ABSTRACT

In correctional settings, a diagnosis of sexual sadism is likely to have negative consequences for the person thus assessed. Sexual sadists are typically considered high risk, non-eligible for parole, and difficult to treat. Hence, sexual sadists have good reasons to dissimulate or outright deny their sexual preference disorder. Methods have been developed to overcome the risk of faking; for example, the use of clinician ratings and the recording of physiological responses are potentially less prone to faking than are self-report measures. In the current chapter, we review the evidence for and against phallometric assessment, indirect measures, and structured clinician ratings. The Severe Sexual Sadism Scale (SeSaS)—its development, properties and definitions—is highlighted. This file-based screening can guide the diagnostic process in forensic cases in which sadism is suspected. Finally, the proper use of SeSaS is explained.