A Systematic Scoping Review of the Prevalence, Etiological, Psychological, and Interpersonal Factors Associated with BDSM

Inadequate Coping Strategies of Men who Have Committed Sexual Aggression Against Women: A Study of Their Developmental Antecedents

Several researchers have found that men who have committed sexual aggression have inadequate coping strategies (e.g., paraphilic sexual fantasies, substance abuse). However, very few researchers have empirically examined the factors potentially associated with the development of these strategies. In 2011, Maniglio hypothesized that the inadequate coping strategies of men who have committed sexual aggression are the result of childhood victimization, mediated by internalized psychological problems. The present study therefore empirically tested this hypothesis in a Canadian sample of 205 men who had committed sexual aggression against women, of whom 37 committed sexual murder. Structural equation modeling (SEM) resulted in the identification of several direct and indirect trajectories leading from childhood victimization (psychological, physical, sexual) to the development of inadequate coping strategies (paraphilic sexual fantasies, alcohol and drug use) mediated by internalized psychological problems (e.g., anxiety, depression, social isolation). The theoretical and clinical implications of these developmental trajectories are discussed.

Theories on the Etiology of Deviant Sexual Interests: A Systematic Review

Not much is known about the etiology, or development, of deviant sexual interests. The aim of this systematic review was to provide a broad overview of current theories on the etiology of sexual deviance. We conducted a systematic search of the databases PubMed and APA PsycInfo (EBSCO). Studies were included when they discussed a theory regarding the etiology or development of sexual deviance. Included studies were assessed on quality criteria for good theories. Common etiological themes were extracted using thematic analysis. We included 47 theories explaining sexual deviance in general as well as various specific deviant sexual interests, such as pedophilia and sadism/masochism. Few theories (k = 7) were of acceptable quality as suggested by our systematic assessment of quality criteria for good theories (QUACGOT). These theories indicated that deviant sexual interests may develop as the result of an interplay of various factors: excitation transfer between emotions and sexual arousal, conditioning, problems with "normative" sexuality, and social learning. Neurobiological findings could not be included as no acceptable quality neurobiological theories could be retrieved. The important roles of excitation transfer and conditioning designate that dynamic, changeable processes take part in the etiology of sexual deviance. These same processes could potentially be deployed to diminish unwanted deviant sexual interests.

Not Twisted, Just Kinky: Replication and Structural Invariance of Attachment, Personality, and Well-Being Among BDSM Practitioners

BDSM is a range of diverse sexual practices. Stigma regarding BDSM is associated with dysfunctional personalities, insecure attachment styles, or damaged well-being. Previous studies have shown contrary evidence to these views. However, the replicability of these findings remains understudied. This study conducts a close replication to examine personality, attachment, rejection sensitivity, and well-being differences between BDSM practitioners and non-practitioners. To address previous limitations, this study provides a highly powered sample of a new population (Spanish, N = 1,907), assessing effect sizes and the impact of LGTBIQA+ individuals and employing an alternative BDSM role classification. Additionally, we examined attachment styles, personality, and well-being differences among BDSM practitioners. As predicted, BDSM practitioners showed higher levels of secure attachment, conscientiousness, openness, and well-being while also lower levels of insecure attachments, rejection sensitivity, neuroticism, and agreeableness, countering the stigma. Gender, sexual orientations, and experience with BDSM showed explanatory potential. The associations between attachment, personality, and well-being were consistent across both BDSM practitioners and non-practitioners, as well as across various BDSM roles. BDSM practitioners share the same psychological structure as non-practitioners but also show more functional profiles. Thus, de-stigmatizing BDSM populations is reinforced and recommended. Limitations and implications for applied and research audiences are discussed.

Research in brief: How prevalent is rough sex? Results from a national online sample of adults in Germany

BACKGROUND

Rough sex refers to consensual sexual activities that incorporate playful aggression, such as hair pulling, spanking, or choking. It is relevant in the context of sexual health as it can enhance sexual arousal, pleasure, and intimacy among consenting partners. However, it can also be associated with consent violations, discomfort, and injuries ranging from mild to severe or even fatal. The prevalence of rough sex in Germany is widely unknown. Our study aims to establish, for the first time, the overall age-related and gender-related prevalence rates of active and passive rough sex involvement among adults in Germany.

METHODS

A national online sample of 1101 adults from Germany, aged 18-69 years (50% men, 49% women, 1% gender-diverse individuals) gave informed consent and reported on their lifetime engagement in rough sex in active and passive roles. We recruited participants through a professional panel provider for a multi-themed sexual health survey. Data analysis was conducted using R, with 95% confidence intervals of prevalence rates computed to answer the research questions.

RESULTS

Lifetime prevalence of rough sex involvement was 29%. Adults below the age of 40 reported higher rates of involvement (up to 43%) than people over 40 (up to 26%). Men reported predominantly active role involvement and women reported primarily passive role involvement.

DISCUSSION

Results show that rough sex is common. Sexual health professionals, educators, and researchers should be prepared to guide current and aspiring practitioners of rough sex, helping them understand potential benefits, risks, and age- and gender-related differences.

The Psychology of Kink: A Cross-Sectional Survey Investigating the Association Between Adult Attachment Style and BDSM-Related Identity Choice in China

BDSM is a type of sexual preference that includes bondage and discipline, dominance and submission, and sadism and masochism. Research has identified three specific power exchange roles in the practice of BDSM: dominance, submission, and switch. It has also been suggested that attachment style potentially influences BDSM interests. This study investigated the potential roles of attachment style in driving BDSM identity. A questionnaire was completed by a cross-sectional Chinese sample (n = 3310, age range 18-30 years), including 1856 BDSM practitioners (436 men, 1420 women). To assess attachment style, the questionnaire included a Chinese translation of the Adult Attachment Scale as well as items surveying BDSM interests. Compared to non-BDSM practitioners, attachment styles were not significantly different from BDSM practitioners. However, practitioners with different BDSM identities showed a significant difference in their attachment styles. Secure and avoidant attachment styles were associated with dominance, whereas submissiveness recorded high average scores of separation anxiety in both males and females. BDSM identities based on gender revealed that 60.5% of female practitioners assumed the role of submissiveness and this group recorded the highest average scores of separation anxiety among all groups. These results show that BDSM identity is related to attachment style. However, the results did not support the hypothesis that attachment styles potentially drive BDSM identities. Further research is needed to explore other psychological processes that drive BDSM identities in order to provide guidance for BDSM practitioners in choosing suitable identities, thereby helping practitioners to choose suitable identity partners and avoid negative experiences during BDSM participation.

Factor Analysis With Unusual Sexual Interests: A Replication Study in a Representative Population Sample

A previous study found a variety of unusual sexual interests to cluster in a five-factor structure, namely submission/masochism, forbidden sexual activities, dominance/sadism, mysophilia, and fetishism (Schippers et al., 2021). The current study was an empirical replication to examine whether these findings generalized to a representative population sample. An online, anonymous sample (N = 256) representative of the Dutch adult male population rated 32 unusual sexual interests on a scale from 1 (very unappealing) to 7 (very appealing). An exploratory factor analysis assessed whether similar factors would emerge as in the original study. A subsequent confirmatory factor analysis served to confirm the factor structure. Four slightly different factors of sexual interest were found: extreme, illegal and mysophilic sexual activities; light BDSM without real pain or suffering; heavy BDSM that may include pain or suffering; and illegal but lower-sentenced and fetishistic sexual activities. The model fit was acceptable. The representative replication sample was more sexually conservative and showed less sexual engagement than the original convenience sample. On a fundamental level, sexual interest in light BDSM activities and extreme, forbidden, and mysophilic activities seem to be relatively separate constructs.

An Evolutionary Psychological Approach Toward BDSM Interest and Behavior

Bondage/discipline, Dominance/submission, and Sadism/Masochism (BDSM) have gained increased attention and discussion in recent years. This prevalence is accompanied by a shift in perceptions of BDSM, including the declassification of sadomasochism as a paraphilic disorder. Evolutionary psychology offers a unique perspective of why some individuals are interested in BDSM and why some prefer certain elements of BDSM over others (e.g., dominance versus submission). In this paper, we examine BDSM from an evolutionary standpoint, examining biopsychosocial factors that underlie the BDSM interests and practice. We articulate this perspective via an exploration of: proximate processes, such as the role of childhood experiences, sexual conditioning, and physiological factors; as well as ultimate explanations for power play and pain play dimensions of BDSM, highlighting the potential adaptive advantages of each. While BDSM may not be adaptive in itself, we examine the literature of sex differences in BDSM role preferences and argue that these preferences may stem from the extreme forms of behaviors which enhance reproductive success. In the realm of pain play, we explore the intersection of pain and pleasure from both physiological and psychological perspectives, highlighting the crucial role of psychological and play partner factors in modulating the experience of pain. Finally, we encourage future research in social sciences to utilize evolutionary frameworks to further explore the subject and help alleviate the mystification surrounding BDSM. This multifaceted exploration of BDSM provides valuable insights for clinicians, kink-identified individuals, and scholars seeking to understand the evolutionary perspectives of human sexual behavior and preferences.

A Pilot Study Assessing Sexual Behavior as Self-Injury in College Students

OBJECTIVE

The use of sexual activity to self-injure has been proposed in research literature but remains underexplored. The purpose of this pilot study was to determine the feasibility of identifying sexual activity as self-injury in a U.S. college-based sample and to provide a preliminary examination of sexual activity as self-injury to inform future study on this topic.

METHOD

A cross-sectional descriptive pilot study was conducted to assess for recognition of and attitudes toward sexual behavior as self-injury and to identify participant-reported experiences of sexual activity to self-injure.

RESULTS

A total of 50 participants completed the online survey. Thirteen (26%) participants reported they had heard of the concept of "sex as self-injury." Six (12%) participants reported ever having used sexual activity to cause physical or psychological harm to themselves. Participants reported intentions for engaging in sexual activity to self-injure, including causing physical pain, reliving past self-harm or trauma, showing vulnerability, proving self-worth, pleasing or wanting to feel needed by their partner, and suicidal ideation.

CONCLUSION

Sexual activities have been used by some college students as a means of self-harm. Further research is needed to understand this phenomenon and clinicians should consider screening for this in patients who participate in dangerous sexual behaviors or self-injurious behaviors.

The correlation between sadomasochists' experience and their sadomasochistic behaviors and fantasies: A qualitative analysis of interviews

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.

The Complex Interplay between BDSM and Childhood Sexual Abuse: A Form of Repetition and Dissociation or a Path Toward Processing and Healing?

In this theoretical paper the authors explore the connections between BDSM (i.e., practices involving bondage, discipline, dominance, submission, sadism, masochism) and CSA (childhood sexual abuse) in order to investigate the potential unconscious mechanisms at play and the therapeutic functions of BDSM practices among CSA victims. Drawing on the embodiment framework, the authors address how BDSM may serve as a form of unconscious repetition of traumatic experiences for certain CSA victims, with the aim of processing trauma and healing. A review of the empirical evidence regarding the links between BDSM and CSA trauma, along with the potential of BDSM to trigger trauma and elicit dissociation, guilt, or shame, is conducted. Finally, BDSM practices are reviewed through the concept of trauma-play, which involves deliberate rescripting. In short, the complex relationship between BDSM and CSA is highlighted, as well as its implications for understanding and potentially addressing trauma experiences in therapy.

Sexual Activity as Self-Injury: A Scoping Review

Suicide and other self-injurious behaviors (SIB) are significant causes of morbidity and mortality as well as healthcare costs. Sexual risk behaviors are associated with many SIB, and sexual activities may act as SIB as well. In this scoping review, we consider ways in which sexual activity has been conceptualized as SIB - types of sexual activities as a form of self-injury - and cases in which sexual activities as SIB have been classified as direct or indirect self-injury. We include English-language publications that discuss any aspect of sexual activity as SIB. Database, citation list, and gray literature searches yielded 33 publications. Sexual activities as a form of self-injury included exposure to HIV/AIDS and other sexually transmitted infections, sadomasochistic behaviors undertaken for punishment rather than pleasure, selling sex, injury to the genitals, and sexual encounters with undesired partners or consisting of undesired acts. Twenty-three publications did not categorize sexual activities to self-injure as either direct or indirect self-injury, three publications categorized them as indirect self-injury, and seven publications as direct self-injury. Sexual activity is used to self-injure in a variety of ways and its conceptualization as indirect or direct self-injury remains unclear.

Female Affective Perception of Mainstream and Paraphilic Pornography: Associations with Sexual and Psychological Intrapersonal Variables

Understanding affective perceptual processes can further contribute to the explanation of motivation and actions, as well as sexual risk behaviors. Pornography can be considered salient emotional content and is popular, also among females. Yet, the female perspective on pornography has often been overlooked and it remains unclear how individual variables may be associated with the affective perception of pornography and could provide a risk profile. Possible associations between several sexual and psychological intrapersonal variables and the affective perception of various forms of pornography were analyzed from the female perspective. A sample of 231 females (M = 21.87 years; SD = 3.9 years) provided ratings of affective valence, arousal, disgust, and moral and ethical acceptance for mainstream pornographic and paraphilic images of dominance, submission, or sexual violence. Paraphilic pornography was perceived as less pleasant, arousing, and moral and ethically acceptable, but more disgusting compared to mainstream pornography. This was more pronounced among females who had never consumed pornography. Results further suggest that the female affective perception of pornography was associated with the following sexual intrapersonal variables: sexual sensation seeking for physical sensations, erotophilia, lack of sexual control, problematic pornography consumption, and sexual disgust sensitivity. Of the assessed psychological intrapersonal variables, only anxiety was negatively associated with disgust for paraphilic pornography. It is important to further analyze the female affective perception of pornography and associated variables to include them in strategies for prevention and for addressing problematic consequences of the acceptance of specific sexual content and behaviors, especially related to sexualized violence.

"It's Their Consent You Have to Wait For": Intimate Partner Violence and BDSM Among Gender and Sexual Minority Youth

Gender and sexual minoritized (GSM) youth are more likely than their cisgender heterosexual peers to experience intimate partner violence (IPV) and practice bondage and discipline, domination and submission, sadism, and masochism (BDSM). Although IPV and BDSM are vastly different phenomena, superficial similarities (e.g., violent behaviors) can lead to misidentification in both practice and research. This study explores how GSM youth (a) experience and understand the differences between IPV and BDSM and (b) report consensual violent and controlling behaviors when answering items on IPV measures. Nine demographically diverse GSM youth (mean age 21.2) were drawn from a GSM youth-serving organization in the Northeast United States. Participants were interviewed about their experiences with IPV, BDSM, and consent. Participants also were asked to describe the process of completing two standardized measures of IPV. Interviews were coded using conventional and directed content analysis. Eight of nine participants reported IPV victimization, and seven reported BDSM interest or experiences. Four themes emerged: (a) GSM youth experience a spectrum of IPV victimization, often related to their gender and sexual identity; (b) interest in BDSM does not imply an acceptance of IPV; (c) GSM youth have a nuanced understanding of consent and strategies to communicate consent with their partners; and (d) Consent is the organizing framework by which GSM youth distinguish IPV from BDSM. Participants reported various degrees of certainty that they would include BDSM behaviors when answering questions about violent behaviors. Findings underscore the importance of conceptually and operationally differentiating IPV and BDSM. Programs that serve GSM youth should address IPV victimization, offer sex-positive education regarding healthy relationships and BDSM, and assist GSM youth in differentiating abusive behaviors from consensual BDSM. Standardized measures that do not conflate BDSM with IPV are crucial for studying IPV among GSM youth.

Psychometric Properties of the Brief Resilience Scale Among Alternative Sexuality Community Members

Assessing resilience among alternative sexuality (alt-sex; e.g., kink, polyamory) community members is imperative as alt-sex individuals often face discrimination and possess intersecting marginalized identities. The Brief Resilience Scale (BRS) has extensive psychometric support; however, prior research indicates both a one- and two-factor (i.e., succumbing and resilience) structure. Further, the psychometric properties of the BRS have not been examined among alt-sex community members. As such, the current study examined the BRS factor structure among alt-sex individuals and measurement invariance across demographic groups (i.e., sexual orientation, gender identity, and sexual assault history). Confirmatory factor analyses and multi-groups invariance analyses were conducted. The two-factor BRS model demonstrated better fit to the data. Model fit did not differ by sexual orientation or gender identity. Measurement invariance was observed by lifetime sexual assault history, with higher factor loadings on succumbing items among alt-sex community members with a lifetime history of sexual assault. Our findings support use of the BRS to measure resilience among alt-sex individuals. Succumbing, or weakened resilience, is a salient factor for alt-sex community members who are sexual assault survivors, warranting further attention.

An International Survey of BDSM Practitioner Demographics: The Evolution of Purpose for, Participation in, and Engagement with, Kink Activities

While general proclivities for BDSM participation have been investigated in various countries, few large-scale studies have been conducted specifically with BDSM practitioners, which would allow for more in-depth analyses of participation. Through an online survey of 810 BDSM practitioners, the predictability of demographics and BDSM-related traits on the who, what, when, where, why, and how of BDSM participation were examined. Descriptive and regression analyses led to six findings. First, BDSM is practiced globally by a heterogeneous group. Second, learning about to participating in BDSM is a stepwise progression occurring over years. Third, pathways into BDSM vary with self-introduction, often as a form of sexual exploration, more common for adolescents, and friends/partners, and as a form of self-growth, more common for those introduced later in life. Fourth, historically viewed as sex-driven, few demographics predicted purpose for BDSM participation, while enjoyment/fun was the most common motivation. Fifth, practitioners participate in BDSM with multiple others beyond intimate partners, suggesting a communal element. Sixth, as a person gains more BDSM experience, their purpose/motivation evolves and the frequency and "risk" (i.e. edge-play) of activities participated in increases. Implications for further research into BDSM sub-culture are discussed, relating to the role of BDSM in sexual practice, sexual orientation, and leisure (hobby) activity identity formation, the impact of geographic, racial, and generational differences on participation, differing experiences of sexual and gender minorities (e.g. transgender, pansexual), and the importance of BDSM-specific measures, such as years of experience and occupying multiple BDSM-related roles, in analyses.

BDSM in North America, Europe, and Oceania: A Large-Scale International Survey Gauging BDSM Interests and Activities

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.

Clinical Guidelines for Working with Clients Involved in Kink

People involved in kink (BDSM or fetish) subcultures often encounter stigma and bias in healthcare settings or when seeking psychotherapy. Such individuals typically encounter well-meaning clinicians who are not prepared to provide culturally competent care or who have not recognized their own biases. Over a two-year period, a team of 20 experienced clinicians and researchers created clinical practice guidelines for working with people involved with kink, incorporating an extensive literature review and documentation of clinical expertise. This article summarizes the guidelines and discusses relevant issues facing clinicians and their clients, as well as implications for clinical practice, research and training.

Kink-Oriented People and Exogenous Oppressions: Understanding Mental Health and Related Service Use in a Rural Context

Rural, kink-oriented people experience much exogenous oppression and yet related research is scarce. This study examined the risk and protective factors of kink-oriented rural Tasmanian Australians with preexisting mental health conditions and help-seeking barriers and facilitators. Participants completed either an online survey (n = 42), an interview (n = 10), or both. Thematic analysis and descriptive statistics were used to analyze the qualitative and quantitative data, respectively. Participants aged 18 to 61 were gender and sexually diverse and better educated but had more lifetime suicide attempts than the general public. Despite the increasing normalization of kink, 90.5% of participants have never seen a kink-aware mental health professional (MHP) and nearly 83.0% did not disclose to an MHP for fear of stigma or discrimination. Self-awareness, resilience, social support and kink improved participants' mental health. Tailored support from trained MHP is vital to improve the mental health of kink-oriented people in rural areas.

Psychological and Developmental Correlates of Paraphilic and Normophilic Sexual Interests

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.

An exploration of marks/injuries related to BDSM sexual experiences

Background

Despite its growing prevalence, BDSM practice (bondage, discipline, dominance, submission, and sadomasochism) is still stigmatized, and little is known about the physical marks and injuries that individuals sustain from consensual BDSM-related activities.

Aim

In this exploratory study, we examined BDSM sexual experiences and the physical marks and injuries resulting from these experiences in a convenience sample of 513 US adults.

Methods

We examined the extent to which individuals at various stages of BDSM exploration engage with different types of BDSM and kink behaviors, along with the frequency with which they communicate about, inflict, and receive physical marks from these activities.

Outcomes

Our main outcome measures were intentional and unintentional marks sustained from BDSM-related activities, BDSM experiences, and the use of safe words.

Results

Results revealed that BDSM marks and injuries are common and quite varied (from small scratches to very large bruises) and unintentional and intentional marks differ in terms of typical size, place on body, and severity of injury. Additionally, BDSM experience is positively associated with the use of safe words and marking behaviors.

Clinical Translation

Disclosure of marks and injuries, intentional and unintentional, may be improved if health care providers are aware of, and make efforts to reduce stigma surrounding, BDSM and rough sex activity.

Strengths and Limitations

The findings of this study must be interpreted with acknowledgment of the limitations that it was a survey study with a convenience sample. However, as one of the few studies exploring the marks and injuries sustained from BDSM activities, the exploration of intentional and unintentional marks sustained provides a critical starting point for future examination of BDSM consequences that intersect with health care and the law.

Conclusion

Marks and injuries from BDSM-related activities are common, and despite the greater use of safe words, practitioners with more BDSM experience inflict more marks than those with less BDSM experience.

Deconstructing "Sexual Deviance": Identifying and Empirically Examining Assumptions about "Deviant" Sexual Fantasy in the DSM

We identify and examine three assumptions underpinning "sexual deviance" in the Diagnostic and Statistical Manual (DSM) of Mental Disorders: (1) the "sexual deviant" - often, "the male sex offender" - prefers "deviant," and has limited (if any) "non-deviant," sexual fantasies; (2) this differentiates them from the non-sexual-/non-offending "norm"; (3) preferred fantasies are "deviant" or "non-deviant." Adult volunteers (N = 279; equal numbers of sexual offending [SO], non-sexual offending [NSO] and non-offending [NO] men) provided anonymous descriptions of their favorite sexual thought and responses to a revised Wilson Sex Fantasy Questionnaire during a wider computerized survey of 6,289 men from prison and the community. Latent class analysis identified five types of favorite sexual thought; vaginal/oral sex with 1+ woman was commonest for SO men and the WSFQ findings supported this - challenging the first assumption. Both SO and NO men were over-represented for thought types considered "deviant" by the DSM - tempering the second assumption - although SO men were over-represented for thoughts involving children specifically. All thought types were multidimensional; none included solely elements considered "deviant" by the DSM - contesting the third assumption. Notions of the "sexual deviant" as "different"/"other" may underpin these assumptions, potentially negatively impacting research, therapy and understanding sexual crime.

From Fantasy to Reality: Self-Reported Aggression-Related Sexual Fantasies Predict Sexually Sadistic Behavior beyond Indirect and Direct Measures of Sexual Preference

Aggression-related sexual fantasies (ASF) have been related to various forms of harmful sexual behavior in both sex offender and community samples. However, more research is needed to fully understand this relation, particularly whether ASF is associated with harmful sexual behavior beyond hostile sexism against women and a sexual preference for violence and sexual violence. In the present study, N = 428 participants (61.9% women) between 18 and 83 years of age (M = 28.17, SD = 9.7) reported their ASF and hostile sexism. They rated their sexual arousal by erotic, violent, and sexually violent pictures as a direct measure of sexual preference. Response latencies between stimulus presentation and arousal ratings were used as an indirect measure of sexual preference. ASF and the directly and indirectly assessed sexual preference for violent and sexually violent stimuli were positively correlated. They were unrelated to hostile sexism against women. ASF showed the strongest associations with self-reported sexually sadistic behavior and presumably non-consensual sexual sadism beyond these preferences and hostile sexism in the total group and separately among men and women. The findings indicate that ASF and sexual preference are not equivalent constructs and further underscore the potential relevance of ASF for harmful sexual behavior.

The Prevalence of BDSM in Finland and the Association between BDSM Interest and Personality Traits

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.

Grievance-fueled sexual violence

The grievance fueled violence paradigm encompasses various forms of targeted violence but has not yet been extended to the theoretical discussion of sexual violence. In this article, we argue that a wide range of sexual offenses can be usefully conceptualized as forms of grievance fueled violence. Indeed, our assertion that sexual violence is often grievance fueled is unoriginal. More than 40 years of sexual offending research has discussed the pseudosexual nature of much sexual offending, and themes of anger, power, and control – themes that draw clear parallels to the grievance fueled violence paradigm. Therefore, we consider the opportunities for theoretical and practical advancement through the merging of ideas and concepts from the two fields. We examine the scope of grievance in the context of understanding sexual violence, and we look to the role of grievance in the trajectory toward both sexual and nonsexual violence, as well as factors that might distinguish grievance fueled sexual from nonsexual violence. Finally, we discuss future research directions and make recommendations for clinical practice. Specifically, we suggest that grievance represents a promising treatment target where risk is identified for both sexual and nonsexual violence.

Current biopsychosocial science on understanding kink

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.

Pain and masochistic behaviour: The role of descending modulation

BACKGROUND

The mechanisms of pain perception in individuals with masochistic behaviour (MB) remain poorly documented. We hypothesized that MB is associated with context-specific changes in descending pain modulation.

METHODS

We compared the effects of four standardized sets of images with positive (erotic), negative (mutilations), masochistic or neutral emotional valences on the RIII nociceptive reflex evoked by electrical stimulation of the sural nerve and recorded on the ipsilateral biceps femoris in 15 controls and 15 men routinely engaging in MB. We systematically assessed the RIII reflex threshold and recruitment curves (up to the tolerance threshold), thermal (heat and cold) pain thresholds measured on the upper and lower limbs and responses to the pain sensitivity questionnaire, to compare basal pain perception between our two groups of participants. We also assessed anxiety, depression, empathy, alexithymia, high sensation seeking and catastrophizing, to investigate their potential influence on the emotional modulation of pain.

RESULTS

Thermal pain thresholds, RIII reflex recruitment curves, and responses to the psychological and pain sensitivity questionnaires were similar in the two groups. Neutral, positive and negative images modulated the RIII reflex similarly in the two groups. By contrast, masochistic images induced a significant (p < 0.01) decrease in RIII reflex responses in subjects with MB, whereas it tended to increase these responses in control subjects.

CONCLUSIONS

Our data suggest that psychological profile, basal pain sensitivity and the emotional modulation of pain are normal in individuals with MB but that these subjects selectively engage descending pain inhibition in the masochistic context.

SIGNIFICANCE

Decrease pain perception related to masochistic behaviours is associated with specific activation of descending pain inhibition.

Dark personalities and general masochistic tendencies: Their relationships to giving and receiving sexualized pain

Recent research has shown that a tendency to harm others goes hand in hand with a tendency to harm oneself. The present two studies further supported the notion that the joy of harming others and oneself has a common core by showing positive relationships between dark personality traits (particularly psychopathy) and sexual masochistic preferences and between general masochistic tendencies and sexual sadistic preferences. Despite the overlap between dark personality traits and general masochistic tendencies, they independently predicted the engagement in sexual sadomasochism. These relationships statistically held when controlling for the impact of basic personality (Study 1). Study 2 found that self-enhancement, openness to change, and low conservation values serve as motivators for a person's attraction to sexual sadomasochism and shed some light on the differences between sexual sadomasochism and the Dark Tetrad. Overall, people who score relatively high on dark personalities and masochism are particularly predisposed to engage in sexual sadomasochism, in both the dominant and the submissive roles.

Männer sterben früher, Frauen leiden mehr

Männer leben im Durchschnitt mehrere Jahre weniger als Frauen. Dies gilt in allen Kulturen. Aufgrund der Universalität des Phänomens wurden lange Zeit biologische bzw. genetische Ursachen als selbstverständlich erachtet. Erst mit den quasiexperimentellen Analysen der sog. Kloster- und Lebensstilstudien wurden Sozialisationsbedingungen als wesentlicher Grund für die geschlechtsspezifische Mortalität belegt. Geschlecht wurde damit dekomponiert, von einem auf genotypischen und phänotypischen Merkmalen beruhenden Dimorphismus hin zu einem auf der Interaktion zwischen „Sex“ und „Gender“, also den biologischen Grundlagen und der Identitätsbildung, beruhenden eher kontinuierlichen Konstrukt. Die Pole „männlich“ und „weiblich“ werden durch eine sich über die Zeit von traditionell nach modern wandelnde Auffassung von Geschlechterrolle in Bezug auf die Dimensionen Gesellschaft, Sexualität, Persönlichkeit und Körperbau charakterisiert. Auch wenn die Polung selbst heute durch die immer stärkere Bedeutung von Transidentität und Neubewertung der Störungen der Geschlechtsentwicklung möglicherweise in Auflösung begriffen ist, sind die tradierten Geschlechterrollen nach wie vor wirkmächtig – nicht nur im Hinblick auf die Mortalität, sondern auch unter Berücksichtigung der geschlechtsspezifischen Morbidität (Krankheitslast). Die Reflexion der Bedeutung von Geschlecht ist nicht nur als gesellschaftlicher Diskurs relevant, sondern kann auch einen wichtigen Beitrag für das Agieren in der psychotherapeutischen Beziehung vom Mann-Frau- oder Nonbinärsein zum geschlechtssensiblen Handeln mit dem Anspruch eines geschlechtsaufmerksamen Bewusstseins leisten.

Perceptions of and stigma toward BDSM practitioners

Despite a recent increase in academic attention, little is known about how the general population perceives BDSM practitioners. Though the gay/lesbian community has undergone de-medicalization and de-stigmatization over time, the same process for BDSM practitioners is in its infancy. Past research suggests that BDSM practitioners do expect to be stigmatized by others, especially in the healthcare system; however, little is known about how the general population currently perceives and stigmatizes the BDSM community. In the current study, we found that the general population (N = 257) does stigmatize BDSM practitioners more than the gay/lesbian population, and both are stigmatized more than a low-stigma comparison group (people in romantic relationships), F(2, 253) = 21.70, p < .001,η 2 = 0.15. These findings help to inform mental healthcare providers and the general population about BDSM practitioners, with the goal of inspiring additional research and activism aimed at combating misinformation and reducing stigma toward this population.

Challenge at the Intersection of Race and Kink: Racial Discrimination, Fetishization, and Inclusivity Within the BDSM (Bondage-Discipline, Dominance-Submission, and Sadism-Masochism) Community

The bondage-discipline, dominance-submission, and sadism-masochism (BDSM) community has achieved diversity with respect to gender identity and sexual orientation yet does so to a lesser extent with respect to race and ethnicity. A total of 398 BDSM practitioners recruited in 2018 and 2019 from BDSM conferences located within the Southern, Midwestern, and Western regions of the U.S., as well as online, completed surveys asking about racial and ethnic discrimination, fetishization, and inclusivity. People of color were 16 times more likely than non-people of color to feel discriminated against at BDSM events and 17 times more likely to feel fetishized. Qualitative results included troubling stories of overt racism and offensive racial slurs, and examples of microaggressions, feelings of isolation, and feelings of being dismissed. The results suggest that organizations can increase inclusivity by understanding the unique costs faced by people of color with an awareness that these costs might be invisible to non-people of color, diversifying positions of authority and leadership, and teaching well-meaning members what types of behaviors could create a hostile environment.

How safe is BDSM? A literature review on fatal outcome in BDSM play

A noteworthy number of people are interested in BDSM (bondage and discipline, dominance and submission, sadism, and masochism). Fatal outcomes while participating in BDSM activities occur. The aim of this literature review is to give a better insight into potential dangerous BDSM play by summarizing published data on BDSM fatalities. A literature search was conducted. It was searched for non-natural death related to BDSM activity. Seventeen cases were found. The age of the deceased ranged between 23 and 49 years (mean age 34.9 years). Strangulation in the course of erotic asphyxiation was the most common cause of death (88.2%). In 13 cases, a toxicology report for the deceased was mentioned, of which in eight cases (61.5%) toxicology analysis was positive. In four of these cases, the BDSM partner was also tested positive with the same substance. Drugs or alcohol was involved in 64.3% of fatal BDSM play. In nine cases, the level of experience in BDMS activity of the deceased and the partner was described, and in all of them, the deceased and the partner were not new to BDSM play. Fatal outcomes of BDSM plays are rarer than autoerotic fatalities and natural deaths related to sexual activities. Safeguards and education on medical aspects exist in the BDSM communities. If they are followed by the practitioners, the risks of BDMS play can be reduced. Cases of non-natural death connected to BDSM are rare incidents and can be prevented.

Findommes, Cybermediated Sex Work, and Rinsing

INTRODUCTION

Financial domination involves the payment of cash or gifts from a wish list by a money slave to a money mistress, financial dominatrix, or findomme. Boundaries for findommes working through webcam and video-call services may be more fluid than via text-based modes since the domme engages in more visible displays, and modification of language, voice, and feelings to fulfil the fantasy for a client. We explore the nature of findomme work and its relationship to BDSM to understand how the interaction progresses and how the boundaries, of reasonable and permissible behaviour which affect both incoming and outgoing interactions between people, are maintained.

METHODS

The study was in two stages. The first stage was a survey of online findommes (n = 56) in UK and the USA. For the second stage, we explored the experience of findommes (n = 195) on money-slavery websites and social media feeds using netnography as an observation method with cisgender male, female, and transgender participants.

RESULTS

Our analysis reveals how findomme interaction progresses from text-based interaction to virtual face-to-face and voice communication. We show financial domination to be on a continuum from being a lifestyle choice in the BDSM community that reaps financial benefits to a purely economic and legitimate form of commercial labour. Although financial domination clearly elicits sexual arousal for clients, the relationship can also be exclusively psychological and focus on the relinquishing of control to a money mistress for a prescribed period.

CONCLUSION

The findings also show how personal boundaries are negotiated and enhance understanding of how the microculture of findomming interacts with other microcultures. By demystifying the process of financial domination, we clarify its relationship with other microcultures and add to the growing body of literature that destigmatizes consensual erotic labour.

IMPLICATIONS

These findings show how online support, in a decriminalised environment, enabled new and 'instadommes' to set and maintain healthy boundaries for enhanced physical and psychological well-being, and the research provides valuable insight into sex work that is safely carried out in online spaces by a large number of participants so adding to the growing body of work on decriminalization.

Exploratory Factor Analysis of Unusual Sexual Interests

BACKGROUND

Unusual sexual interests are largely intercorrelated, yet not much is known about underlying patterns of clusters between various sexual interests.

AIM

To identify underlying clusters of unusual sexual interests using exploratory factor analysis.

METHODS

We conducted exploratory factor analysis with self-reported interest in a wide variety of unusual sexual acts for an online, international sample (N = 669; 61% female), and for women and men separately. Factor regression weights were correlated to self-reported sex life satisfaction, sexual outlet, and psychiatric symptoms.

OUTCOMES

Participants rated the attractiveness of 50 unusual sexual activities, and reported on their sex life satisfaction (Arizona Sexual Experiences Scale), sexual outlet, and symptoms regarding ADHD (Adult ADHD Self-Report Screening Scale for DSM-5), depression, anxiety, and stress (Depression, Anxiety, and Stress Scale).

RESULTS

We identified 5 factors of unusual sexual interests that were largely comparable for women and men: submission/masochism, forbidden sexual activities, dominance/sadism, mysophilia (attraction to dirtiness or soiled things), and fetishism. For women, unusual sexual interests related to more psychiatric symptoms and higher sexual outlet, whereas this relation was less explicit for men.

CLINICAL IMPLICATIONS

Different factors of unusual sexual interests may serve different underlying functions or motivations, for instance related to sexual, and emotional regulation. A better understanding of the nature of unusual sexual interests is important to be able to influence sexual interests that are unwanted or cause damage to others.

STRENGTHS & LIMITATIONS

Strength of this study include its anonymity, the avoidance of sexual orientation effects, and the possibility to indicate only a slight endorsement toward sexual items. Limitations include the sample's generalizability and the truthfulness of online responding.

CONCLUSION

Unusual sexual interests could be clustered into 5 factors that were largely comparable for women and men: submission/masochism, forbidden sexual activities, dominance/sadism, mysophilia, and fetishism. Schippers EE, Smid WJ, Huckelba AL, et al. Exploratory Factor Analysis of Unusual Sexual Interests. J Sex Med 2021;18:1615-1631.

Sexual Violence and Trauma in Childhood: A Case Report Based on Strategic Counseling

Children and adolescents are too often victims of sexual abuse and harassment. According to the World Health Organization (WHO), approximately 150 million girls and 73 million children <18 have been victims of violence and sexual exploitation during their childhood. Data show that females are more likely to be a victim of abuse and violence than males (20% vs. 5–10%). Such abuses lead to long-term psychophysical and relational consequences and victims are often afraid of asking for support from both parents and professionals. This case report shows the story of a 17-year-old adolescent, Sara, involved by her mother in a strategic counseling process, to solve BDSM-type sexual addiction (slavery and discipline, domination and submission, sadism and masochism), self-aggressive behavior, and alcohol abuse issues. The strategic counseling process is structured in 15 sessions and was based on problem-solving techniques and corrective behavioral strategies. During the sessions, it emerged that Sara had been a victim of sexual violence at the age of 6 and that she had never talked about the rape with anyone. At the age of 12, she began to experience social anxiety and shame, feelings that led her to use alcohol and seek violent sexual partners and bondage relationships. During the counseling sessions, Sara elaborated on her trauma, becoming more aware of her resources and her desires, and she learned to manage the sense of guilt and shame associated with the violence suffered, through alternative strategies. At the end of the process, Sara normalized her relationship with sex and alcohol, regaining her identity.

Consensual Non-Monogamy Among Kink-Identified Adults: Characteristics, Relationship Experiences, and Unique Motivations for Polyamory and Open Relationships

People who engage in both kink and consensual non-monogamy (CNM) have received little attention in research. The present article reports on the characteristics, relationship experiences, and unique motivations for engaging in CNM of kinky and consensually non-monogamous individuals using data from two U.S. samples-one large, national (N = 690) quantitative survey, and one qualitative study (N = 70) of adults in Northern California. The results describe the prevalence of universal (e.g., jealousy, sexual desire discrepancy) and population-specific relationship experiences (e.g., kink interest discrepancy, "coming out" about relationship structure). Findings indicate that discrepancies in desire for kink are a common relationship experience for kink-CNM individuals and that managing kink interests is an important motivation for CNM in this particular population. Implications for future research and clinical practice with kinky and consensually non-monogamous individuals are discussed.

Kinky Sex Gone Wrong: Legal Prosecutions Concerning Consent, Age Play, and Death via BDSM

This commentary begins by describing the author's research and expert witness practice serving sex and gender minorities, especially practitioners of BDSM/kinky sex. Then, it reviews the three most common reasons that BDSM is legally prosecuted. First, consent: was this assault, rape, and/or kidnapping, or was it consensual kinky sex that either got out of hand or is now being strategically employed to punish the other partner? Second, age play: was this adult trying to have sex with children or was he (and it is virtually always men) intending to age play with an adult who is pretending to be an adolescent? Third, death by kinky sex: was this a person who murdered their lover or was this an accidental death? Finally, this article concludes with recommendations for kinksters who wish to assure consent and safe play, and for litigators involved in the prosecution of kinky sex.

Are psychological distress, substance misuse, and sexual sensation seeking associated with autoerotic asphyxiation-related distress?

Autoerotic asphyxiation (AEA) involves enhancing sexual arousal by deliberately self-inducing a reduction of oxygen to the brain. Most studies of AEA have focused on those who have expressed distress or who have died from the practice. The present study explores correlates of AEA-related distress in a community sample, focusing on self-reported measures of psychological distress, substance misuse, and sexual sensation seeking. Individuals who expressed an interest in AEA ( n = 165) participated in an online anonymous survey. Findings revealed a significant positive association between AEA-related distress and symptoms of depression, and a significant negative association between AEA-related distress and sexual sensation seeking. Both depression and sexual sensation seeking remained associated with AEA-related distress at the multivariate level. The findings are consistent with prior literature on AEA that suggests comorbidity with depression and highlights the importance of psychological screening when people present to clinicians due to AEA, particularly for depression. Contrary to our hypothesis, those with higher sexual sensation seeking reported lower levels of AEA-related distress. Future research on AEA-related distress may benefit from using a sexual sensation seeking measure that better assesses sexual dysregulation.