Letters to the Editor
Sexual Sadism With Lust-Murder Proclivities in a Female?
Dear Editor:
While there are sparse reports of sexually sadistic proclivities in females (1–3), its most extreme subtype, lust-murder, has to my knowledge only been reported in male subjects (4).
Case Report
A heterosexual woman in her late 20s was referred for a forensic psychological assessment to determine her fitness to stand trial on charges of arson. Her mother’s pregnancy history, as well as her birth, growth and milestones, medical screening, and mental status exam all yielded unremarkable findings. Her psychological history unsheathed depressive episodes that resulted in trials of antidepressants, some self-reported episodes of panic attacks, and an episode of mania or hypomania that she had experienced 10 to 15 years earlier. She reported a psychosocial history that included a single incident of childhood sexual abuse and numerous incidences of physical violence against childhood peers, together with other antisocial behaviours (for example, truancy, fire setting, cruelty to animals, and some experimentation with substances). Further, she reported multiple paraphilic and fetishistic interests (for example, “men in diapers”); a personal study of sexual torture techniques; a history of adult homicidal ideation (that is, wanting to stab or shoot others); a captivation with, and admiration for, the most notorious serial homicidal criminals, along with a yearning to attain membership within that pantheon; the suppression of inordinate anger and hostility that was perennially at the point of exploding (for example, “feeling like a dormant volcano”), along with episodes of explosive dyscontrol; and an escalation of sadistic acts over time, culminating in meticulously planned, albeit thwarted, sexual homicides motivated by self-reported thrill seeking. A psychometric examination revealed prominent features of psychopathic personality disorder, with additional borderline features and negativistic features associated with an elevated potential for criminality. However, there was no evidence of a mood or thought disorder of any genre.
The patient’s predatory sexual and homicidal proclivities involved a process of painstaking planning to murder young males toward whom she was sexually attracted. For example, she amassed photographic and informational files on her intended victims’ daily schedules. In one case, she had planned to use a knife to kill a 13-year-old delivery boy after luring him to a secluded park; in another, she had planned the dispatch of a particular adult male musician.
This case appeared to clearly meet the DSM-IV “essential features” criteria for a sexually sadistic paraphilia (that is, recurrent, intense, sexually arousing fantasies and sexual urges or behaviours regarding the psychological or physical suffering or humiliation of others) (5). It also exhibited correlates found among the more serious sexually sadistic and homicidal offenders (for example, fetishism). To my knowledge, this is the first description of a possible case of a lust-murder paraphilia in a female.
References
1. Kinsey AC, Pomeroy WB, Maratin CE, Gebhard PH. Sexual behaviour in the human female. Philadelphia: Saunders; 1953.
2. Hunt M. Sexual behaviour in the 1970s. New York: Playboy Press; 1974.
3. Arndt W, Foehl J, Good F. Specific sexual fantasy themes: a multidimensional study. J Pers Soc Psychol 1985;48:472–80.
4. Hucker SJ. Sexual sadism: psychopathology and theory. In: Laws DR, O’Donohue W, editors. Sexual deviance: theory, assessment, and treatment. New York: Guilford Press; 1997.
5. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington (DC): APA; 1994.
Larry C Litman, PhD, CPsych, FACAPP, FPPR, FSMI, FICPP
London, Ontario
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