the significant relation between BDSM disclosure and thwarted belongingness. There were no significant moderated mediation or indirect effects related to perceived burdensomeness. We also provide supplemental analyses with positive ideation (i.e., positive thoughts toward life) as the criterion variable. In conclusion, BDSM disclosure appears to be protective against suicidal ideation through thwarted belongingness but only for SGM individuals. This work furthers our understanding of the impact of intersecting marginalized identities on suicide risk and resilience. Implications, limitations, and future directions are further discussed.
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Affiliation(s)
- Sarah L Brown
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychological Sciences, Texas Tech University, Mail Stop 2051, Lubbock, TX, 79409-2051, USA
| | - Nicole E Seymour
- Department of Psychological Sciences, Texas Tech University, Mail Stop 2051, Lubbock, TX, 79409-2051, USA
| | - Sean M Mitchell
- Department of Psychological Sciences, Texas Tech University, Mail Stop 2051, Lubbock, TX, 79409-2051, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Emma H Moscardini
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Jared F Roush
- VA Long Beach Healthcare System, Long Beach, CA, USA
| | - Raymond P Tucker
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Kelly C Cukrowicz
- Department of Psychological Sciences, Texas Tech University, Mail Stop 2051, Lubbock, TX, 79409-2051, USA.
- School of Veterinary Medicine, Texas Tech University, Texas Tech University, Amarillo, TX, USA.
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Brown A, Barker ED, Rahman Q. A Systematic Scoping Review of the Prevalence, Etiological, Psychological, and Interpersonal Factors Associated with BDSM. JOURNAL OF SEX RESEARCH 2020; 57:781-811. [PMID: 31617765 DOI: 10.1080/00224499.2019.1665619] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
BDSM (bondage, discipline, dominance, submission, and sadomasochism) encompasses a diverse set of sexual interests. Research interests in BDSM have been historically underpinned by examining potential mental health issues, unhealthy fixations on specific sexual behaviors, and/or the presence of childhood trauma, as is predicted by psychopathological and psychoanalytic models. The objective of this scoping review was to provide an overview of the current landscape of BDSM research, including incidence rates, evidence for psychopathological, psychoanalytical, biological, and social etiological factors, demographics of BDSM practitioners, and the psychological correlates of those with BDSM interests. After the literature search and screening process, 60 articles were included. BDSM related fantasies were found to be common (40-70%) in both males and females, while about 20% reported engaging in BDSM. Results show little support for psychopathologic or psychoanalytic models. In the selected samples studied, BDSM practitioners appear to be white, well educated, young, and do not show higher rates of mental health or relationship problems. Research supports BDSM being used as a broadening of sexual interests and behaviors instead of a fixation on a specific interest. Future empirical research should focus on non-pathological models of BDSM, discrimination of BDSM practitioners, interpersonal relationships, and biological factors.
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Affiliation(s)
- Ashley Brown
- Psychology Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London
| | - Edward D Barker
- Psychology Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London
| | - Qazi Rahman
- Psychology Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London
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Preferences in Information Processing, Marginalized Identity, and Non-Monogamy: Understanding Factors in Suicide-Related Behavior among Members of the Alternative Sexuality Community. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093233. [PMID: 32384717 PMCID: PMC7246640 DOI: 10.3390/ijerph17093233] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 04/29/2020] [Accepted: 05/02/2020] [Indexed: 02/07/2023]
Abstract
Suicide-related behavior (SRB) is a mental health disparity experienced by the alternative sexuality community. We assessed mental health, relationship orientation, marginalized identities (i.e., sexual orientation minority, gender minority, racial minority, ethnic minority, and lower education), and preferences in information processing (PIP) as factors differentiating lifetime SRB groups. An online cross-sectional survey study was conducted in 2018. Members of the National Coalition for Sexual Freedom (NCSF; n = 334) took part. Bivariate analyses identified the following SRB risk factors: female and transgender/gender non-binary identity, sexual orientation minority identity, lower education, suicide attempt/death exposure, Need for Affect (NFA) Avoidance, depression, and anxiety. Monogamous relationship orientation was a protective factor. Multi-nomial regression revealed the following: (1) monogamous relationship orientation was a protective factor for suicidal ideation and attempt; (2) lower education was a risk factor for suicide attempt; (3) anxiety was a risk factor for suicide attempt; and (4) depression was a risk factor for suicidal ideation. A two-way interaction showed that elevated NFA Approach buffered the negative impacts of depression. Relationship orientation, several marginalized identities (i.e., based on gender, sexual orientation, and educational level), and PIP all contributed uniquely to SRB. Further study is necessary to understand the role of relationship orientation with suicide. Health education and suicide prevention efforts with NCSF should be tailored to account for marginalized identity, mental health, and NFA factors.
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Coppens V, Ten Brink S, Huys W, Fransen E, Morrens M. A Survey on BDSM-related Activities: BDSM Experience Correlates with Age of First Exposure, Interest Profile, and Role Identity. JOURNAL OF SEX RESEARCH 2020; 57:129-136. [PMID: 30676097 DOI: 10.1080/00224499.2018.1558437] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BDSM is an omnibus term covering a spectrum of activities within bondage/discipline, dominance/submission, and sadism/masochism relationships. To date, BDSM practitioners experience stigma due to a general unfamiliarity with the practice and marginalization of this type of sexual behavior. Destigmatization occurs partly through knowledge expansion and identification with the stigmatized group. In this study within the Belgian population, we aimed to characterize certain aspects of socioeconomic status and specific BDSM preferences of individuals with differing BDSM experience levels. We show that individuals who perform BDSM in a community setting (BDSM clubs, events. BDSM-CP) are generally higher educated, are significantly younger when first becoming aware of their inclination toward kink-oriented sex, and have a more strict BDSM role identity (Dom vs. Sub) than individuals who engage in BDSM-related activities in a private setting (BDSM-PP). This latter group in turn display a more pronounced Dom/Sub identification than individuals who only fantasize about the practice (BDSM-F). Our data indicate BDSM interest is a sexual preference already manifesting at early age, with role identification profiles becoming gradually more pronounced based on the practitioner's contextual experience.
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Affiliation(s)
- V Coppens
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp
- University of Antwerp University Department of Psychiatry
| | - S Ten Brink
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp
| | - W Huys
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp
- University of Antwerp University Department of Psychiatry
| | - E Fransen
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp
| | - M Morrens
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp
- University of Antwerp University Department of Psychiatry
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De Neef N, Coppens V, Huys W, Morrens M. Bondage-Discipline, Dominance-Submission and Sadomasochism (BDSM) From an Integrative Biopsychosocial Perspective: A Systematic Review. Sex Med 2019; 7:129-144. [PMID: 30956128 PMCID: PMC6525106 DOI: 10.1016/j.esxm.2019.02.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 01/25/2019] [Accepted: 02/03/2019] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION BDSM (bondage and discipline, dominance and submission, and sadism and masochism) increasingly receives attention from the scientific community. Where earlier research efforts mainly focused on epidemiologic characteristics, psychological and biologic factors driving BDSM preferences have recently gained interest as well. AIM To bring together all the existing scientific literature on BDSM from a biopsychosocial perspective. METHODS Based on the PRISMA guidelines, the current systematic review brings together all the existing literature on BDSM from a biopsychosocial perspective. MAIN OUTCOME MEASURE Prevalence rates of BDSM interests were investigated in the literature, as well as the associations between BDSM interests on one hand and personality traits, adverse childhood experiences, education levels, sexual orientations and biological markers on the other. RESULTS Biologic factors such as gender identity, sex hormone levels, and the neurologic constitution of the brain's pain and reward systems influence BDSM orientation. With regard to psychological factors, both personality traits (eg, higher levels of openness or extraversion) and the presence of a personality disorder have been associated with a heightened interest in BDSM, although only limited supporting evidence is available. Additionally, sensation-seeking levels and impulsivity seem to contribute, because they presumably guide one's drive to explore new or more-intense kinks. Whereas attachment styles impact couple dynamics, they also influence willingness to explore limits in a BDSM context. Lastly, education levels impact relational and sexual dynamics. STRENGTHS AND LIMITATIONS The limitations of the current review reflect those of the topical scientific literature. Although the number of studies focused on all aspects of BDSM is exponentially growing, most of these are only descriptive, and very few focus on underlying driving processes. CONCLUSION From this biopsychosocial perspective, we offer a dimensional approach while integrating the factors driving the onset and evolution of BDSM interests. De Neef N, Coppens V, Huys W, et al. Bondage-Discipline, Dominance-Submission and Sadomasochism (BDSM) From an Integrative Biopsychosocial Perspective: A Systematic Review. Sex Med 2019;7:129-144.
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Affiliation(s)
- Nele De Neef
- Europe Hospitals, Campus St Michel, Brussels, Belgium
| | - Violette Coppens
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium; University Psychiatric Hospital Antwerp, Campus Duffel, Duffel, Antwerp, Belgium
| | - Wim Huys
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium
| | - Manuel Morrens
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium; University Psychiatric Hospital Antwerp, Campus Duffel, Duffel, Antwerp, Belgium.
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