Psychological Functioning of Bondage/Domination/Sado-Masochism (BDSM) Practitioners

Psychological Functioning
of Bondage/Domination/Sado-Masochism
Downloaded by [University Of Rhode Island] at 15:14 22 April 2013
(BDSM) Practitioners
Pamela H. Connolly, PhD
ABSTRACT. A demographic questionnaire and 7 psychometric tests

were administered to 32 self-identified Bondage/Domination/Sado-
Masochism (BDSM) practitioners. Although psychoanalytic literature
suggests that high levels of certain types of psychopathology should be
prevalent among BDSM practitioners, this sample failed to produce
widespread, high levels of psychopathology on psychometric measures
of depression, anxiety, obsessive-compulsion, psychological sadism,
psychological masochism, or PTSD. In fact, on measures of clinical
psychopathology and severe personality pathology, this sample ap-
peared to be comparable to both published test norms and to DSM-
IV-TR estimates for the general population. There were, however, some
exceptions to this general pattern, most notably the higher-than-average
levels of narcissism and nonspecific dissociative symptoms found in the
sample. This study also raises significant concern about the appropri-
ateness of the diagnosis of sexual masochism and sadism in the Diag-
nostic and Statistical Manual of the American Psychiatric Associa-
tion or, minimally, the diagnostic criteria of these disorders. [Article
copies available for a fee from The Haworth Document Delivery Service:
Pamela H. Connolly is affiliated with the California Graduate Institute, Los Angeles
Sexuality Center.
The author would like to thank Jessica Gendelman and Judith B. Miller for their
assistance in data collection and Hilary Haley for assistance in data analysis.
Address correspondence to: Pamela H Connolly, PhD, Los Angeles Sexuality
Center, 436 North Bedford Drive #305, Beverly Hills, CA 90210 (E-mail:
DRPConnolly@ aol.com).
Journal of Psychology & Human Sexuality, Vol. 18(1) 2006
Available online at http://www.haworthpress.com/web/JPHS
© 2006 by The Haworth Press, Inc. All rights reserved.
doi:10.1300/J056v18n01_05 79
80 JOURNAL OF PSYCHOLOGY & HUMAN SEXUALITY
1-800-HAWORTH. E-mail address: <docdelivery@haworthpress.com> Website:

<http://www.HaworthPress.com> © 2006 by The Haworth Press, Inc. All
rights reserved.]
KEYWORDS. Bondage, domination, sado-masochism, paraphilia,

psychopathology
BDSM is a collective term that refers to erotic behaviors involving

bondage and discipline, dominance and submission, sadism and mas-
ochism, and/or slave and master relationships. It has been shown that
there is considerable crossover among different BDSM behaviors, but
also that not all BDSM practitioners engage in all aspects of BDSM
(Emulf & Innala, 1995). Moreover, it has been found that people with
BDSM interests represent virtually all age groups, ethnicities, genders,
relationship styles, sexual orientations and occupations (Weinberg,
Williams, & Moser, 1984).
Despite pioneering research on those who engage in BDSM behavior
(e.g., Moser & Levitt, 1987; Weinberg et al., 1984), there remains a
paucity of empirically derived information about the psychological fea-
tures of this population. What largely exists instead, especially in the
psychoanalytic literature, are non-empirical, hypothetical discourse and
single case studies. Such writings have spawned the assumption that
psychopathology underlies all BDSM interests and behaviors, even
those expressed safely and consensually. This research, in which an em-
pirical study was conducted with a sample of BDSM practitioners, rep-
resents a preliminary effort to fill a longstanding gap in the literature.
BDSM AND PSYCHOPATHOLOGY:

PSYCHOANALYTIC THEORY
Psychoanalytical writers have long interpreted BDSM eroticism as a
symptom of underlying psychopathology. Explanations of the origins of
BDSM eroticism have included early traumatic experiences (e.g.,
Stolorow, 1975; Valenstein, 1973), developmental failures (Bychowski,
1959; Mollinger, 1982) and unresolved infantile conflicts (e.g., Blum,
1976). Freud (1975, 1961) applied his notion of repetition-compulsion to
sexual masochists, whom he characterized as formerly abused children
who try to gain mastery by replicating traumatic events in controlled situ-
ations. Later writers have elaborated upon Freud’s view, including Glenn
(1984), Chu (1991), and others (e.g., see Silverstein, 1994; Socarides,
Pamela H. Connolly 81
1958). More recently, sexual sadism and sexual masochism have been as-
sociated with posttraumatic stress disorder (e.g., Levy, 2000) and its
symptoms, such as dissociation (Blizard, 2001; Howell, 1996).
Some writers have linked sexually expressed masochism and sadism

with mood disorders, such as anxiety (e.g., Bond, 1981; Freud, 1961;
Socarides, 1974; Stolorow, 1975) and depression (Blum, 1988). Others
have posited connections between sadomasochism and obsessionality
or compulsivity (e.g., Dabrowski, 1937; Garma, 1945). BDSM sexual-
ity is thought by some to coexist with personality pathology, such as
narcissism (Bernstein, 1957; Blum, 1988; Eidelberg, 1968; Rothstein,
1991) and paranoia (Bak, 1946; Nydes, 1963). Other writers (e.g.,
Breiner, 1994; Tomassini, 1992) perceive a borderline personality
structure at the root of sadomasochistic behavior.
Given the wide range of disparate views regarding the origins of
BDSM, psychologists and others who might seek to understand people
with BDSM interests have been handicapped in their efforts. Sources of
confusion in the study of people who engage in erotic BDSM play were
examined by Breslow (1989), who concluded that psychodynamic the-
ories on the subject are overly complex. He identified three main
sources of theoretical confusion: defining difficulties, overgeneral-
izations, and a tendency to, “base broad theoretical statements on obser-
vations made from a small and possibly unrepresentative clinical
sample” (p. 269). Breslow also argued that there is confusion in the
literature as to whether sadism and masochism are sexual phenomena,
psychological phenomena, or both. Along the same lines, Maleson
(1984) concluded that little distinction was made between sexual and
non-sexual masochism, and that inconsistent use of the term masochism
might incorrectly imply similarity among diverse phenomena.
In field research, Stoller (1991) implied that not all sadomasochism
was founded on perversion, while Weinberg et al. (1984) concluded that
traditional concepts of sadomasochism were erroneous and unconnected
with BDSM participants’ actual experiences and practices. In their view,
the traditional model was over-generalized and atomistic. Reviewing
these findings, Breslow (1989) argued that a solid base of empirical data
must be gathered in order to test the various theories properly.
RESEARCH QUESTIONS
To address the need for an empirically derived, psychological under-

standing of people who engage in BDSM, a demographic questionnaire
and a comprehensive psychometric test battery were administered to a

sample of people who indicated that they engage in BDSM. An initial
goal of this research was to document the general demographic charac-
teristics, social behaviors, and sexual practices of this population. These

findings would provide a background against which to interpret psycho-
metric test results.
A second and more central goal was to examine existing hypotheses
connecting BDSM interests to specific types of psychopathology. The
existing literature, reviewed above, would suggest that people who en-
gage in BDSM should have higher-than-average levels of (a) depres-
sion, anxiety, and/or obsessive-compulsion; (b) posttraumatic stress
disorder and/or dissociation; (c) sexual sadism and/or sexual masoch-
ism; and (d) narcissism, borderline pathology, and/or paranoia. It was
decided to test each of these hypotheses, and extend these analyses to
(e) a host of other types of personality pathology (e.g., histrionic fea-
tures, dependent features).
Finally, this research included a series of supplementary, exploratory
analyses. These analyses included (a) an examination of whether BDSM
orientation (i.e., a tendency to be submissive versus dominant) was as-
sociated with any of the major scales used in the study; (b) an examina-
tion of the individual psychological profiles of the sample; and (c) an
analysis conducted in a preliminary effort to explore the possibility that
measures of psychopathology, used without vigilance on a BDSM popu-
lation, might yield inaccurate results. For example, psychological mea-
sures of anxiety address emotional states commonly experienced during
consensual BDSM erotic play, such as tingling, trembling, and fear of
losing control. It was anticipated that those who engage in BDSM could
receive artificially inflated scores if they responded to items with re-
spect to their recent BDSM experiences. To test this hypothesis, an anx-
iety measure employed in the current research was administered twice
to each participant: once with instructions to respond only in terms of
BDSM experiences, and once with instructions to respond only in terms
of experiences unrelated to BDSM.
METHOD
Participants
Participants in this study were 132 self-identified BDSM practitio-

ners, recruited in Southern California via e-mail notices posted to
BDSM clubs and organizations. The total sample consisted of 73 males,

56 females, and 3 transgendered individuals. As a group, participants
ranged in age from 25 to 74 years, with a mean age of 43.02 years (SD =
9.96). While 52 of the participants were California natives, 76 were

born in other parts of North America, and 4 were born outside of North
America. One hundred and twenty-three participants described them-
selves as White/Caucasian, 4 as Asian, 2 as Latino/Hispanic, 2 as Na-
tive American, and 1 as Pacific Islander. Despite repeated attempts to
recruit greater numbers of minority participants, particularly Black/Af-
rican-American participants, the final sample remained relatively ra-
cially/ethnically homogeneous.
Instruments
Materials consisted of a detailed demographic questionnaire and a

battery of 7 commonly used, self-report measures of psychopathology.
The demographic questionnaire included items about participants’ be-
liefs, social behaviors, and sexuality, in addition to basic demographic
indices.
With respect to the measures of psychopathology, a few important
points should be made. First, while some of the tests provide informa-
tion about just one type of psychopathology (e.g., paranoia), others
yield information about more than one type of psychopathology (e.g.,
depression and anxiety). As a result, for some types of psychopathology
(e.g., narcissism) there as just one appropriate measure to examine,
while for other types (e.g., depression) several different measures were
analyzed. Second, it should be noted that within the test battery, the
scale or scales chosen to measure each type of pathology were those be-
lieved to best correspond to the relevant DSM-IV-TR criteria.
The Minnesota Multiphasic Personality Inventory-2 (MMPI-2). The
MMPI-2 is a measure of various personality and psychological disorders
(Butcher, Graham, Ben-Porath, Tellegen, Dahlstrom, & Kaememer, 2001).
The entire inventory contains 567 true-false items, which comprise numer-
ous individual scales. Further, the MMPI-2 includes 8 validity scales that
serve as safeguards against inconsistent and/or potentially dishonest re-
sponding. Thus, while individual MMPI-2 scores can be examined, it is the
individual’s full profile that provides optimum diagnostic information
(Caldwell & O’Hare, 1975; Graham, 2001; Greene, 2000).
The Millon Clinical Multiaxial Inventory-III (MCMI-III). The
MCMI- III is a 175-item true-false measure that yields a total of 24 indi-
ces of various personality and clinical syndromes (Millon, Davis, &
Millon, 1997). One of the assets of this measure, as compared to the

MMPI-2, is that it was designed to correspond directly to the diagnostic
criteria of the DSM-IV-TR (American Psychiatric Association, 2000).
The Trauma Symptom Inventory (TS1). The TSI (Briere, 1995) is a

100-item measure designed to assess acute and chronic symptoms asso-
ciated with trauma. The inventory contains 3 validity scales, as well as
10 relatively specific clinical scales: Anxious Arousal (AA); Depres-
sion (D); Anger/Irritability (AI); Intrusive Experiences (IE); Defensive
Avoidance (DA); Dissociation (DIS); Sexual Concerns (SC); Dysfunc-
tional Sexual Behavior (DSB); Impaired Self-Reference (ISR); and
Tension Reduction Behavior (TRB). Like MMPI-2 scales, all TSI
scales are standardized using T-scores, with a mean of 50 and a standard
deviation of 10. It is conventional to interpret scores of 65 or greater–
those 1.5 standard deviations above the mean or higher–as clinically
significant.
The Posttraumatic Stress Disorder Scale (PDS). The PDS is a
49-item questionnaire that assesses respondents’ experiences with, and
reactions to, specific traumatic events (Foa, 1995). The PDS provides a
straightforward yes-no index of whether an individual is diagnosable
with post-traumatic stress disorder (PTSD), and is designed to measure
PTSD in a manner consistent with the DSM-IV (American Psychiatric
Association, 1994).
The Multiscale Dissociation Inventory (MDI). The MDI is a 30-item
measure of dissociative symptoms, which comprises 6 relatively spe-
cific scales: Disengagement (DENG); Depersonalization (DEPR);
Derealization (DERL); Emotional Constriction (ECON); Memory
Disturbance (MEMD); and Identity Dissociation (IDDIS). As Briere
(2002) writes: “The, multidimensional focus of the MDI allows for the
assessment of separate dissociative symptom clusters that may differ in
their function, etiology, and clinical importance” (p. 33), though, at the
same time, “the scales of the MDI are not independent, and the assessor
should consider relationships among scales when interpreting scores”
(p. 11). The MDI scales are standardized using T-scores, with a mean of
50 and a standard deviation of 10. In this case, T scores of 80 and above
are considered clinically significant on all of the 6 scales except for
Identity Dissociation (IDDIS), where only T-scores of 95 or greater are
considered clinically significant (see Briere, 2002).
The Beck Depression Inventory–Second Edition (BDI-II). The
BDI-II is a 21-item test that yields a single depression score between 0
and 63, where scores of 20 to 28 indicate moderate depression and
scores of 29 to 63 indicate severe depression (Beck, Steer, & Brown,
1996) . The BDI-II is designed to correspond to the American Psychiat-

ric Association’s DSM-IV (1994) diagnostic criteria for depressive dis-
orders.
The Beck Anxiety Inventory (BAI). The BAI (Beck & Steer, 1993) is a
21-item test yielding a single anxiety score between 0 and 63, where
scores of 16 to 25 are suggestive of moderate anxiety and scores of 26
and up are suggestive of severe anxiety. Like the BDI-II, this instrument
was designed to be consistent with diagnostic criteria outlined by the
American Psychiatric Association (in this case, the DSM-III, 1980 and
the DSM-III-R, 1987).
Summary of Measures Used, by Specific Type of Psychopathology
As mentioned above, some types of psychopathology were measured

with just 1 scale, while others were measured with 2 or more different
scales (see Table 1). MMPI Profile coding and reviewing were con-
ducted by independent psychometricians (A. Caldwell, R. Greene, per-
sonal consultation, February 20, 22, 2004). The BAI was administered
twice to each participant: once with instructions to respond only in
terms of BDSM experiences, and once with instructions to respond only
in terms of experiences unrelated to BDSM.
Procedure
Participants attended one of eleven proctored testing sessions. These

sessions took place at the California Graduate Institute in Los Angeles;
at a community hall in San Diego; and at 2 other Southern California lo-
cations. In all cases, participants followed the same procedure, with ex-
ception of one location where a community-based video and recruiting
talk were presented first. The subject of the video was the attitudes of
“outsiders” towards people who engage in BDSM.
All participants were informed about the confidentiality of their re-
sponses and asked to sign an informed consent form. They were then given
a packet containing the demographic questionnaire and the full battery of
psychological measures.
Following completion of all materials, participants were reimbursed for
travel ($0.25 per mile) and parking expenses (from $0.00-$6.50) and asked
if the testing session had been comfortable and satisfactory. Researchers
examined participants’ completed BD I-II test forms for suicidality indica-
tors and no cases of imminent danger were found.
86
TABLE 1. Summary of Scales Used to Assess Different Types of Psychopathology
MMPI-2 MCM-I-III TSI PDS MDI BDI-II BAI

PRIMARY ANALYSES
Major Psychopathology
Depression Clinical Scale 2 (1) Scale 2B (Depressive)
(D: Depression) (2) D (Dysthymia) Scale
(3) CC (Major Depression) Scale
Anxiety ANX (Anxiety) A (Anxiety ) Scale Full Scale
Content Scale (Non-BDSM
Version)
Obsessive-Compulsion OBS (Obsessions) Scale 7 (Compulsive)
Content Scale
Post Traumatic Stress Disorder (PTSD) and Related Phenomena
PTSD PK (PTSD: Keane) R (PTSD) Sclae Full scale
Supplementary Scale
Trauma-Related 10 Scales
Phenomena (Full Test)
Dissociation 6 Scales
(Full Test)
Psychological Dominance and Submission
Dominance Do (Dominance) Scale 6B
Supplementary Scale (Sadistic [Aggressive])
Submission LSE2 (Submission) Scale 8B
Content Subscale (Masochistic [Self-Defeating])
Personality Pathology
Narcissism Scale 5 (Narcissism)
Borderline Personality C (Borderline) Scale
Paranoia Scale 6 (1) P (Paranoid) Scale
(Pa: Para- (2) Scale PP (Delusional
noia) Disorder)
Other Personality Pathology Remaining 12 Clinical
Scales
SUPPLEMENTARY ANALYSES
BDSM Orientation Analysis All 7 Scales All 24 Scales Above All 10 Scales Full Scale All 6 Full Full Scale
Above Scales Scale
Overall Profile Analysis All MMPI-2
Clinical
Scales
BAI Dual Administration Analysis Full Scale
(Both
Versions)
87
RESULTS
Preliminary Analyses
In order to ascertain that the community video did not have unintended
effects on participant responses, a series of one-way ANOVA tests was
conducted comparing responses 0 participants who were shown the video
(n = 66) with responses of other participants (n = 66). A comparison (for
the MMPI-2 Lie [L] Scale) revealed a marginally significant difference,
F(123) = 3.93, p = .05, suggesting that those who were presented with the
video (m = 48.66) were less likely to “fake good” than those who were
not (m = 51.78). The result found here is precisely the opposite trend
that would have been expected. One statistically significant difference
was found (for the MDI Disengagement}, [DENG] Scale), F(125) =
4.75, p < .05. Those who watched the video scored lower (m = 59.62) on
disengagement than did those who did not watch the video (m = 65.50), a
difference that was not readily interpretable. In short, these findings there-
fore allayed concerns that the video might have impacted participant re-
sponses.
Demographic Findings, and Findings Regarding Social

and Sexual Behavior
As there were some cases in which participants elected not to answer

certain questions, sample sizes varied from item to item (Ns = 118-129,
unless noted).
Education and Employment
Compared to figures from the U.S. Census Bureau’s 2002 Current

Population Survey (CPS), this was a highly educated group. The vast
majority (96.9%) had completed high school, most (57.8%) had earned
a bachelor’s degree, and a fairly large percentage (17.2%) had earned a
master’s or doctoral degree as well. Most of these respondents (67.0%)
worked in professional fields, though a reasonably large percentage
(22.7%) worked in creative fields. Among the respondents were writ-
ers, teachers, filmmakers, designers, secretaries, accountants, and gov-
ernment officials.
Relationship Status and Relating Behavior
People in this sample were relatively diverse in terms of relationship

status and relating behavior. Roughly a third (36.7%) identified them-

selves as single, 20.0% as married, 18.3% as cohabiting, and 1.7% as in a
Holy Union. Another 15.8% were divorced, 0.8% widowed, and 1.7%
separated. The remaining 5.0% indicated a relationship status of “other”
(e.g., “owned,” “two life partners”). In terms of relating behavior, 33.6%
of participants reported monogamy, 17.6% non-monogamy, 21.0% dat-
ing, and 15.1 % polyamory. In addition, 4.2% of participants categorized
their relating behavior as celibate by choice, 3.4% as swinger, 1.6% as
imposed chastity, and 3.4% as “other.”
Sexual Orientation and BDSM Orientation
The demographic questionnaire included a Kinsey-type scale of sex-

ual orientation (Kinsey, Pomeroy, & Martin, 1948, 1953). On this scale,
34.1% indicated that they were exclusively heterosexual (0) and 14.0%
that they were exclusively gay or lesbian (6). The remaining partici-
pants fell between these two poles: 36.4% were mainly heterosexual but
engaged in occasional gay/lesbian behavior (1) 10.2% were mostly het-
erosexual but engaged in fairly frequent gay/lesbian behavior (2) 3.1%
were equally heterosexual and gay/lesbian (3) and the final 2.3% were
mainly gay/lesbian with occasional heterosexual behavior (4-5).
Participants also completed a scale of dominance and submission ori-
entation that was modeled by Moser (personal communication, 2003)
after the Kinsey Scale of sexual orientation (see Table 2). Approxi-
mately equal percentages of the sample were classified as more-or-
less dominant and more-or-less submissive (47.6% and 45.9%, re-
spectively). Equal switches (people who take both roles) comprised
the remaining 6.5% of the sample. Gender differences in BDSM ori-
entation were notable, with the majority of males falling along the
dominant end of the spectrum and the majority of females falling
along the submissive end of the spectrum. Indeed, gender and BDSM
orientation were reasonably strongly correlated, r = .28, and a
chi-square test revealed that the gender difference in BDSM orientation
was highly significant, r(l, N = 113) = 14.82, p < .01 (with participants
classified as either more-or-less dominant or more-or-less submissive,
and equal switches removed).
TABLE 2. Participants’ BDSM Orientation, by Gender
BDSM Orientation Males (n, %) Females (n, %) Total (n, %)

Exclusively submissive 9 (12.9%) 19 (35.2%) 28 (22.6%)

Mainly submissive, with occasional 8 (11.4%) 15 (27.8%) 23 (18.5%)
dominance
Mainly submissive, but with frequent 3 (4.3%) 3 (5.6%) 6 (4.8%)
dominance
Equally submissive and dominant 7 (10.0%) 1 (1.9%) 8 (6.5%)
Mainly dominant, but with frequent 7 (10.0%) 3 (5.6%) 10 (8.1%)
submission
Mainly dominant, with occasional 8 (11.4%) 5 (9.3%) 13 (10.5%)
submission
Exclusively dominant 28 (40.0%) 8 (14.8%) 36 (29.0%)
Total 70 (100.0%) 54 (100.0%) 124 (100.0%)
BDSM Behaviors
Participants were asked to list the various BDSM activities that they
engaged in, and indicate which activity they enjoyed most. Table 3
shows various activities listed by participants, along with the percent-
ages of participants indicating that they engaged in each activity. In
terms of the most preferred BDSM activity (not shown in the table),
whipping/caning/flogging was identified by the largest percentage of
participants (25.6%), closely followed by bondage (24.8%), and then
spanking (15.4%).
The questionnaire also included an item concerning heavy play versus
light play. These are colloquialisms used among BDSM practitioners to
refer to extremes, or degrees, of play intensity, and are acknowledged to
be highly subjective terms (Warren, 2000, p. 219). 14.4% of participants
self-identified as light players, 39.0% as medium players, 30.5% as heavy
players, 15.3% as edge (most extreme) players, and the remaining 0.8%
(1 participant) as “other.”
A common credo within BDSM community groups is “Safe, Sane,
and Consensual” (Houlberg, 1993), and safety during BDSM play was
a priority for this group. Nearly all participants (90.5%) attested to using
safewords (or pre-arranged signals used between players to indicate
their levels of comfort during an ongoing scene or negotiated BDSM
experience) at least sometimes, and a large percentage (48.0%) attested
to using them without exception.
TABLE 3. Percentages of Participants Who Engage in Various BDSM Activities
Play Type % Play Type % Play Type %

Age Play 16.5 Electric Play 42.2 Muscle Worship 5.6

Animal Play 7.1 Enema Play 17.2 Nipple Torture 67.2
Body Modification 7.9 Feminization 9.4 Paddling 55.9
Body Torture 46.8 Fire Play 19.7 Piercing Play 19.7
Bondage 85.8 Fisting 26.0 Pony Play 10.2
Branding 8.7 Gender Play 7.9 Role Playing (General) 37.8
Breath Play 26.8 Goddess 18.1 Scarification 4.7
Worship
Caging 20.6 Golden 18.3 Scat Play 3.1
Showers
Catheter Play 10.9 Humiliation 34.6 Sensory Deprivation 37.8
Play
C & B Torture 32.8 Infant Play 3.9 Spanking 80.5
Corporal 34.4 Kidnap Scenes 26.0 Water Sports 20.5
Punishment
Corsetry 18.1 Knife Scenes 39.7 Wax/Candle Play 63.8
Forced 9.4 Imposed 2.4 Whipping/Caning/ 81.4
Cross-Dressing Masculinization Flogging
Cutting 14.2 Mummification 31.5 Other 15.7
Note. N = 118.
Those in the study sample were also found to engage in sexual styles
other than BDSM. Indeed, 32% of the sample indicated that BDSM
play occurred less than half the time they spent in sexual activity with
partners, and just 11.2% indicated that BDSM play was their only form
of sexual activity.
Professional BDSM Service Providers and Customers
The majority of study participants (87.1%) indicated that they en-

gaged in BDSM play without financial exchange. The remaining partic-
ipants (12.9%), however, indicated that they occasionally paid for
BDSM services from professional dominants or submissives. When
asked whether they themselves were typically paid for engaging in
BDSM activity, just a few of our participants (3.2%) responded in the
affirmative.
Fear of Discovery
For most participants, the fact that they were involved in BDSM ac-
tivities caused them minimal distress. Approximately half of our sample

(54.3%) indicated that they were never distressed by their involvement,
44.9% that they were sometimes distressed and just 0.8% that they were
frequently distressed. One-third (34.1%) of the sample felt they could
be “out” with most of the adults in their lives. The majority (52.4%) felt
that they could be out with some adults but not others, while 9.5% said
they could not disclose their BDSM interests to anyone, and 4.0% en-
dorsed the most extreme response, “I always feel I have to hide.” More-
over, when asked how they felt about the possibility of their BDSM
activities being “discovered,” roughly half (53.7%) of respondents indi-
cated that they felt uncomfortable or worse about this possibility; spe-
cifically, 41.5% reported that it made them uncomfortable, 6.5% that it
worried them, 4.1% that it made them very worried, and 1.6% that it ter-
rified them.
BDSM Community Activities
The vast majority of participants (89.9%) indicated that they held

current membership in at least one BDSM club or organization, a figure
is appropriately high given that participants were recruited through
BDSM clubs and organizations. In addition, a majority (73.0%) indi-
cated that they regularly attended BDSM events such as lectures, work-
shops, community infrastructure meetings, outreach presentations, or
play parties. When asked to indicate all of the ways that their member-
ship in their BDSM club or organization helped them, the majority of
participants (70.9%) indicated that their involvement provided them
with social support. While many also indicated that their membership
provided access to erotic enjoyment (77.2%) and partners (43.3%),
even more people agreed that their memberships paved the way for
friendships (85.0%) and provided them with education (84.3%).
Results from the Psychometric Measures Test Scoring

and Data Considerations
Of the 127 participants who completed the MMPI-2, 3 of these par-

ticipants were removed from analyses due to high validity scores (all
above 80 on the F scale, a scale based on this measure of “faking bad”),
leaving a total of 124 cases. Of the 119 individuals completed the
MCMI-III, 34 had scores of 75 or above on one or more of the

MCMI-III validity indices (32 returning tests indicating invalidity on
the Y scale, a measure of social desirability). Although removal of these
34 cases resulted in just 86 cases for MCMI-III analyses, Millon (T.

Millon, personal communication, 2003) indicated that it is in fact typi-
cal for 30%-35% of non-clinical populations to return invalid tests, and
that removal of these cases was appropriate. Seven people failed to
complete the TSI, and an additional 8 received elevated scores on one or
more validity indices, leaving 117 cases for TSI analyses. There were
117, 126, and 124 participants who completed the PDS, MDI, and
BDI-II, respectively. Finally, there were 128 and 129 participants who
completed the non-BDSM and BDSM versions of the BAI, respec-
tively, and 127 who completed both versions.
The percentages of participants receiving clinically significant scores
on each of the various measures were then compared with existing prev-
alence estimates for the general population, when available. In addition,
a series of simple comparisons (t-tests) was performed for the various
scales, comparing sample means to either normative (standardization)
mean values or to means from available comparison samples.
For the 7 MMPI-2 scales, 10 TSI scales, and 6 MDI scales examined
in this study (i.e., the standardized tests that use T-scores), comparisons
were made with the normative (standardization) mean of 50. For the 24
MCMI-III scales, which are also standardized but use BR scores, com-
parisons were made with the normative (standardization) median (60),
as Millon et al. (1997) provide scale medians (but not means). For the
PDS, comparisons were made with published figures for the standard-
ization (general population) sample (N = 120) (see Briere, 1995). For
the BDI-II, comparisons were made (lacking data for a more nationally
representative sample) with published figures for a North American
college sample (N = 120) (see Beck et al., 1996). For the BAI (again
lacking other data) comparisons were made with published figures for a
diagnostically mixed sample of outpatients (N = 160) (see Beck &
Steer, 1993).
Despite the large number of comparative tests performed, it was de-
cided to consider comparison results to be significant when p < .05 rec-
ognizing that because of the large number of tests, it was relatively
likely that one or more results would be significant on the basis of
chance alone. In addition to these t-tests, multivariate analyses were
performed. In these analyses, the differences between current sample
scores and comparison/normative values were examined across several
scales simultaneously. These analyses allowed tests of various scales of
depression, for example, to be packaged into a single test, without re-

quiring that scale scores be in any way transformed. Because these
multivariate analyses present results in terms of pathology, or features,
rather than in terms of specific scales, they were deemed a useful com-
plement to the simple t-tests.
Major Psychological Disorders
Depression. Across all 5 depression scales, the majority of partici-

pants scored within normal ranges (see Table 4). Across the 5 scales, the
percentages of the sample with clinically significant or severe scores
(0.81-16.28%) were in some cases high when compared with the DSM-
IV-TR prevalence estimate for Major Depressive Disorder (3.5%- 6.0%).
The sample mean on the MMPI-2 scale of depression (51.52), however,
was not significantly different from the standardization mean of 50,
1(123) = 1.37, ns. Further, the sample means for each of the 3 MCMI-III
measures of depression (42.10, 23.66, and 25.23) were well below the
standardization median of 60. Similarly, this sample mean for the
BDI-II (5.64) was lower than that of the comparison (college student)
sample (12.56). To examine the sample’s results on all 5 of the depres-
sion scales simultaneously, a multivariate analysis was performed. This
analysis suggested that the current sample was, overall, lower in depres-
sion than the various normative (comparison) samples (approximate
F(74) = 58.11, Hotelling’s trace = 3.93, p < .001).
Anxiety. There was little evidence of anxiety across the 3 anxiety
scales examined in this study (see Table 4). Across the 3 scales, the per-
centages of the sample with clinically significant scores (0.78% to
18.55%) were generally higher than the point prevalence estimate given
by the DSM-IV-TR (3.0%). However, the sample mean for the MMPI-2
scale of anxiety (52.23) was not significantly different from the stan-
dardization mean of 50, 1(123) = 1.81, ns. Similarly, the sample mean
for the MCMI-III scale of anxiety (31.51) was well below the standard-
ization median of 60, and the sample mean for the BAI (5.69) fell far be-
low that of the (diagnostically mixed) comparison sample (22.35; t[127] =
⫺14.15, p < .001). Finally, to examine the sample’s results on all 3 of
the anxiety scales simultaneously (relative to the various comparison
groups), a multivariate analysis was performed. This analysis suggested
that the current sample was, overall, lower in anxiety than the various
comparison groups, approximate F(77) = 425.84, Hotelling’s trace =
16.59, p < .001. This result should be interpreted with caution since the
comparison group for the BAI is a diagnostically mixed sample rather
TABLE 4. Sample Statistics and General Population Prevalence Estimates for Measures of Selected Major Disorders
Psychopathology Assessment Scales Sample Means (SDs) Percentages of Sample

(Estimates of Prevalence with Clinically
in the General Populationa) Significant Scores
Depression MMPI-2 Scales (D: Depression) (N = 124) 51.52 (11.97) 13.71%
(3.5%-6.0%)b MCMI-III Scales 2B (Depressive) (N = 86) 42.10 (29.81) 16.28%
MCMI-III Scale D (Dysthymia) (N = 86) 23.66 (26.25) 5.81%
MCMI-III Scale CC (Major Depression) (N = 86) 25.23 (25.90) 1.16%
BDI-II (N = 124) 5.64 (7.09) 6.45% (moderate)
0.81% (severe)
Anxiety MMPI-2 ANX (Anxiety) Content Scale 52.23 (11.82) 18.55%
(3.0%)b (N = 124)
MCMI-III A (Anxiety) Scale (N = 86) 31.51 (28.71) 16.28%
BAI (non-BDSM version, (N = 128) 5.69 (10.33) 7.81 % (moderate)
0.78% (severe)
Obsessive-compulsion MMPI-2 OBS (Obsessions) Content Scale 48.13 (9.69) 10.48%
c
(1.0%) (N = 124)
MCMI-III Scale 7 (Compulsive) (N = 86) 51.16 (14.39) 4.65%
a
Estimates taken from the DSM-IV-TR
b
Percentage represent point prevalenceestimates.
c
Percentage represents a lifetime prevalence estimate.
95
than a non-clinical “general population” sample. Nonetheless, across

the 3 measures of anxiety, there is no evidence that levels of anxiety are
higher among BDSM practitioners than within the general population.
Obsessive-compulsion. The sample’s scores for the two measures of

obsessive-compulsion are also shown in Table 4. On the MMPI-2 scale,
10.48% of the sample received scores of 65 or above, and on the
MCMI-III scale 4.65% received scores of 75 or above. These figures
were somewhat high as compared with the DSM-IV-TR 1.0% lifetime
prevalence estimate for Obsessive-Compulsive Disorder (OCD). That
said, the sample mean for the MMPI-2 measure (47.76) fell below the
MMPI-2 standardization mean of 50, and the sample mean for the
MCMI-III measure (51.20) fell below the MCMI-III standardization
median of 60. A multivariate analysis indicated that, taken together,
the sample scores on the MMPI-2 and MCMI-III were no different
than their respective comparison scores, approximate F(80) = 3.05,
Hotelling’s trace = .076, ns.
PTSD, Trauma-Related Phenomena, and Dissociation
PTSD and trauma-related phenomena. Table 5 shows the sample

means for the PTSD and PTSD-related scales included in the battery, as
well as the percentages of participants receiving scores in clinically signifi-
cant ranges. On the MMPI-2 scale, 13.71% of participants received scores
of 65 or greater, and participants’ scores were found to be significantly
higher than the standardization mean of 50, 1(123) = 2.41, p < .05. On the
other hand, just 1/16% of the sample scored in the clinically significant
range on the MCMI-III scale, and the sample mean in this case (28.21)
was lower than the standardization median of 60. As for the PDS, which
yielded a straightforward yes-no index of probable PTSD, it was found
that 1.71 % of the present group received clinically significant scores, as
compared with Briere’s (1995) report that 23.33% of the normative
(standardization) sample was PTSD-positive. Further, there were no in-
stances of clinically significant results on the TSI, which assesses
trauma-related phenomena. Indeed, on 8 of the 10 TSI scales, the sam-
ple mean was lower than the standardization mean of 50, the 2 excep-
tions being the Dysfunctional Sexual Behavior (DSB) scale (M = 56.79)
and the Tension Reduction Behavior (TRB) scale (M = 52.86). Al-
though there were no instances at all of clinical significance on any of
the 10 TSI scales, sample scores on these 2 scales were significantly dif-
ferent from the standardization mean of 50; for the DSB scale, t(116) =
TABLE 5. Sample Statistics for Measure of PTSD and Related Symptoms
Assessment Scales Sample Means (SDs) Percentages of Sample

with Clinically Significant Scores
MMPI-2 PK (Post-Traumatic Stress Disorder: Keane) Supplementary 52.54 (11.64) 13.71%
Scale (N = 124)
MMCMI-III Scale R (Post Traumatic Stress Disorder) (N = 86) 28.21 (23.56) 1.16%
PDS (N = 117) 47.00 (5.61) 1.71%
a
TSI: Anxious Arousal (AA) 48.78 (7.93) 0.00%
TSI: Depression (D) 49.96 (9.27) 0.00%
TSI: Anger/Irritability (AI) 47.37 (7.84) 0.00%
TSI: Intrusive Experiences (IE) 48.79 (7.84) 0.00%
TSI: Defensive Avoidance (DA) 48.57 (9.58) 0.00%
TSI: Dissociation (DIS) 47.75 (6.48) 0.00%
TSI: Sexual Concerns (SC) 48.87 (7.72) 0.00%
TSI: Dysfunctional Sexual Behavior (DSB) 56.79 (10.78) 0.00%
TSI: Impaired Self-References (ISR) 48.45 (7.95) 0.00%
TSI: Tension Reduction Behavior (TRB) 52.86 (9.98) 0.00%
MDI: Disengagement (DENG)b 62.52 (15.35) 10.32%

MDI: Depersonalization (DEPR) 52.94 (11.95) 4.76%
MDI: Derealization (DERL) 52.75 (10.26) 3.17%
MDI: Emotional Constriction (ECON) 52.63 (12.13) 3.97%
MDI: Memory Disturbance (MEMD) 52.96 (15.08) 7.14%
MDI: Identity Dissociation (IDDIS) 51.44 (18.91) .79%
a
Forall TSI scales, N = 117.
b
For all MDI scales, N = 126.
97
6.68, p < .001; and for the TRB scale, 1(116) = 3.06, p < .01. All in all,
then, numbers for trauma-related phenomena compare favorably with
general population lifetime prevalence estimates for PTSD (roughly
8.0%; Millon et al., 1997). As above, it was decided to conduct

multivariate analyses in order to obtain an overall picture of the PTSD
results. In this case, the MMPI-2 and MCMI-III scales were examined
simultaneously; the PDS was not included here as it lacked a direct
comparison measure, and the TSI was excluded because it is a mea-
sure of trauma-related phenomena rather than PTSD per se. This anal-
ysis suggested that PTSD scores on the MMPI-2 and MCMI-III scales
were lower in the current sample than in the general population, approxi-
mate F(80) = 78.05, Hotelling’s trace = 1.95, p < .001.
Dissociation. Participants’ scores on the MDI scales are also
shown in Table 5. It should be mentioned that the DSM-IV-TR pro-
vides no estimates for the prevalence of simple dissociative symp-
toms (e.g., disengagement); therefore comparisons with DSM-IV-TR
estimates could not be made. Nonetheless, MDI scores are of particular
note since the sample scores were significantly higher than the stan-
dardization mean (of 50) in 5 out of 6 cases, specifically on the
measures of disengagement (DENG; 1[125] = 9.15, p < .001), deper-
sonalization (DEPR; 1[125] = 2.77, p < .01), derealization (DERL;
1[125] = 3.01, p < .01), emotional constriction (ECON; t[125] = 2.43, p <
.05), and memory disturbance (MEMD; 1[125] = 2.43, p < .05); only
the MDI measure of identity dissociation was found to be non-signifi-
cant. As would be expected, a multivariate test examining all 6 of the
MDI scales simultaneously indicated that the current sample’s MDI
scale scores were generally higher than normative (standardization) val-
ues, approximate F(120) = 17.46, Hotelling’s trace = 0.87, p < .001.
The picture is slightly different, however, when data are probed for
probable cases of actual dissociative identity disorder (DID). According
to the MDI manual (Briere, 2002), a diagnosis of DID is possible when
an individual receives a raw score of 12 or higher on the identity dis-
sociation scale, and probable when this raw scale score is bumped
up to 15 or above. Using this criteria, just one participant in the cur-
rent sample (who received a raw score of 21 on the identity dissocia-
tion scale) was diagnosable with DID. Thus, while the present
sample shows higher-than-average levels of various types of
dissociative symptomatology, there is not an unusually high rate of
DID per se.
Psychological Sadism and Masochism
Table 6 shows sample statistics for measures of psychological sadism

and psychological masochism. It should be noted that comparisons were

not drawn with DSM-IV-TR figures for the general population, as the di-
agnostic manual does not provide such figures for either psychological
sadism or psychological masochism.
Psychological sadism. On the MMPI-2 scale, 10.48% of the sample
scored at or above 65, and the sample mean (53.06) was found to be sig-
nificantly higher than the normative (standardization) mean of 50,
t(123) = 3.57, p < .001. The sample mean for the MCMI-III, on the other
hand (39.63), was lower than the standardization median (60). In addi-
tion, multivariate analysis suggested that the current sample, as a whole,
scored relatively low on measures of psychological sadism relative to
the normative (standardization) means, approximate F(80) = 13.80,
Hotelling’s trace = 0.35, p < .001. Additional analyses were conducted
in order to assess whether participants’ BDSM orientation (domi-
nance-versus-submission), as measured by the 7-point scale discussed
earlier, related to their psychological sadism scores. In light of the tight
correlation between gender and BDSM orientation, it was decided to
perform two types of regression analyses in order to thoroughly explore
the data here. These were: (1) simple regressions, with gender “uncon-
trolled,” and (2) hierarchical regression analyses, with gender entered in
the first step and BDSM orientation entered in the second step. Neither
of these analyses revealed effects for BDSM orientation (on either the
MMPI-2 scale or the MCMI-III scale).
TABLE 6. Sample Statistics for Measures of Psychological Sadism and Psy-

chological Masochism
Assessment Scale Sample Percentage

Means (SDs) of Sample
with Clinically
Significant Scores
MMPI-2 Do (Dominance) Supplementary Scale 53.06 (9.04) 10.48%
(N = 124)
MCMI-III Scale 6B (Sadistic [Aggressive]) 39.63 (22.11) 0.00%
(N = 86)
MMPI-2 Scale LSE2 (Low Self-Esteem) 47.03 (9.04) 5.65%
Content Scale (N = 124)
MCMI-III Scale 8B (Masochistic [Self-Defeating]) 29.57 (29.98) 15.12%
(N = 86)
Psychological masochism. As shown in Table 6, participants scored

below comparison values on the MMPI-2 (M = 47.03) and MCMI-III
(M = 29.57) measures of masochism. And a multivariate test indicated
that the current sample showed lower-than-normative (standardiza-

tion) levels of psychological masochism, approximate F(80) = 20.85,
Hotelling’s trace = 0.52, p < .001. Regression analyses parallel to
those performed with the psychological sadism scales revealed no ef-
fect for BDSM orientation on psychological masochism, regardless of
whether gender was controlled.
Personality Pathology
Narcissism. As shown in Table 7, nearly one-third of the sample

(30.23%) received scores of 75 or greater on the MCMI-III narcissism
measure. This percentage is especially high in comparison to the very
low DSM-IV-TR point prevalence estimate for the general population
(of less than 1.0%). Moreover, the sample mean on this scale (66.49)
was significantly higher than the median standardization value (60),
t(85) = 3.21, p < .01. Thus, narcissism is one construct one on which
BDSM practitioners appear to score relatively highly.
Borderline pathology. Participants’ results on the MCMI-III bor-
derline scale are also shown in Table 7. On this scale, 3.49% of the
sample received a clinically significant result, a percentage that is
slightly higher than the DSM-IV-TR general population point preva-
lence estimate of 2.0%. That said, the sample’s mean score (31.78) fell
below the standardization median (60). There was therefore no strong
evidence to suggest that our sample showed relatively high levels of
borderline features.
Paranoia. Sample results for the 3 measures of paranoia are also dis-
played in Table 7. While there were no participants scoring in the clini-
cally significant range on either of the MCMI-III measures, 16.93%
received clinically significant scores on the MMPI-2 scale. The sample
mean for the MMPI-2 measure (54.03) was also found to be signifi-
cantly higher than the normative (standardization) mean of 50, t(121) =
4.33, p < .001. On the other hand, the sample means for the 2 MCMI-III
scales (26.20 and 22.37) both fell below the normative (standardization)
median (60). A multivariate analysis examining all 3 scales simulta-
neously suggested that the current sample in fact shows lower levels of
paranoia as compared with normative (standardization) mean values,
approximate F(79) = 51.24, Hotelling’s trace = 1.95, p < .001.
TABLE 7. Sample Statistics and General Population Prevalence Estimates

Relating to Personality Pathology
Disordered Personality Assessment Scales Sample Percentage

Features (Estimates Means (SDs) of Sample
of Prevalence in the with Clinically
General Populationa) Significant Scores
Narcissism MCMI-III Scale 5 66.49 (18.76) 20.23%
(less than 1.0%) (Narcissistic) (N = 86)
Borderline Pathology MCMI-III Scale C 31.78 (22.73) 3.49%
(2.0%) (Borderline) (N = 86)
Paranoia MMPI-2 Scale 6 54.03 (10.28) 16.93%
(1.3% - 6.3%) (Pa: Paranoia)
MCMI-III Scale P 26.20 (26.39) 0.00%
(Paranoid) (N = 86)
MCMI-III Scale PP 22.37 (22.28) 0.00%
(Delusional Disorder)
(N = 86)
a
Estimates taken from the DSM-IV-TR; all percentages represent point prevalence estimates.
Additional Types of Personality Pathology
Table 8 shows sample means for the remaining 12 scales of the

MCMI-III not addressed above, as well as the percentages of participants
receiving clinically significant scores on each. Notable here are the rela-
tively high percentages for measures of histrionic features (19.77%),
avoidant features (17.44%), and dependent features (13.95%). Despite
these seemingly high percentages, on all of the scales shown in Table 8,
including the histrionic and avoidant scales, there was no instance in
which the sample scored significantly above the normative (standardiza-
tion) mean (60).
Supplementary Analyses
As mentioned earlier, a series of supplementary, exploratory analy-

ses were performed. These included (a) an examination of whether
BDSM orientation (dominance-versus-submission) was associated
with any of the major scales used in the study; (b) an examination of
participants’ overall test profiles on the MMPI-2; and (c) an appraisal of
participant responses to the 2 different versions of the BAI.
BDSM orientation analyses. To examine whether BDSM orientation
was associated with any of the scales used in the study, a series of re-
TABLE 8. Sample Statistics for the Remaining MCMI=III Scales
a
Assessment Scales Sample Means (SDs) Percentages
of Sample with Clinically

Significant Scores
Scale 1 (Schizoid) 40.15 (26.28) 10.46%
Scale 2a (Avoidant) 40.49 (26.62) 17.44%
Scale 3 (Dependent) 33.74 (26.00) 13.95%
Scale 4 (Histrionic) 57.29 (19.28) 19.77%
Scale 6a (Antisocial) 48.56 (22.23) 6.98%
Scale 8a (Passive-Aggressive) 31.23 (22.73) 5.81%
S (Schizotypal) Scale 32.14 (26.02) 0.00%
H (Somatoform) Scale 25.79 (27.36) 1.16%
N (Bipolar Manic) Scale 37.94 (24.35) 1.16%
B (Alcohol Dependence) Scale 36.50 (25.05) 4.65%
T (Drug Dependence) Scale 49.64 (23.21) 9.30%
SS 2Scale (Thought Disorder) 23.19 (22.83) 0.00%
a
For all scales, N = 86
gression analyses was performed. These analyses, like those presented

above for psychological dominance and submission, were performed
twice (with and without controlling for gender effects). Analyses were
performed for each of the 50 scales examined above except for the (pre-
viously examined) scales measuring psychological dominance and psy-
chological submission. Despite the large number of analyses, results
were still considered statistically significant at p < .05, a practice that
makes significant findings relatively likely. Using this criterion, BDSM
orientation was found to be significantly related to several different
scales.
There was an effect for the BAI scale, indicating that the more sub-
missive people were, the more anxious they tended to appear on the
BAI. This finding held true regardless of whether gender was not con-
trolled (␤ .37, p < .001) or was controlled (␤ = .34, p < .001). Partic-
ipants who self-identified as more-or-less submissive (n = 57) received
higher scores on the BAI (m = 7.88) than did participants who self-iden-
tified as more-or-less dominant (m = 3. 78, n = 59). Despite the differ-
ence, there was no evidence that submissive individuals received
unusually high BAI scores. Indeed, only one such individual received a
score in the “severely anxious” range, and BAI scores for submissive
individuals (m = 7.88) were found to be far lower than those reported for
the diagnostically mixed sample (m = 22.35). In short, while there is a

significant positive relationship between submission and BAI scores,
there is no evidence that those who identify as more-or-less-submissive
have unusually high levels of anxiety.

Significant results were also found for the MDI Memory Disturbance
(MEMD) and Depersonalization (DEPR) scales. Specifically, the more
submissive people were, the more symptoms of memory disturbance
they tended to show, regardless of whether gender was uncontrolled ( =
.20, p < .05) or controlled ( = .28, p < .01). Likewise, submission
was positively associated with experiences of depersonalization, re-
gardless of whether the analysis did not ( = .23, p < .01) or did ( =
.20, p < .05) control for gender. Those who self-identified as more-
or-less submissive (n = 57) received higher scores on the MEMD and
DEPR scales (m’s = 56.31 and 56.36, respectively) as compared with
those who self-identified as more-or-less dominant (m’s = 50.05 and
50.45, respectively, n = 57). Fairly high numbers of submissive partici-
pants received scores in the clinically significant range on these scales
(7 of 57, or 12.28%, and 5 of 57, or 8.77%, respectively). And the means
for the submissive group were found to differ significantly from the
normative (standardization mean) of 50 for both the MEMD variable,
t(57) = 2.75, p < .01 and the DEPR variable, t(57) = 3.25, p < .01.
Submission was also found to be associated with an increased likeli-
hood of receiving a PTSD-positive score on the PDS, a finding that ob-
tained regardless of whether gender was not controlled ( = .22, p <
.05) or was controlled ( = .31, p < .01). Two individuals identifying
as more-or-less-submissive were classified as PTSD-positive, while no
individuals identifying as more-or-less-dominant were so classified.
Thus, while the two groups significantly differed on this measure, nei-
ther group showed an unusually high likelihood of being PTSD-posi-
tive.
BDSM orientation was additionally associated with participant
responses to some of the MMPI-2 and MCMI-III scales. To begin with,
submission was positively associated with the MCMI-III paranoia scale,
one of the 3 measures of paranoia examined in this study. Those iden-
tifying as submissive received higher MMPI-2 paranoia scores (m =
55.98, n = 57) than those identifying as dominant (m = 51.82, n = 57), and
the submission-paranoia association held true both in the simple regression
( = .24, p < .05) and when gender was accounted for ( = .27, p <
.05). Further, the paranoia score of the submissive group was
significantly higher than the normative (standardization) value of 50,
t(52) = 4.15, p < .001. (Notably, however, submission was not associ-
ated with the other two measures of paranoia). Submission was also
positively related to two of the “miscellaneous” MCMI-III scales: 3
(Dependent) and SS (Thought Disorder). Participants identifying as

submissive received higher dependence scores (m = 38.58, n = 41) than
participants identifying as dominant (m = 28.87, n = 39), and the sub-
mission-dependence link was significant both in the simple regression
( = ⫺.22, p < .05) and when gender was taken into account ( = ⫺.27,
p < .05). Findings for the thought disorder measure were slightly more
complicated. While those identifying as submissive tended to receive
higher thought disorder scores (m = 26.44, n = 41) than those identify-
ing as dominant (m = 19.41, n = 39), submission was not significantly
predictive of thought disorder in the simple regression (p = ⫺.18, ns); it
was only predictive when gender was controlled (p = ⫺.31, p < .05).
Thus, in this particular case, to the extent that one is interested in exam-
ining BDSM orientation independent of gender, gender seems to
“mask” orientation effects. It should also be noted, however, that for
both the dependence scale and the thought disorder scale, the submis-
sive group scored well below the standardization (normative) value,
t(40) = 2.58, p < .05, and t(40) = 6.97, p < .05, indicating that despite a
submissive-dominance split on these scales, both groups score very low
on them.
Significant results were found for two more MCMI-III scales-the his-
trionic and narcissistic measures and in these cases it was those who were
more-or-less dominant who tended to receive higher scores. As was
found for the thought disorder results, these results were significant only
when gender was controlled. Thus, while individuals identifying as dom-
inant tended to receive higher histrionic scores (m = 59.69, n = 41) and
higher narcissism scores (m = 70.13, n = 41) than individuals identifying
as submissive (m’s = 55.19 and 63.93; both n’s = 39), dominance did not
predict either score in simple regression ( ’s = .118, ns; .157, ns, respec-
tively). Instead, dominance only predicted histrionic and narcissistic
scores when gender was taken into account ( = .36, p < .01, and = .31,
p < .05, respectively). It is noteworthy that relatively large numbers of
participants in the dominant group received clinically significant histri-
onic scores (5 of 39, or 12.82%) and/or narcissism scores (7 of 39, or
17.95%). Moreover, the dominant group was found to score significantly
above the normative (standardization) value on both the histrionic scale,
t(38) = 3.08, p < .01, and the narcissism scale, t(38) = 7.49, p < .001.
MMPI-2 profile analyses. An examination of participants’ overall
MMPI-2 profiles was conducted next, in an effort to determine whether
there were any profile patterns that were pervasive among the sample.
These profile analyses were performed to search for trends in codeable
types. These types usually involve just 2 or 3 key scales each, and con-
cern the interrelationships among scale scores (e.g., high scores on 2

specific scales, or high scores on 2 particular scales coupled with a low
score on third scale). Information about an individual’s profile type is
thought to afford greater, and subtler, insight into an individual’s psy-
che than simple observation of single scale scores.
This analysis found that this sample was extremely diverse in terms
of their personality profiles. That is, there were no common profile
types that resurfaced again and again. While the sample generally
showed no evidence of common typology, there were nonetheless sev-
eral small groups of people showing similar typologies. Three individ-
uals, for example, showed the 2-7/7-2 profile, a profile suggesting
anxiety and depression. Five other subjects produced tests with a
Spike 4, a profile that is relatively common among non-conformist in-
dividuals, but also associated with elements of egocentricity, immatu-
rity, impulsiveness and/or childishness (Caldwell & O’Hare, 1975;
Graham, 2001; Greene, 2000). In addition, 3 people produced 7-8/8-7
profiles, indicating anxiousness, self-preoccupations, feelings of infe-
riority, shyness, obsessive-compulsion, and schizoid features. Four
participants showed the 8-9/9-8 profile type; this is a relatively ex-
treme type, associated with identity crisis (often of a sexual nature)
and with demanding, hostile, confused and/or restless personality
styles. Finally, there were 7 individuals with a Pure 9 profile, a profile
in which the test-taker receives a hypomania score that is elevated
with respect to the other MMPI-2 clinical scales. People with this pro-
file may manifest varying degrees of expansiveness, excitability,
sleeplessness, grandiosity, over-productivity, quick temper, and/or
euphoria.
BAI analyses. It will be recalled all participants received 2 versions of
the BAI: one version with instructions to respond only in terms of
BDSM experiences, and one version with instructions to respond only
in terms of experiences unrelated to BDSM. It was hypothesized that
scores from the first version would be somewhat higher, since the types
of experiences assessed in the BAI bear similarities to those experi-
enced during BDSM activities, and it was suggested that a confirmatory
results might be interpreted as preliminary evidence that psychological
measures may yield distorted results for BDSM practitioners if not ad-
ministered and interpreted with a contextual understanding. As antici-
pated, a greater incidence of severe anxiety was found in the BDSM
version of the BAI (10.00%) than in non-BDSM version (0.80%).

Moreover, a paired t-test revealed that participants’ scores on the
BDSM version (M = 10.09) were significantly higher than those on the
non-BDSM version (M = 5.69), 1(126) = 5.18, p < .01.
DISCUSSION
These findings raise the important questions of whether psychoana-

lytic perspectives regarding the psychological organization of BDSM
practitioners are valid, and whether alternative conceptualizations can
or should be posited. It also raises significant concern about the appro-
priateness of the diagnosis of masochism and sadism in the DSM or,
minimally, the diagnostic criteria. Before turning to these major ques-
tions, however, it is important to consider the limitations of the study.
Limitations of the Study
First, several points should be made about the particular group of in-
dividuals studied in this research. It should be recognized that, regard-
less of birthplace, all participants were citizens of Southern California.
There are idiosyncrasies of Southern California, such as the fact that
many have experienced earthquakes, there is a large film industry in
Southern California, and the participants were recruited via email no-
tices that were distributed to a small group of people who had joined
Southern Californian BDSM clubs or organizations. These clubs in turn
comprise an ad hoc BDSM-related “community” that offers support and
friendship, elements that may well contribute to the general mental
health of its members. Indeed, since support groups appear to play a role
in mitigating the distress caused by having different sexual interests
(Moser, 1999), it is probable that people who have not found their way
to such a community would show inferior psychological health in com-
parison to most people in the present sample.
It might be assumed that the participants were more likely to be in-
volved in, and open about, their BDSM behavior, factors that may well
relate to psychological health. At the same time, several writers (e.g.,
Baldwin, 1993; Green, 2001; Henkin & Holiday, 1996; Moser, 1999;
Wright, 2002) have argued that people with BDSM interests are subject
to widespread misunderstanding, fear, and stigmatization from “outsid-
ers.” Results from the demographic survey, reported earlier, revealed
that most people in this study had some fear, from mild to severe, of
their BDSM behaviors being discovered. With a majority of society dis-

approving of BDSM behaviors, a person who seeks to avoid disclosure
is very likely to suffer some ill effects of censure (Nichols, 2003). It is
beyond the scope of this paper to gauge the exact ill effects of condem-
nation, or “BDSM-negativity,” on the results reported here, yet such ef-
fects are very likely to have existed. This being the case, it should be
kept in mind that BDSM practitioners in other geographic regions, or
without involvement in a BDSM community, are likely to experience
different and varying degrees of BDSM-negativity and its effects.
Whatever ill effects these participants may have experienced, they did
not seem to contribute to much overt psychopathology.
To add to the complexity of understanding the nature of this sample,
there are subgroups within it. The demographic questionnaire showed
there was, for example, diversity of age, occupation, and sexual orien-
tation. Their particular types of BDSM activities varied, as did their
relationship styles. Participants’ BDSM orientation (i.e., whether they
considered themselves mainly submissive, mainly dominant, or equal
switches) also varied, and although statistical analyses were con-
ducted to tease out submissive-dominant differences, such findings
may be misleading. This is because simple conceptualizations of dom-
inant and submissive do not necessarily apply to everyone in this sam-
ple, and it is not exactly a binary system. Even though participants
self-identified as belonging in one position or another on the BDSM
orientation scale, nevertheless, as the study’s demographic survey
showed, there is much variety in power-exchange sexuality. The no-
tion of sadism, for example, is not the same as domination, although
people who mainly engage in either would likely self-identify on the
BDSM scale as “dominant.” Thus, roles defy neat compartmental-
ization, and can be temporary. Results here may occasionally reflect
such subtle, between-subgroups differences.
Another limitation was the decision not to include a control group in
the study design. Although normative (general population or other com-
parison sample) estimates were available for all of the psychometric
tests used, a control group would have afforded better demographic
comparisons, and would have reduced error in the analyses. A final lim-
itation, common to studies of this kind but nonetheless important, is the
fact that the causality of observed relationships cannot be directly
assessed. That is, the results in this study yield information about correla-
tions among variables, but do not provide any information about whether
or how certain phenomena lead to other phenomena. Thus, conclusions
about cause-and-effect relationships between BDSM behaviors and

psychological variables can be drawn only with extreme caution.
Consideration of Psychometric Results in Light

of Psychoanalytic Perspectives
Results of testing showed that people in this sample, as a whole, did

not differ from comparison samples and/or normative values on most
measures of major clinical disorders (e.g., depression) and severe per-
sonality disorders (e.g., borderline pathology) identified in the psy-
choanalytic literature as coexisting with BDSM. Millon et al. (1997)
differentiate between two categories of personality disorders: severe
personality pathology (borderline pathology, paranoia, and schizotypal
pathology) and (the relatively less severe) clinical personality pat-
terns (e.g., histrionic personality disorder and narcissism). Paranoia
and borderline pathology, the severe personality disorders described
in the psychoanalytic literature as ubiquitous among BDSM practitio-
ners, were remarkable in their absence from this sample. While partic-
ipants scored relatively highly on one of the paranoia measures, they
scored below average on the other measures. Similarly, contrary to
psychoanalytic theory, there was no evidence at all of higher-than-av-
erage levels of borderline pathology.
In examining measures of (the relatively less severe) clinical person-
ality patterns on the MCMI-III scale, however, there was evidence of a
significantly higher level of narcissism in this group, compared with
general population estimates. While this finding does not support those
psychoanalytic notions that imply a narcissistic personality structure is
present in all, or even most, people who practice BDSM, it does point to
the likelihood that some BDSM practitioners (in this case 30.23%) are
“clinically significant” on this measure, indicating the presence of
greater-than-average levels of narcissistic features and possibly suffer
from narcissistic personality disorder. The particular narcissism scale
used in this research is designed to assess a personality type marked by
ego self-involvement, overvaluation of self-worth, and little interest in
give-and-take in social life (Millon et al., 1997, p. 17). It is notable,
however, that past research has also indicated that the scale “may at
times reflect personality strengths as well as personality pathology”
(p. 125). Similarly, Millon et al., in discussing narcissism, along with
histrionic and compulsive features, have indicated, “these three con-
structs tend, at modest levels of magnitude, to include normal if not
adaptive traits” (p. 125). Further, Millon et al. have suggested that,
given MCMI- III scoring procedures, “when an individual without sig-

nificant personality pathology completes the instrument, the absence of
pathology will tend to elevate these three scales (p. 125). It should also
be noted that the high narcissism scores are consistent with Millon’s (T.
Millon, personal communication, 2003) prediction that individuals who
score highly on social desirability will also tend to score highly on both
the narcissism and histrionic scales. Indeed, there was evidence of
strong positive correlations between MCMI-III Social Desirability and
Narcissism Scales, r = .56 (p < .01, N = 126), as well as between
MCMI-III Social Desirability and Histrionic Scales (r = .70,p < .01, N =
126). In addition, the MMPI-2 profile code that is a marker for patho-
logical narcissism is a 4-9, 9-4 profile, yet only two people in this sam-
ple produced such profile types. The, despite the relatively high levels
of narcissism in this group, the present findings are not indicative of
pathological narcissism.
There was evidence of a significantly higher level of histrionic fea-
tures in this group compared with general population estimates, as mea-
sured by the MCMI-III histrionic scale. According to Millon et al.
(1997, p. 17), individuals who receive high scores on this scale “often
exhibit an insatiable if not indiscriminate search for stimulation and af-
fection,” and often harbor “a fear of genuine autonomy and a need for
repeated signs of acceptance and approval.” These scores clearly sug-
gest the presence of histrionic personality patterns among some people
in this sample and possibly histrionic personality disorder. As discussed
above, however, this finding should be interpreted with caution since
Millon et al. identified the histrionic scale as one for which moderate el-
evations might be considered “normal,” or even adaptive. Additionally,
the finding may reflect, to some degree, lifestyle and location consider-
ations rather than pathological attention-seeking. Many people in the
entertainment industry, for example, seem very comfortable with a dra-
matic presentation of self. It has been noted that people in the Los An-
geles BDSM community meet frequently for “play parties” in which a
high level of exhibitionism is deemed appropriate (e.g., performing
consensual BDSM “scenes” in front of many others, in highly stylized
and creative outfits). The pure theatricality of BDSM play has been dis-
cussed at length (e.g., Brame, Brame, & Jacobs, 1993) and it would not
be surprising if people with histrionic tendencies should find their way
to such community experiences where they might feel more comfort-
able manifesting them. Alternatively, it may be that both histrionic and
narcissistic findings here reflect what Mansfield (1992) has conceptual-
ized “exhibitionistic narcissism,” a type of narcissism with histrionic
features that is thought to develop when an individual’s self-aggran-

dizement is reinforced by his or her environment, as described above.
Along similar lines, analyses showed that the present sample received
higher-than-average scores on 5 of the 6 the MDI scales, each of which is

designed to tap into dissociative symptomatology. The present results are
difficult to interpret, however, as only 1 participant qualified for a possi-
ble diagnosis of dissociative identity disorder (DID), and as single scales
on the MDI are not necessarily clinically meaningful. That said, since the
sample scored relatively highly on almost all of the scales, there is a defi-
nite trend here that may point to a higher prevalence of a dissociative syn-
drome among this sample. In seeking to make sense of the MDI results, it
is worth noting that the measure assesses both uncommon experiences
(e.g., “out of body” experiences), and more common ones (e.g., missing
one’s freeway exit because one’s mind is elsewhere). It is also worth not-
ing that the MDI manual (Briere, 2002) lists, in addition to DID, several
DSM-IV-TR-classified disorders that may be associated with high MDI
scores, among them depersonalization disorder and dissociative amnesia.
The manual further suggests that “the various symptoms attributed to dis-
sociation are substantial in type and number” and that “the use of the term
dissociation, as though it referred to a single psychological phenome-
non, may be misleading” (p. 2). Thus, while the sample–undeniably-re-
ceived relatively high scores on the MDI, suggesting a greater-than-
average tendency to experience various dissociative phenomena, there
is no evidence of a higher-than-average likelihood of DID, and, more
generally, no direct link that can be made between the MDI scores and
anyone particular disorder.
There was evidence of higher-than-average scores on just 1 of the 4
trauma measures. Specifically, the present sample received higher-
than-average scores on the MMPI-2 measure of PTSD, with 13.71 % of
participants showing clinically significant values. At the same time,
however, participants did not show unusually high levels of trauma on
the MCMI-III or on the PDS, and there were no cases of clinically sig-
nificant trauma on the TSI. Thus, despite the high MMPI-2 scores, the
scales as a whole did not indicate especially high levels of trauma.
It is worth noting, however, that although no participants received
clinically significant TSI scores, the sample as a whole received higher-
than-average scores on 2 of the TSI scales: the Dysfunctional Sexual
Behavior (DSB) scale and the Tension Reduction Behavior (TRB)
scale. These relatively high scores were of theoretic interest. As Briere
suggests, “high scores on the DSB may suggest sexual risk-taking and
involvement in unsafe sexual practices (Briere, 1995, p. 14),” As for the
TRB, it “measures the individual’s tendency to externalize distress

through suicidality, aggressiveness, inappropriate sexual behavior, self-
mutilation, and activities intended to forestall abandonment or aloneness
(Briere, 1995, p. 14).” Judgmental societal attitudes towards BDSM,

rather than absolute measures of pathology, would seem to underlie no-
tions of “inappropriateness” inherent in this measure. Items on these
scales concerned, among other things, getting into trouble because of
one’s sexual behavior, sexual attraction to potentially dangerous per-
sons, and using sex to feel important or powerful. Thus, engagement in
BDSM behavior, by itself, is essentially considered a symptom of
trauma when assessed using this scale. Whereas the BAI, for example,
includes items that are ambiguous for those who engage in BDSM, the
TSI includes items that effectively consider BDSM behavior to be
pathological, or at least problematic. It is beyond the scope of this paper
to explore this question in detail, but future research should address
whether BDSM behavior, by itself, can be or should be isolated from
other symptoms within theoretic models and within tests of trauma,
anxiety, and related disorders. A similar set of issues is explored to-
wards the end of this discussion, in a consideration of the appropriate-
ness and validity of different tests for use with the BDSM population.
In considering this set of psychometric findings as a whole, the gen-
eral psychological profile found among this sample is not consistent
with that described by psychoanalytic literature (i.e., traumatized, de-
pressed, anxious, or obsessive-compulsive people who are sometimes
out of touch with their surroundings. After conducting over 100 statisti-
cal comparisons, a significant result on one or more disorders seemed
almost guaranteed on the basis of chance alone. However, there were no
significant results on most measures of PTSD, on obsessive-compul-
sion, or on depression or anxiety.
Likewise, a misconception created by confusion in the literature be-
tween psychological and sexual sadism and masochism has been ad-
dressed: this study has shown that this sample of BDSM practitioners is
not necessarily psychologically masochistic or sadistic. Similarly, with
regard to personality pathology, this sample has not completely fulfilled
expectations indicated by some writers, that there is widespread person-
ality pathology within this group. The finding that 30.23% scored high
on narcissism, though certainly significant, does not match literature-
based predictions that most BDSM practitioners would show narcis-
sism. Of even more importance is the absence of borderline pathology
among this sample, for assumptions that such severe personality pathol-
ogy was an integral part of the psyche of all BDSM practitioners are
longstanding. All of the above suggests that overpathologization is ex-

tremely likely to have occurred with respect to at least some people with
BDSM interests.
Psychological Correlates of Submission and Dominance
Before turning to a discussion of other psychological approaches to

understanding BDSM, it is also important to consider that the findings
differed slightly for those who self-identified as more-or-less dominant
rather than more-or-less submissive. In the present study, only about
half of the participants saw themselves as exclusively dominant or sub-
missive; thus, the dominant-submissive distinction cannot be consid-
ered a clear-cut, “either-or” distinction. Nonetheless, there were visible
differences between those on the dominant and submissive sides of the
spectrum. Specifically, submission was found to relate to a variety of
measures, among them measures of anxiety, dissociative phenomena,
paranoia, and dependence, while dominance was found to relate to just
2 measures: measures of histrionic and narcissistic personality features.
In the simplest terms, these results suggest that those who are more-
or-less submissive are generally more prone to suffer from a psycholog-
ical disorder (relative to those who are more-or-less dominant), but
also–not surprisingly–that submission and dominance are associated
with different types of measures. Thus, beyond the fact that the there is
not strong evidence of psychopathology in the sample as a whole, there
do appear to be different tendencies, or profiles, associated with sub-
mission versus dominance. Given these tentative conclusions, it seems
that more detailed analyses of submissive-dominant differences (and
similarities) will constitute a fruitful area for future inquiry and re-
search.
Alternative Conceptualizations of BDSM Behavior
If this sample does not conform to earlier, specific assumptions about

widespread psychopathology among BDSM practitioners, then what
might be the psychological constellation evidenced here? It was hoped
that a thorough examination of individual MMPI-2 profiles might show
some overall trends, however results showed no such thing. It might be
argued that these people are indeed different, by virtue of their atypical
sexuality, and that there must be pathology to match. Or is it possible
that a psychologically “normal” person might sometimes (only 11.2%
of subjects indicated that BDSM play was their only form of sexual ac-
tivity) seek erotic pleasure through pain or punishment, for example?

People in this sample comprise a psychologically diverse group,
seemingly similar only in terms of their desire to engage in BDSM, the
diversity of their relationship styles, their fear of discovery, their

participation in BDSM clubs and community life, their tendency to be
well-educated, and their tendency to score highly on measures of nar-
cissism and histrionic features.
So why do some people engage in BDSM behaviors if it is not driven
or associated with severe psychopathology? Two particular points of
view come to mind. First, there is the physiological perspective, which
could examine, for example, individual differences in how endorphins
function to interconnect pain and pleasure. Second, there is a sociologi-
cal, or cultural, perspective, which, for example, could explore the degree
to which BDSM interests and, their expression relate to cultural norms,
social sanctions, and so on. In short, while the present findings do not pro-
vide any simple explanations for why people engage in BDSM and/or
how people who do so might differ psychologically from others, they do
suggest that there may not be simple psychological differences, and that
a thorough understanding of BDSM behavior might be best sought by
exploring several different avenues of study.
Cultural Aspects of the Psychological Testing of BDSM Practitioners
It is important to discuss the issue of the “cultural appropriateness” of

the tests administered in this study. At the outset, there was concern that
certain items and/or scales might present specific ambiguities or re-
sponding dilemmas for those who engage in BDSM behavior. Since
such a scenario could potentially inflate (or decrease) pathology scores,
a thorough consideration of cultural appropriateness is important.
Ethical standards emphasize the need for a lack of bias in psychologi-
cal assessment tools. Mental health service providers are expected to re-
main cognizant of their clients’ unique cultural contexts, and to provide
unbiased services to diverse populations (e.g., American Psychological
Association, Office of Ethnic Minority Affairs, 1993). At the same
time, however, there is still evidence that mental health practitioners are
generally poorly equipped to effectively treat clients from sexual mi-
nority groups (Cole, Denny, Eyler, & Samons, 2000; Fassinger and
Richie, 1997). This is of particular concern given that there are wide-
spread biases towards such individuals (Moser, 1999; Nichols, 2003),
and that there is an increasing likelihood that clinicians will encounter
such clients in therapy (see Ettner, 1999). In terms of BDSM practitio-
ners, it is notable that in many cases clinicians are trained to link BDSM
with psychopathology, and to focus on the origins of a client’s BDSM
behaviors regardless of the client’s presenting problems (Cole et al.,
2000; Fassinger & Richie, 1997).

Given the foregoing, it was reasonable to be concerned that common
psychometric tests may have been designed in such a way that items
and/or scales were ambiguous, or particularly problematic, for BDSM
practitioners. Such a situation might occur, for example, if an item re-
ferred to affective states that are commonly experienced during the
course of consensual BDSM eroticism, such as nervousness.
This issue was explored by using two versions of the BAI, a measure
that is entirely focused on fear and anxiety states. As expected, signifi-
cantly different results were found when participants completed the
BAI with reference to their BDSM behaviors as opposed to with refer-
ence to the non-BDSM aspects of their lives. The BAI test-retest corre-
lation is typically high in normative samples (Beck & Steer, 1990); two
administrations of the test should relate relatively strongly. However,
here the two administrations of the BAI produced very different results
for participants, depending on whether or not they answered with re-
spect to their BDSM activities. This finding is important, as it suggests
that test responses, and thus overall scores, can be different to the extent
that test-takers interpret items within the context of BDSM behaviors.
In order for clinicians to know precisely what they are measuring when
they administer tests like the BAI, it would appear that contextual quali-
fiers are needed. That said, the differences in the BAI findings should
not be weighted too heavily, as the dual administration of the BAI may
have introduced demand characteristics. Specifically, participants may
well have felt that they should respond differently to each version, since
they were given two different sets of instructions.
In another effort to explore the issue of cultural appropriateness,
feedback was solicited from participants regarding all of the tests used
in the study. Their informal responses suggested a number of question-
able items on several tests, especially those that addressed desires to
hurt or be hurt by a loved one, affective states commonly sought during
consensual BDSM play, and negative consequences of sexual behav-
iors. For example, Items 323 and Item 332 on the MMPI-2 items that
address causing and receiving hurt from loved ones, sparked numerous
comments, from participants who were confused about whether or not
they should answer them in the context of consensual hurt. A partici-
pant with a strong moral sense would not endorse a desire to deliber-
ately hurt a loved one outside consensual BDSM play, but the questions
lacked contextual clarification.
After soliciting participant feedback, a series of analyses was under-
taken to examine the validity of the scales used in this research. The
questions guiding these analyses were: “Is there reason to believe these
tests are invalid for the present sample?” and “Is there any evidence that
the items identified as questionable affect overall scale scores?” First, a
series of reliability analyses was performed. Specifically, reliability
was examined for the following: all 7 of the MMPI-2 scales; the 12
MCMI-III scales used in the principle analyses; all 10 of the TSI scales;
all 6 of the MDI scales; the BAI (both versions) and the BDI-II. Alphas
ranged from .62 to .91 on the MMPI-2 scales, from .60 to .90 on the
MCMI-III scales, from .64 to .91 on the TSI scales, and from .60 to .86
on the Mill; for the BAI, the alpha was .83, and for the BDI-II it was .92.
These values are all acceptably high, comparable to those published in
the test manuals for these scales, and indicative of high internal validity.
This series of analyses was then repeated with the questionable items
removed. Notably, there were no instances in which removal of the
items had a significant impact on alpha (in all cases, change in a < .02).
In many cases, the alpha value remained unchanged or dropped slightly
with removal of the questionable items. Thus, the questionable items
did not affect the internal consistency of the scales. This first set of anal-
yses suggested, in short, that the scales were valid for use the current
sample.
The issue of validity was further addressed with respect to the TSI,
the MDI, the BAI (both versions), and the Bill-II. Specifically, a series
of principle components factor analyses was performed on these scales.
It is worth mentioning that these analyses were not performed on the
MMPI-2, the MCMI-III, or the PDS since appropriate comparative in-
formation was not available for these tests. With the TSI and the MDI,
varimax rotation was used, and with the BAI and the BAI-II, to be con-
sistent with Beck et al. (1996) and Beck and Steer (1993), promax
(oblique) rotation was used instead. For the MDI, BAI-II and BAI, all of
the test items were put into an analysis (e.g., for the MDI, one large fac-
tor analysis was conducted with all 30 items). For the TSI, following
Briere (1995), the 10 scales were put into the analysis. This series of
factor analyses showed factor structures that were remarkably similar to
those shown in the test manuals. In the case of the TSI, both the present
analysis and that presented in the manual obtained 2 factors total (both
with eigenvalues > 1.0), and these factors had the exact same loadings.
For the MDI, while the manual reported 7 factors accounting for 65.4%
of the total variance, the present analysis found 8 factors accounting for
75.40% of the variance. In both cases, the patterns of loadings were
nearly identical, and the factors corresponded relatively well to the 6
MDI scales. For the BAI, like Beck and Steer (1993), we found two
moderately correlated factors (r = .40, p < .001), one generally involv-
ing somatic symptoms and the other generally involving cognitive
symptoms. Finally, for the BDI, we found five factors (with eigenvalues
of 8.32, 1.75, 1.40, 1.31, and 1.01) that were similar to those reported by
Beck et al. (with eigenvalues of 8.55, 1.56, 1.03, 0.91, and 0.83); as with
the other tests, factor loadings were again nearly identical. This series of
factor analyses was then repeated for each of the tests, with the ques-
tionable items removed from each scale; (a second analysis was not run
for the TSI, since scales rather than items were put into the analysis).
Remarkably, there was no evidence that these questionable items had
affected overall scores; in all three cases the number of factors and the
vast majority of loadings were exactly the same. In sum, this second set
of analyses buttressed the findings of the reliability analyses by suggest-
ing that the underlying structures (i.e., the core phenomena) of these
tests were being measured as intended.
In addition to the evidence of test validity shown by the reliability
analyses and the factor analyses, there was also, as reported else-
where, good evidence of convergent validity among the scales used in
this research. For example, the different scales of depression used here
all correlated well with one another. When the questionable items
were removed from such analyses, the same levels of convergent va-
lidity were found. This suggests, again, that the scales were measuring
what they were intended measure, and that the items identified as
questionable did not have a discernable impact on overall scale scores.
There is, however, an important caveat to this conclusion. While
psychometric tests typically produce summary scale scores, they often
also contain a series of “critical items,” single “red flag” items that clini-
cians are trained to inspect individually. Some of these critical items, es-
pecially those relating to harm and sexuality, are potentially ambiguous
for BDSM practitioners, yet endorsement could lead to a respondent be-
ing considered at risk of causing harm to self or others, or in need of spe-
cial focus/crisis intervention. Such items do not take into account the
realities of consensual BDSM play, and since many BDSM practitio-
ners feel uncomfortable disclosing their sexual preferences (Moser,
1999), clinicians are not always in a position to understand “critical
items” in the context of their clients’ sexual preferences and behaviors.
Thus, certain modifications to existing measures would improve clini-
cians’ diagnostic accuracy with respect to those who practice BDSM.

The addition of qualifiers, identifying particular behaviors as consen-
sual or nonconsensual, for example, would improve test items in many
cases. Until such changes are made, clinicians are cautioned to use par-
ticular care when administering psychometric measures to BDSM prac-
titioners.
CONCLUSIONS
In summary, no evidence was found to support the notion that clini-

cal disorders–including depression, anxiety, and obsessive-compul-
sion–are more prevalent among the sample of individuals with BDSM
interests than among members of the general population. Moreover, this
sample did not show evidence of widespread PTSD, trauma-related
phenomena, psychological sadism, psychological masochism, or per-
sonality disturbances. Similarly, no prominent themes were found in a
series of profile analyses. There were, however, some exceptions to this
general pattern, most notably the higher-than-average levels of nonspe-
cific dissociative symptoms and narcissism in this sample. That said,
this body of findings suggests that, contrary to longstanding assump-
tions in the psychoanalytic literature, there is very little support for the
view that psychopathology underlies behavior. This study certainly
raised questions regarding DSM terminology and classification of Sex-
ual Sadism and Masochism or, minimally, the diagnostic criteria of
these disorders. It is hoped that future revisions of DSM will take into
account more recent empirically based evidence of known pathology
among individuals who may express sexually variant behavior. More-
over, the findings in this study underscore the need for future research in
this area.
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Psychological Functioning of Bondage/Domination/Sado-Masochism (BDSM) Practitioners

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Psychological Functioning

ABSTRACT. A demographic questionnaire and 7 psychometric tests

1-800-HAWORTH. E-mail address: <docdelivery@haworthpress.com> Website:

KEYWORDS. Bondage, domination, sado-masochism, paraphilia,

BDSM is a collective term that refers to erotic behaviors involving

BDSM AND PSYCHOPATHOLOGY:

Some writers have linked sexually expressed masochism and sadism

To address the need for an empirically derived, psychological under-

and a comprehensive psychometric test battery were administered to a

teristics, social behaviors, and sexual practices of this population. These

Participants in this study were 132 self-identified BDSM practitio-

BDSM clubs and organizations. The total sample consisted of 73 males,

9.96). While 52 of the participants were California natives, 76 were

Materials consisted of a detailed demographic questionnaire and a

Millon, 1997). One of the assets of this measure, as compared to the

The Trauma Symptom Inventory (TS1). The TSI (Briere, 1995) is a

1996) . The BDI-II is designed to correspond to the American Psychiat-

Summary of Measures Used, by Specific Type of Psychopathology

As mentioned above, some types of psychopathology were measured

Participants attended one of eleven proctored testing sessions. These

MMPI-2 MCM-I-III TSI PDS MDI BDI-II BAI

Demographic Findings, and Findings Regarding Social

As there were some cases in which participants elected not to answer

Education and Employment

Compared to figures from the U.S. Census Bureau’s 2002 Current

Relationship Status and Relating Behavior

People in this sample were relatively diverse in terms of relationship

status and relating behavior. Roughly a third (36.7%) identified them-

Sexual Orientation and BDSM Orientation

The demographic questionnaire included a Kinsey-type scale of sex-

TABLE 2. Participants’ BDSM Orientation, by Gender

BDSM Orientation Males (n, %) Females (n, %) Total (n, %)

Exclusively submissive 9 (12.9%) 19 (35.2%) 28 (22.6%)

TABLE 3. Percentages of Participants Who Engage in Various BDSM Activities

Play Type % Play Type % Play Type %

Age Play 16.5 Electric Play 42.2 Muscle Worship 5.6

Professional BDSM Service Providers and Customers

The majority of study participants (87.1%) indicated that they en-

tivities caused them minimal distress. Approximately half of our sample

BDSM Community Activities

The vast majority of participants (89.9%) indicated that they held

Results from the Psychometric Measures Test Scoring

Of the 127 participants who completed the MMPI-2, 3 of these par-

MCMI-III, 34 had scores of 75 or above on one or more of the

34 cases resulted in just 86 cases for MCMI-III analyses, Millon (T.

depression, for example, to be packaged into a single test, without re-

Major Psychological Disorders

Depression. Across all 5 depression scales, the majority of partici-

Psychopathology Assessment Scales Sample Means (SDs) Percentages of Sample

than a non-clinical “general population” sample. Nonetheless, across

Obsessive-compulsion. The sample’s scores for the two measures of

PTSD, Trauma-Related Phenomena, and Dissociation

PTSD and trauma-related phenomena. Table 5 shows the sample

TABLE 5. Sample Statistics for Measure of PTSD and Related Symptoms

Assessment Scales Sample Means (SDs) Percentages of Sample

MDI: Disengagement (DENG)b 62.52 (15.35) 10.32%

8.0%; Millon et al., 1997). As above, it was decided to conduct

Psychological Sadism and Masochism

Table 6 shows sample statistics for measures of psychological sadism

and psychological masochism. It should be noted that comparisons were

TABLE 6. Sample Statistics for Measures of Psychological Sadism and Psy-

Assessment Scale Sample Percentage

Psychological masochism. As shown in Table 6, participants scored