Made by DATEXIS (Data Science and Text-based Information Systems) at Beuth University of Applied Sciences Berlin
Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
Funded by The Federal Ministry for Economic Affairs and Energy; Grant: 01MD19013D, Smart-MD Project, Digital Technologies
Selective serotonin reuptake inhibitors (SSRIs) are used, especially with exhibitionists, non-offending pedophiles, and compulsive masturbators. They are proposed to work by reducing sexual arousal, compulsivity, and depressive symptoms. However, supporting evidence for SSRIs is limited.
Pharmacological treatments can help people control their sexual behaviors, but do not change the content of the paraphilia. They are typically combined with cognitive behavioral therapy for best effect.
Psychosexual disorders can vary greatly in severity and treatability. Medical professionals and licensed therapists are necessary in diagnosis and treatment plans. Treatment can vary from therapy to prescription medication. Sex therapy, behavioral therapy, and group therapy may be helpful to those suffering distress from sexual dysfunction. More serious sexual perversions may be treated with androgen blockers or selective serotonin reuptake inhibitors (SSRIs) to help restore hormonal and neurochemical balances.
Psychopathy has often been considered untreatable. Its unique characteristics makes it among the most of personality disorders, a class of mental illnesses that are already traditionally considered difficult to treat. People afflicted with psychopathy are generally unmotivated to seek treatment for their condition, and can be uncooperative in therapy. Attempts to treat psychopathy with the current tools available to psychiatry have been disappointing. Harris and Rice's "Handbook of Psychopathy" says that there is currently little evidence for a cure or effective treatment for psychopathy; as of yet, no pharmacological therapies are known to or have been trialed for alleviating the emotional, interpersonal and moral deficits of psychopathy, and patients with psychopathy who undergo psychotherapy might gain the skills to become more adept at the manipulation and deception of others and be more likely to commit crime. Some studies suggest that punishment and behavior modification techniques are ineffective at modifying the behavior of psychopathic individuals as they are insensitive to punishment or threat. These failures have led to a widely pessimistic view on its treatment prospects, a view that is exacerbated by the little research being done into this disorder compared to the efforts committed to other mental illnesses, which makes it more difficult to gain the understanding of this condition that is necessary to develop effective therapies.
Although the core character deficits of highly psychopathic individuals are likely to be highly incorrigible to the currently available treatment methods, the antisocial and criminal behavior associated with it may be more amenable to management, the management of which being the main aim of therapy programs in correctional settings. It has been suggested that the treatments that may be most likely to be effective at reducing overt antisocial and criminal behavior are those that focus on self-interest, emphasizing the tangible, material value of prosocial behavior, with interventions that develop skills to obtain what the patient wants out of life in prosocial rather than antisocial ways. To this end, various therapies have been tried with the aim of reducing the criminal activity of incarcerated offenders with psychopathy, with mixed success. As psychopathic individuals are insensitive to sanction, reward-based management, in which small privileges are granted in exchange for good behavior, has been suggested and used to manage their behavior in institutional settings.
Psychiatric medications may also alleviate co-occurring conditions sometimes associated with the disorder or with symptoms such as aggression or impulsivity, including antipsychotic, antidepressant or mood-stabilizing medications, although none have yet been approved by the FDA for this purpose. For example, a study found that the antipsychotic clozapine may be effective in reducing various behavioral dysfunctions in a sample of high-security hospital inpatients with antisocial personality disorder and psychopathic traits. However, research into the pharmacological treatment of psychopathy and the related condition antisocial personality disorder is minimal, with much of the knowledge in this area being extrapolations based on what is known about pharmacology in other mental disorders.
Sadomasochism is the giving or receiving pleasure from acts involving the receipt or infliction of pain or humiliation. Practitioners of sadomasochism may seek sexual gratification from their acts. While the terms sadist and masochist refer respectively to one who enjoys giving or receiving pain, practitioners of sadomasochism may switch between activity and passivity.
The abbreviation S&M is often used for sadomasochism, although practitioners themselves normally remove the ampersand and use the acronym S-M or SM or S/M when written throughout the literature. Sadomasochism is not considered a clinical paraphilia unless such practices lead to clinically significant distress or impairment for a diagnosis. Similarly, sexual sadism within the context of mutual consent, generally known under the heading BDSM, is distinguished from non-consensual acts of sexual violence or aggression.
Sexual sadism disorder is the condition of experiencing sexual arousal in response to the extreme pain, suffering or humiliation of others. Several other terms have been used to describe the condition, and the condition may overlap with other conditions that involve inflicting pain. It is distinct from situations in which consenting individuals use mild or simulated pain or humiliation for sexual excitement. The words "sadism" and "" are derived from Marquis de Sade.
Zoophilia is a paraphilia involving a sexual fixation on non-human animals. Bestiality is cross-species sexual activity between human and non-human animals. The terms are often used interchangeably, but some researchers make a distinction between the attraction (zoophilia) and the act (bestiality).
Although sex with animals is not outlawed in some countries, in most countries, bestiality is illegal under animal abuse laws or laws dealing with buggery or crimes against nature.
Psychosexual disorder is a term which may simply refer to a sexual problem that is psychological, rather than physiological in origin. "Psychosexual disorder" was a term used in . The term of psychosexual disorder (Turkish: "Psikoseksüel bozukluk") used by the TAF for homosexuality as a reason to ban the LGBT people from military service.
Nichols (2006) compiled some common clinical issues: countertransference, non-disclosure, coming-out, partner/families, and bleed-through.
Countertransference is a common problem in clinical settings. Despite having no evidence, therapists may find themselves believing that their client’s pathology is "self-evident". Therapists may feel intense disgust and aversive reactions. Feelings of countertransference can interfere with therapy. Another common problem is when clients conceal their sexual preferences from their therapists. This can compromise any therapy. To avoid non-disclosure, therapists are encouraged to communicate their openness in indirect ways with literatures and artworks in the waiting room. Therapists can also deliberately bring up BDSM topics during the course of therapy. With less informed therapists, sometimes they over-focus on clients’ sexuality which detracts from original issues such as family relationships, depression, etc. A special subgroup that needs counselling is the "newbie". Individuals just coming out might have internalized shame, fear, and self-hatred about their sexual preferences. Therapists need to provide acceptance, care, and model positive attitude; providing reassurance, psychoeducation, and bibliotherapy for these clients is crucial. The average age when BDSM individuals realize their sexual preference is around 26 years. Many people hide their sexuality until they can no longer contain their desires. However, they may have married or had children by this point. Therefore, therapists need to facilitate couple's counselling and disclosure. It is important for therapists to consider fairness to partner and family of clients. In situations when boundaries between roles in the bedroom and roles in the rest of the relationship blurs, a "bleed-through" problem has occurred. Therapists need to help clients resolve distress and deal with any underlying problems that led to the initial bleed-through.
Biastophilia (from Greek "biastes", "rape" + "-philia") and its Latin language-derived counterpart raptophilia (from Latin "rapere", "to seize"), also paraphilic rape, is a paraphilia in which sexual arousal is dependent on, or is responsive to, the act of assaulting an unconsenting person, especially a stranger. Some dictionaries consider the terms synonymous, while others distinguish raptophilia as the paraphilia in which sexual arousal is responsive to actually raping the victim.
The source of the arousal in these paraphilias is the victim's terrified resistance to the assault, and in this respect it is considered to be a form of sexual sadism. Biastophilia is accepted as potentially lethal, other such paraphilias including, but not being limited to asphyxiophilia, autassassinophilia, hybristophilia, and chremastistophilia.
Under the name paraphilic coercive disorder, this diagnosis was proposed for inclusion in DSM-5. This diagnosis, under the name "paraphilic rapism", was proposed and rejected in the DSM-III-R. It has been criticized because of the impossibility of reliably distinguishing between paraphilic rapists and non-paraphilic rapists, and because this diagnosis, under the term "Paraphilia NOS" (not otherwise specified), non-consent had been used in Sexually Violent Person/Predator commitment.
Czech sexology standardly use a concept of pathologic sexual aggressivity instead. This term is strongly distinguished from sadism. This disorder is understood as a coordination anomaly of the sexual motivation system (SMS), a "courtship disorder" according to Kurt Freund or displacement paraphilia by John Money, or a missing segment of SMS.
BDSM is a variety of often erotic practices or roleplaying involving bondage, discipline, dominance and submission, sadomasochism, and other related interpersonal dynamics. Given the wide range of practices, some of which may be engaged in by people who do not consider themselves as practicing BDSM, inclusion in the BDSM community or subculture is usually dependent upon self-identification and shared experience.
The term "BDSM" is first recorded in a Usenet posting from 1991, and is interpreted as a combination of the abbreviations B/D (Bondage and Discipline), D/s (Dominance and submission), and S/M (Sadism and Masochism). BDSM is now used as a catch-all phrase covering a wide range of activities, forms of interpersonal relationships, and distinct subcultures. BDSM communities generally welcome anyone with a non-normative streak who identifies with the community; this may include cross-dressers, body modification enthusiasts, animal roleplayers, rubber fetishists, and others.
Activities and relationships within a BDSM context are often characterized by the participants taking on complementary, but unequal roles; thus, the idea of informed consent of both the partners is essential. The terms "submissive" and "dominant" are often used to distinguish these roles: the dominant partner ("dom") takes psychological control over the submissive ("sub"). The terms "top" and "bottom" are also used: the top is the instigator of an action while the bottom is the receiver of the action. The two sets of terms are subtly different: for example, someone may choose to act as bottom to another person, for example, by being whipped, purely recreationally, without any implication of being psychologically dominated by them, or a submissive may be ordered to massage their dominant partner. Despite the bottom performing the action and the top receiving they have not necessarily switched roles.
The abbreviations "sub" and "dom" are frequently used instead of "submissive" and "dominant". Sometimes the female-specific terms "mistress", "domme" or "dominatrix" are used to describe a dominant woman, instead of the gender-neutral term "dom". Individuals who can change between top/dominant and bottom/submissive roles—whether from relationship to relationship or within a given relationship—are known as "switches". The precise definition of roles and self-identification is a common subject of debate within the community.
Gerontophilia is the sexual preference for the elderly. A person with such a sexual preference is a gerontophile. The word "gerontophilia" was coined in 1901 by Richard von Krafft-Ebing. It derives from Greek: geron, meaning "old man or woman" and philie, meaning "love". Gerontophilia is classified as a paraphilia, but is not mentioned in the "Diagnostic and Statistical Manual of Mental Disorders" or International Classification of Diseases.
The prevalence of gerontophilia is unknown. A study of pornographic search terms on a peer-to-peer network reported that 0.15% had gerontophilic themes. Sex offenders with elderly victims do not necessarily have gerontophilia. There are other possible motivations for these offenses, such as rage or sadism, or the increased vulnerability of elderly as a social group, which are factors that may not involve a sexual preference for the elderly. There are no studies showing that most such offenders are gerontophiles. In one small study, two of six sex offenders against the elderly evinced gerontophilic tendencies. Gerontophilia can also be expressed with consenting elderly partners in a legal context.
Research on gerontophilia is limited to a small number of case studies, beginning with a paper by French physician Charles Féré in 1905. Féré described a 27-year-old man who rejected an arranged marriage with a 20-year-old "beauty" in favor of a 62-year-old woman. Such studies commonly report that the subject had an early sexual experience with a much older woman.
With paraphilic coercive disorder, the individual employs enough force to subdue a victim, but with sexual sadism disorder, the individual often continues to inflict harm regardless of the compliance of the victim, which sometimes escalates not only to the death of the victim, but also to the mutilation of the body. What is experienced by the sadist as sexual does not always appear obviously sexual to non-sadists: Sadistic rapes do not necessarily include penile penetration of the victim. In a survey of offenses, 77% of cases included sexual bondage, 73% included anal rape, 60% included blunt force trauma, 57% included vaginal rape, and 40% included penetration of the victim by a foreign object. Moreover, in 40% of cases, the offender kept a personal item of the victim as a souvenir.
On personality testing, sadistic rapists apprehended by law enforcement have shown elevated traits of impulsivity, hypersexuality, callousness, and psychopathy.
Although there appears to be a continuum of severity from mild ("hyperdominance" or "BDSM") to moderate ("paraphilic coercive disorder") to severe ('sexual sadism disorder), it is not clear if they are genuinely related or only appear related superficially.
Very little is known about how sexual sadism disorder develops. Most of the people diagnosed with sexual sadism disorder come to the attention of authorities by committing sexually motivated crimes. Surveys have also been conducted including people who are interested in only mild and consensual forms of sexual pain/humiliation (BDSM).
Most of the people with full-blown sexual sadism disorder are male, whereas the sex ratio of people interested in BDSM is closer to 2:1 male-to-female.
People with sexual sadism disorder" are at an elevated likelihood of having other paraphilic sexual interests.
The PCL-R, the PCL:SV, and the PCL:YV are highly regarded and widely used in criminal justice settings, particularly in North America. They may be used for risk assessment and for assessing treatment potential and be used as part of the decisions regarding bail, sentence, which prison to use, parole, and regarding whether a youth should be tried as a juvenile or as an adult. There have been several criticisms against its use in legal settings. They include the general criticisms against the PCL-R, the availability of other risk assessment tools which may have advantages, and the excessive pessimism surrounding the prognosis and treatment possibilities of those who are diagnosed with psychopathy.
The interrater reliability of the PCL-R can be high when used carefully in research but tend to be poor in applied settings. In particular Factor 1 items are somewhat subjective. In sexually violent predator cases the PCL-R scores given by prosecution experts were consistently higher than those given by defense experts in one study. The scoring may also be influenced by other differences between raters. In one study it was estimated that of the PCL-R variance, about 45% was due to true offender differences, 20% was due to which side the rater testified for, and 30% was due to other rater differences.
To aid a criminal investigation, certain interrogation approaches may be used to exploit and leverage the personality traits of suspects thought to have psychopathy and make them more likely to divulge information.
Gynophobia or gynephobia is an abnormal fear of women, a type of specific social phobia. In the past, the Latin term horror feminae was used.
Gynophobia should not be confused with misogyny, the hatred, contempt for and inveterate prejudice against women, although some may use the terms interchangeably, in reference to the social, rather than pathological aspect of negative attitudes towards women.
An antonym is philogyny, the love, respect for and admiration of women.
Three key terms commonly used in regards to the subject — "zoophilia", "bestiality", and "zoosexuality" — are often used somewhat interchangeably. Some researchers distinguish between zoophilia (as a persistent sexual interest in animals) and bestiality (as sexual acts with animals), because bestiality is often not driven by a sexual preference for animals. Some studies have found that a preference for animals is rare among people who engage in sexual contact with animals. Furthermore, some zoophiles report that they have never had sexual contact with an animal. People with zoophilia are known as "zoophiles", though also sometimes as "zoosexuals", or even very simply "zoos". Zooerasty, sodomy, and zooerastia are other terms closely related to the subject but are less synonymous with the former terms, and are seldom used. "Bestiosexuality" was discussed briefly by Allen (1979), but never became widely established. Ernest Bornemann (1990, cited by Rosenbauer, 1997) coined the separate term "zoosadism" for those who derive pleasure – sexual or otherwise – from inflicting pain on animals. Zoosadism specifically is one member of the Macdonald triad of precursors to sociopathic behavior.
The term "sadomasochism" is used in a variety of different ways. It can refer to cruel individuals or those who brought misfortunes onto themselves and psychiatrists define it as pathological. However, recent research suggests that sadomasochism is mostly simply a sexual interest, and not a pathological symptom of past abuse, or a sexual problem, and that people with sadomasochistic sexual interest are in general neither damaged nor dangerous.
The two words incorporated into this compound, "sadism" and "masochism", were originally derived from the names of two authors. The term "Sadism" has its origin in the name of the Marquis de Sade (1740–1814), who not only practiced sexual sadism, but also wrote novels about these practices, of which the best known is "Justine". "Masochism" is named after Leopold von Sacher-Masoch, who wrote novels expressing his masochistic fantasies. These terms were first selected for identifying human behavioural phenomena and for the classification of psychological illnesses or deviant behaviour. The German psychiatrist Richard von Krafft-Ebing introduced the terms "Sadism" and "Masochism"' into medical terminology in his work "Neue Forschungen auf dem Gebiet der Psychopathia sexualis" ("New research in the area of Psychopathology of Sex") in 1890.
In 1905, Sigmund Freud described sadism and masochism in his "Drei Abhandlungen zur Sexualtheorie" ("Three papers on Sexual Theory") as stemming from aberrant psychological development from early childhood. He also laid the groundwork for the widely accepted medical perspective on the subject in the following decades. This led to the first compound usage of the terminology in "Sado-Masochism" (Loureiroian "Sado-Masochismus") by the Viennese Psychoanalyst Isidor Isaak Sadger in his work "Über den sado-masochistischen Komplex" ("Regarding the sadomasochistic complex") in 1913.
In the later 20th century, BDSM activists have protested against these ideas, because, they argue, they are based on the philosophies of the two psychiatrists, Freud and Krafft-Ebing, whose theories were built on the assumption of psychopathology and their observations of psychiatric patients. The DSM nomenclature referring to sexual psychopathology has been criticized as lacking scientific veracity, and advocates of sadomasochism have sought to separate themselves from psychiatric theory by the adoption of the term "BDSM" instead of the common psychological abbreviation, "S&M". However, the term BDSM also includes, B&D (bondage and discipline), D/s (dominance and submission), and S&M ( and masochism). The terms "bondage" and "discipline" usually refer to the use of either physical or psychological restraint or punishment, and sometimes involves sexual role playing, including the use of costumes.
In contrast to frameworks seeking to explain sadomasochism through psychological, psychoanalytic, medical or forensic approaches, which seek to categorize behavior and desires, and find a root cause, Romana Byrne suggests that such practices can be seen as examples of "aesthetic sexuality", in which a founding physiological or psychological impulse is irrelevant. Rather, according to Byrne, sadism and masochism may be practiced through choice and deliberation, driven by certain aesthetic goals tied to style, pleasure, and identity, which in certain circumstances, she claims can be compared with the creation of art.
There are many different forms (modalities) of treatment used for personality disorders:
- Individual psychotherapy has been a mainstay of treatment. There are long-term and short-term (brief) forms.
- Family therapy, including couples therapy.
- Group therapy for personality dysfunction is probably the second most used.
- Psychological-education may be used as an addition.
- Self-help groups may provide resources for personality disorders.
- Psychiatric medications for treating symptoms of personality dysfunction or co-occurring conditions.
- Milieu therapy, a kind of group-based residential approach, has a history of use in treating personality disorders, including therapeutic communities.
- The practice of mindfulness that includes developing the ability to be nonjudgmentally aware of unpleasant emotions appears to be a promising clinical tool for managing different types of personality disorders.
There are different specific theories or schools of therapy within many of these modalities. They may, for example, emphasize psychodynamic techniques, or cognitive or behavioral techniques. In clinical practice, many therapists use an 'eclectic' approach, taking elements of different schools as and when they seem to fit to an individual client. There is also often a focus on common themes that seem to be beneficial regardless of techniques, including attributes of the therapist (e.g. trustworthiness, competence, caring), processes afforded to the client (e.g. ability to express and confide difficulties and emotions), and the match between the two (e.g. aiming for mutual respect, trust and boundaries).
Until the 1990s, it tended to be described mostly as acrotomophilia, at the expense of other disabilities, or of the wish by some to pretend or acquire disability. Bruno (1997) systematised the attraction as factitious disability disorder. A decade on, others argue that erotic target location error is at play, classifying the attraction as an identity disorder. In the standard psychiatric reference "Diagnostic and Statistical Manual of Mental Disorders", text revision (DSM-IV-tr), the fetish falls under the general category of "Sexual and Gender Identity Disorders" and the more specific category of paraphilia, or sexual fetishes; this classification is preserved in DSM-5.
In the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), recurrent, intense sexual interest in corpses can be diagnosed under Other Specified Paraphilic Disorder (necrophilia) when it causes marked distress or impairment in important areas of functioning. A ten-tier classification of necrophilia exists:
1. Role players: People who get aroused from pretending their live partner is dead during sexual activity.
2. Romantic necrophiliacs: Bereaved people who remain attached to their dead lover's body.
3. Necrophilic fantasizers: People who fantasize about necrophilia, but never actually have sex with a corpse.
4. Tactile necrophiliacs: People who are aroused by touching or stroking a corpse, without engaging in intercourse.
5. Fetishistic necrophiliacs: People who remove objects (e.g., panties or a tampon) or body parts (e.g., a finger or genitalia) from a corpse for sexual purposes, without engaging in intercourse.
6. Necromutilomaniacs: People who derive pleasure from mutilating a corpse while masturbating, without engaging in intercourse.
7. Opportunistic necrophiliacs: People who normally have no interest in necrophilia, but take the opportunity when it arises.
8. Regular necrophiliacs: People who preferentially have intercourse with the dead.
9. Homicidal necrophiliacs: Necrosadists, people who commit murder in order to have sex with the victim.
10. Exclusive necrophiliacs: People who have an exclusive interest in sex with the dead, and cannot perform at all for living partners.
Sadism involves gaining pleasure through themselves or others undergoing discomfort or pain. The opponent-process theory explains the way in which individuals not only display, but also enjoy committing sadistic acts. Individuals possessing sadistic personalities tend to display recurrent aggression and cruel behavior. Sadism can also include the use of emotional cruelty, purposefully manipulating others through the use of fear, and a preoccupation with violence.
Theodore Millon claimed there were four subtypes of sadism, which he termed Enforcing sadism, Explosive sadism, Spineless sadism, and Tyrannical sadism.
Attraction to disability or devotism is a sexualised interest in the appearance, sensation and experience of disability. It may extend from normal human sexuality into a type of sexual fetishism. Sexologically, the pathological end of the attraction tends to be classified as a paraphilia. (Note, however, that the very concept "paraphilia" continues to elude satisfactory definition and remains a subject of ongoing debate in both professional and lay communities) Other researchers have approached it as a form of identity disorder. The most common interests are towards amputations, prosthesis, and crutches.
The management and treatment of personality disorders can be a challenging and controversial area, for by definition the difficulties have been enduring and affect multiple areas of functioning. This often involves interpersonal issues, and there can be difficulties in seeking and obtaining help from organizations in the first place, as well as with establishing and maintaining a specific therapeutic relationship. On the one hand, an individual may not consider themselves to have a mental health problem, while on the other, community mental health services may view individuals with personality disorders as too complex or difficult, and may directly or indirectly exclude individuals with such diagnoses or associated behaviors. The disruptiveness that people with personality disorders can create in an organisation makes these, arguably, the most challenging conditions to manage.
Apart from all these issues, an individual may not consider their personality to be disordered or the cause of problems. This perspective may be caused by the patient's ignorance or lack of insight into their own condition, an ego-syntonic perception of the problems with their personality that prevents them from experiencing it as being in conflict with their goals and self-image, or by the simple fact that there is no distinct or objective boundary between 'normal' and 'abnormal' personalities. Unfortunately, there is substantial social stigma and discrimination related to the diagnosis.
The term 'personality disorder' encompasses a wide range of issues, each with a different level of severity or disability; thus, personality disorders can require fundamentally different approaches and understandings. To illustrate the scope of the matter, consider that while some disorders or individuals are characterized by continual social withdrawal and the shunning of relationships, others may cause "fluctuations" in forwardness. The extremes are worse still: at one extreme lie self-harm and self-neglect, while at another extreme some individuals may commit violence and crime. There can be other factors such as problematic substance use or dependency or behavioral addictions. A person may meet the criteria for multiple personality disorder diagnoses and/or other mental disorders, either at particular times or continually, thus making coordinated input from multiple services a potential requirement.
Therapists in this area can become disheartened by lack of initial progress, or by apparent progress that then leads to setbacks. Clients may be perceived as negative, rejecting, demanding, aggressive or manipulative. This has been looked at in terms of both therapist and client; in terms of social skills, coping efforts, defense mechanisms, or deliberate strategies; and in terms of moral judgments or the need to consider underlying motivations for specific behaviors or conflicts. The vulnerabilities of a client, and indeed a therapist, may become lost behind actual or apparent strength and resilience. It is commonly stated that there is always a need to maintain appropriate professional personal boundaries, while allowing for emotional expression and therapeutic relationships. However, there can be difficulty acknowledging the different worlds and views that both the client and therapist may live with. A therapist may assume that the kinds of relationships and ways of interacting that make them feel safe and comfortable have the same effect on clients. As an example of one extreme, people who may have been exposed to hostility, deceptiveness, rejection, aggression or abuse in their lives, may in some cases be made confused, intimidated or suspicious by presentations of warmth, intimacy or positivity. On the other hand, reassurance, openness and clear communication are usually helpful and needed. It can take several months of sessions, and perhaps several stops and starts, to begin to develop a trusting relationship that can meaningfully address a client's issues.
Sadistic personality disorder is a personality disorder involving which appeared in an appendix of the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-III-R). The later versions of the DSM (DSM-IV, DSM-IV-TR and DSM-5) do not include it.
The words "sadism" and "sadist" are derived from Marquis de Sade.
Necrophilia, also known as necrophilism, necrolagnia, necrocoitus, necrochlesis, and thanatophilia, is a sexual attraction or sexual act involving corpses. It is classified as a paraphilia by the "Diagnostic and Statistical Manual" (DSM) of the American Psychiatric Association.
Rosman and Resnick (1989) reviewed information from 34 cases of necrophilia describing the individuals' motivations for their behaviors: these individuals reported the desire to possess a non-resisting and non-rejecting partner (68%), reunions with a romantic partner (21%), sexual attraction to corpses (15%), comfort or overcoming feelings of isolation (15%), or seeking self-esteem by expressing power over a homicide victim (12%).