Increased Frontotemporal Activation During Pain Observation in Sexual Sadism

Abstract

Context Sexual sadism is a psychiatric disorder in which sexual pleasure is derived from inflicting pain, suffering, and/or humiliation on others. While the psychological and forensic aspects of sexual sadism have been well-characterized, little is known about the neurocognitive circuitry associated with the disorder. Sexual sadists show increased peripheral sexual arousal when observing other individuals in pain. The neural mechanisms underlying this unusual response are not well understood. We predicted that sexual sadists, relative to non-sadists, would show increased responses in brain regions associated with sexual arousal (amygdala, hypothalamus, ventral striatum) and affective pain processing (anterior cingulate, anterior insula) during pain observation. Objective To study the neural correlates of pain observation in sexual sadists and non-sadists. Design Case-control, cross-sectional study. Sexual sadists and non-sadists viewed 50 social scenes, 25 which depicted a person in pain (e.g., one person stabbing another person’s hand with scissors) and 25 thematically matched no-pain pictures (e.g., one person stabbing a table with scissors with another person’s hand nearby). Pain severity ratings (0 = none, 4 = severe) were acquired following each picture presentation. Setting Sand Ridge Secure Treatment Center, Mauston, Wisconsin. Participants 15 violent sexual offenders; eight sexual sadists and seven age, IQ, and education-matched non-sadists (defined by the Severe Sexual Sadism Scale). Main Outcome Measures Hemodynamic response revealed by functional magnetic resonance imaging (fMRI), and pain severity ratings. Results Sexual sadists, relative to non-sadists, showed greater amygdala activation when viewing pain pictures. They also rated pain pictures higher on pain severity than non-sadists. Sexual sadists, but not non-sadists, showed a positive correlation between pain severity ratings and activity in the anterior insula. Conclusions These results provide neurobehavioral evidence of unusually heightened sensitivity to the pain of others in sexual sadists.

The sadistic trait predicts minimization of intention and causal responsibility in moral judgment

“…a set of adaptive behavioral tactics through which subclinical psychopaths and Machiavellians get their own way-see Jonason & Buss, 2012;Jonason, Li, Webster, & Schmitt, 2009), sadism appears to be more indicative of a non-goal exaltation where arousal-seeking orientation is pivotal, making sadism an even more socially disturbing behavior. This non-goal exaltation has been evidenced by Harenski, Thornton, Harenski, Decety, and Kiehl (2012) who found that, contrary to non-sadists, sexual sadists showed increased activity in the left amygdala (a region of the brain involved in sexual arousal and the reward system) in response to pictures evoking pain caused by another person, compared to pictures without any kind of pain. Therefore, sadism might be associated with a pattern of moral judgments that would go beyond the inhibition of emotional aversion experienced toward harmful intent or actual harm; the exciting experience associated with such a pattern of moral judgment would possibly add incrementally to the moral distortion.…”

“…The reward-evoking effect of a victim-perpetrator state of affairs is well supported by various neuroscientific evidences. For instance, neuroimaging studies highlighted that sadists showed increased activity in the left amygdala-a region involved in sexual arousal and reward-in response to pictures evoking pain caused by another person (Harenski et al, 2012). The authors also found increased amygdala (a region associated with emotions) activity in sadists only, suggesting that these individuals derived also pleasure (a more general positive emotion than sexual arousal) from seeing such pictures.…”

An fMRI study of affective perspective taking in individuals with psychopathy: imagining another in pain does not evoke empathy

“…Beyond existing literature on the processing of empathy-inducing stimuli in healthy populations, there may be additional cortical or subcortical brain regions that contribute to abnormal processing of these regions in psychopathy. For instance, the ventral striatum has been found to be over-reactive in adolescents with conduct disorder as well as sexual sadists (Decety et al, 2009; Harenski et al, 2012). Therefore, coordinates for the ventral striatum were selected from a recent meta-analysis of fMRI studies (Diekhof et al, 2012).…”

Internet trolling and everyday sadism: Parallel effects on pain perception and moral judgment

“…This research is the first to document such a pattern among everyday sadists. It represents a clear departure from the psychology of disordered sadism, as severe sexual sadists show an opposite tendency to exaggerate others' suffering (Harenski, Thornton, Harenski, Decety, & Kiehl, ) . Our results may simply reflect a response bias generated by the nature of the rating task.…”