A. Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving acts (real, not simulated) in which the psychological or physical suffering (including humiliation) of the victim is sexually exciting to the person.
B. The person has acted on these urges with a nonconsenting person, or the sexual urges or fantasies cause marked distress or interpersonal difficulty.
C. The individual must feel personal distress about their interest, not merely distress resulting from society’s disapproval;
have a sexual desire or behavior that involves another person’s psychological distress, injury, or death, or a desire for sexual behaviors involving unwilling persons or persons unable to give legal consent.
This diagnosis is part of a family of diagnoses called paraphilias. The key to identifying a paraphilic disorder is in the last 2 sections of the diagnostic criteria. To qualify as having any type of paraphilia, regardless of the specific sexual preferences or desires, one must feel personal distress about their interest that is different than distress that is due to society’s disapproval, or that the sexual desire would harm someone else physically or psychologically.
It is important to not the difference between feeling distress because society, family, friends or others don’t approve of the sexual thoughts, feelings or behaviors, and feeling distress about it on a personal level separate from the opinions of others.
With sadism, the feelings of distress must come from recurrent, intense urges, fantasies or behaviors that involve being beating or humiliating a victim.
The exact cause of paraphilias is unknown for sure
The following are a list of possible factors that cause conduct disorder: