Is Paraphilic Coercion a Different Construct from Sadism or Simply the Lower End of an Agonistic Continuum?

Purpose: It has been hypothesized that paraphilic coercive disorder (PCD) constitutes a distinct preference for coercion that can be discriminated from a preference for sadism. Despite the repeated rejections of PCD as an acceptable diagnosis, it continues to be used. In 2013 Knight and colleagues reviewed the evidence that had been proffered to support the admission of PCD to the DSM-5 as a distinct diagnosis and proposed an alternative model that considers PCD and sadism as levels on a single dimension, called the Agonistic Continuum. They provided factor analytic data to support their argument for the unidimensionality of the proposed continuum, taxometrics to explore whether the construct was distributed categorically, and Item Response Theory to explore the ordinal structure of the dimension.

Method: The aim of the present study was to replicate the prior findings and to expand their analyses with latent profile analysis on 680 sexual offenders.

Results: The results supported the viability of an Agonistic Continuum, challenging the hypothesis that PCD and sadism constitute distinct disorders and corroborating the reconceptualization of both paraphilic coercion and sadism.

Conclusion: This dimension suggests important changes in the conceptualization and measurement of the construct of sadism. Implications are discussed.