Attachment, childhood trauma, and adverse childhood experiences as predictors of sadomasochism

Attachment, childhood trauma, and adverse childhood experiences as predictors of sadomasochism | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Attachment, childhood trauma, and adverse childhood experiences as predictors of sadomasochism Rudy Abi-Habib, Sally El Kaaki, Zahra Itani, Nour Yaktine This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6924906/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Sadomasochism (SM) is a sexual behavior that involves sadistic and masochistic practices. While SM has been widely studied in the literature, little is known about its expression and predictors in the Arab world. This study aims to identify predictors of sadomasochism, by evaluating attachment (Sample 1), adverse childhood experiences (Sample 1), and childhood trauma (Sample 2). Sample 1 consisted of 113 participants aged between 18 and 65 and revealed that attachment insecurity and adverse childhood experiences predicted sadomasochistic tendencies in adulthood. Sample 2, consisting of 121 participants within the same age range, showed that childhood trauma predicted engagement in sadomasochistic behaviors. Our findings suggest that adverse and traumatic childhood experiences may shape adult sexual behaviors, with sadomasochism potentially serving as a coping mechanism used to transform previously painful experiences into sources of control or pleasurable. Future research should explore the role of protective factors, and the psychological meaning of sadomasochistic behaviors among adults with histories of childhood adversity. Sadomasochism attachment adverse childhood experiences childhood trauma Arab world Introduction Sadomasochism (SM) is a sexual behavior that involves both sadistic and masochistic practices. The term ‘sadism’ was named after the infamous Marquis de Sade (1740-1814), known for writing about sexual cruelty and eroticizing pain. Sadism is defined as the act of inflicting pain, suffering, and humiliation on others and deriving pleasure out of it. The term ‘masochism’ was named after von Sacher-Masoch (1836-1905), a writer whose novels described pleasure in personal humiliation and submission. Masochism is thus defined as the act of receiving pain, suffering, and humiliation and deriving pleasure and arousal out of it (Weierstall & Giebel, 2017). As a sexual practice, sadomasochism encompasses a wide array of acts such as pinching, beating, strangling, raping, burning, or stabbing. Due to the nature of sadomasochistic activities as well as the violence that can accompany such acts, non-consensual sadomasochism is classified as a psychopathology in diagnostic manuals, referred to as a sexual perversion, paraphilia, or sexual disorder (American Psychiatric Association, 2022; World Health Organization. 2021). In the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR; American Psychiatric Association, 2022), sadomasochism is classified as two distinct paraphilic disorders, under the name of ‘sexual sadism disorder’ and ‘sexual masochism disorder’. In order for sadomasochistic practices to be considered a pathology rather than a sexual preference such as the case of consensual BDSM (Bondage, discipline, dominance, submission, sadism and masochism) activities, sadomasochism should cause distress to the person exhibiting them, rendering them unable to function and perform daily tasks. Scholars investigating the etiology of sadomasochism, sexual aggression, and sexual violence have evoked different factors associated with childhood such as the early caregiver-infant relationship (Chavis, 2018; Russell & King, 2016; Smallbone & Dadds, 2000), as well as adverse childhood experiences and/or childhood trauma, abuse, or neglect (Abrams & Stefan, 2012; Abrams et al., 2022; Grossman, 1991; Nordling et al., 2000). This line of research is grounded in the understanding that adult sexuality begins to develop in early childhood (Abrams et al., 2022), and that sexual desires are significantly influenced by environmental factors and events (Cornwallis & Uller, 2010). Consequently, individuals exposed to adverse or traumatic experiences during childhood may experience disruptions in sexual development and functioning (Fuss et al., 2019; Pedneault et al., 2020), which could, in some cases, contribute to the emergence of sadomasochistic tendencies. Sadomasochism and attachment Attachment theory was first developed by Bowlby (1982) positing that children have an innate biological need to form close relationships with others. Over the years, Bowlby (1982) and Ainsworth (1978) developed the concept of attachment styles; patterns of behavior and ways in which one relates to others. Attachment styles are developed during childhood as a result of early caregiver-child interactions and are thought to remain stable across time (Wismeijer & van Assen, 2013). Attachment styles, which can be secure, insecure-anxious, insecure-avoidant, or disorganized (Ainsworth, 1978), have been shown to have profound implications on adult attachment, interpersonal relationships, and sexual behaviors (Wismeijer & van Assen, 2013). For instance, initial research has shown that secure attachment is highly correlated with pleasurable sexual behavior (Hazan et al., 1994). More recent studies revealed that securely attached individuals are more likely to have balanced relationships characterized by intimacy and satisfaction compared to insecurely attached individuals (Feeney, 2008; Mikulincer & Shaver, 2007). Insecure attachment, on the other hand, is associated with more maladaptive sexual and romantic patterns and behaviors. Studies have shown that individuals with an insecure-avoidant attachment style are more likely to engage in casual sex (Gentzler & Kerns, 2004) and engage in coercive sexual behaviors (Smallbone & Dadds, 2000). While insecure attachment has been shown to foster maladaptive and deviant sexual behaviors, few studies have studied sadomasochism from an attachment framework. Festa (2001) established an association between attachment and sadomasochism, showing that women with an insecure-anxious attachment style are more likely to exhibit masochistic tendencies. More recently, Russell (2016) showed that the subclinical type of sadism -everyday sadism, and insecure attachment predicted sexual aggression. Chavis (2018) argued that sadomasochistic tendencies originate from early mother-infant attachment and are precisely triggered when children develop an insecure organized or disorganized attachment style. It can thus be argued that early experiences of distress in the caregiver-child relationship may give rise to self-defeating or destructive behaviors in adulthood, as individuals attempt to regain control and transform pain into pleasure. While theoretical links have been proposed, a direct association between attachment and sadomasochism has yet to be empirically established. Further research is therefore needed to deepen our understanding of how attachment dynamics may shape the development of sadomasochistic tendencies. Sadomasochism, adverse childhood experiences, and childhood trauma Adverse childhood experiences refer to harmful events that occur during childhood. Examples include separation from caregivers, abandonment, neglect, physical, sexual and/or emotional abuse (Jones et al., 2020). Such experiences can be overwhelming for the child, potentially leading to childhood trauma that hinders the child’s ability to cope effectively and interferes with normative development and the acquisition of age-appropriate experiences. These potentially traumatic events may have a significant impact on physical and mental health, leading to negative outcomes such as poor life satisfaction, depression, anxiety, and substance use (Mersky et al., 2013). Indeed, a relationship between adverse childhood experiences and aggression/hostility in adulthood has been established in the literature (Halle & Darling-Churchill, 2016; Letourneau et al., 2018). In the context of sexual violence, childhood abuse has been shown to be associated with sadomasochistic tendencies (Abrams, 2022). More specifically, men who were sexually abused during childhood were found to be more likely to exhibit sadistic tendencies, while females exhibited more masochistic tendencies. This relationship confirms previous findings (Frías et al., 2017) showing that women with comorbid sexual masochism disorder and borderline personality disorder reported greater sexual abuse during childhood and higher insecure-avoidant attachment. Such drawn conclusions can be explained by the fact that previously abused individuals are more likely to develop helplessness and apprehension towards uncontrollable punishment and aggression (Békés et al., 2017; Novick & Novick, 2004). Thus, it can be argued that individuals with masochistic tendencies escape their perceived vulnerabilities by voluntarily subjecting themselves to pain and suffering (Gabbard, 2012), thus actively acting out what was once experienced passively. Conversely, previously abused individuals with sadistic tendencies tend to mirror and reenact the behavior that they were subjected to during childhood (Levy, 2000) in an attempt to gain control over prior trauma (Lindemann, 2011). So far, the literature has focused on the association between childhood sexual abuse and sadomasochism, possibly due to the fact that these variables both fall under the umbrella of sexuality. However, sadomasochism may not solely be associated with adverse sexual experiences during childhood, but other traumatic events as well, such as physical or psychological abuse (Abrams et al., 2022). Hence, it could be argued that other forms of averse childhood experiences, whether physical or emotional abuse, or physical or emotional neglect, could also be associated with sadomasochistic tendencies in adulthood. Attachment, adverse childhood experiences, and childhood trauma Attachment patterns and dynamics develop early on in life, through the nature and quality of the child-caregiver bond (Bowlby, 1969). If the quality of care is harmful, neglectful, abusive, or traumatic, this can negatively impact the attachment bond, possibly leading to an insecure attachment style. Indeed, studies have shown that adverse childhood experiences can disrupt the infant-caregiver bond and attachment relationship (Choi et al., 2020). More specifically, among the different adverse childhood experiences, forced separation from a parent or caregiver was shown to most significantly predict problematic pediatric emotional and behavioral symptoms, and the need for children to seek behavioral health services (Choi et al., 2020). A possible explanation would be the fact that adverse childhood experiences such as neglect or abuse can lead to children developing a negative internal working model of themselves and/or of others. This, in turn, may foster insecure attachment (Howard et al., 2023). These effects can be long-lasting, as attachment anxiety and avoidance have been shown to mediate the relationship between adverse childhood experiences and adverse health and wellbeing status in adults (Howard et al., 2023). As for childhood trauma, a large body of research has established a relationship between experiencing childhood trauma and developing an insecure attachment. In fact, the term “attachment trauma” (Allen, 2013) was developed to describe the nature of the attachment that is formed between an infant and a caregiver in the context of trauma. To explain, while experiencing childhood trauma can place children at risk of developing an insecure attachment, this process becomes more complex when the childhood trauma relates to the person of the caregiver and when the child realizes that the attachment figure is in fact the cause of the distress and source of trauma (Lahousen et al., 2019). Thus, when a child is exposed to a traumatizing attachment figure, whether through omission trauma such as neglect, or commission trauma such as abuse (Fonagy et al., 2002), this often leads to significant emotional distress, an inability to effectively regulate emotions, and a disorganized attachment pattern (Fonagy et al., 2002). In sum, while the literature has established an association between adverse childhood experiences, childhood trauma, and sadomasochism, most of the studies focus on sexual abuse as the adverse or traumatic event. Research has yet to examine whether other childhood adverse events such as physical abuse, emotional abuse, abandonment, or neglect can contribute to sadomasochistic tendencies. Moreover, research on sadomasochistic tendencies in the Arab world is scarce. This phenomenon is especially crucial to examine given that psychological and physical violence against children is a prevalent issue in the Arab world (El-Ghossain et al., 2019). Indeed, childhood maltreatment is not uncommon in Lebanon (Himaya, 2018, 2019). In 2018, “Himaya”, a local NGO, reported 1,939 cases of child abuse, with 45% consisting of neglect, 25% of physical abuse, 21% of psychological abuse, 8% of sexual abuse, and 1% of exploitation. Thus, this study aims to fill this gap by evaluating whether attachment, adverse childhood experiences, and childhood trauma could predict sadomasochistic tendencies in Lebanese adults. Examining this association would allow mental health professionals to plan on prevention and intervention. To evaluate these associations, two studies were conducted. The first study evaluated attachment and adverse childhood experiences as predictors of sadomasochism, while the second study evaluated childhood trauma as a predictor of sadomasochism. Sample 1 Methods Participants The sample consisted of N=113 participants aged between 18 and 65. All participants were recruited online, using snowball sampling. Most participants (94.7%) were Lebanese, and 5.3% were Syrian. As for gender, 39.8% (n=45) identified as men, 58.4% (n=66) as women, and 1.8% (n=2) as non-binary. Most participants were 77% (n=87) aged between 18-24, 21.2 % (n=24) between 25-39, and 1.8 % (n=2) between 40-65. Finally, 64.6 % (n=73) of the participants were single, 31% (n=35) in a relationship, and 4.4% (n=5) married. Measures The Adverse Childhood Experiences International Questionnaire (ACE-IQ; WHO, 2009) is a 43-item self-report scale developed following the World Health Organization’s model of adverse childhood experiences (WHO, 2009). The scale contains a demographics section, followed by 6 sections: “Marriage”, “Relationship with parents/guardians”, “Family environment”, “Peer violence”, “Witnessing community violence”, and “Exposure to war/collective violence”. Participants are provided with questions and are asked to respond retrospectively, by remembering life events up until the age of 18. Questions are classified into the following 14 categories: “Emotional abuse”; “Physical abuse”; “Sexual abuse”; “Violence against household members”; “Living with household members who were substance abusers”; “Living with household members who were mentally ill or suicidal”; “Living with household members who were imprisoned”; “One or no parents”, “Parental separation or divorce”; “Emotional neglect”; “Physical neglect”; “Bullying”; “Community violence”; and “Collective violence”. The ACE-IQ was found to have good psychometric properties with α ≥ .8 for the total scale (Ho et al., 2019; Kazeem, 2015). The Adult Scale of Parental Attachment-Short Form (ASPA-SF; Snow et al., 2005) is a 40-item self-report scale evaluating adults’ perception of their childhood attachment relationship with their parents based on the 5 following categories: “Safe”, “Dependent”, “Parentified”, “Fearful” and “Distant”. The scale contains 20-items for mother-child attachment and 20-items for father-child attachment. Participants are provided with statements and are asked to rate each one on a 5-point Likert scale with 1=never and 5=constantly. The ASPA-SF was found to have good psychometric properties with α ≥ .7 for most subscales, α= .68 for the mother-parentified subscale, and α= .69 for the father-dependent subscale (Michael & Snow, 2019). The Sadomasochism Checklist (SMCL; Weierstall & Giebel, 2017) is a 24-item checklist that evaluates sadomasochistic practices. Each item is presented twice, once in the active voice for the dominance subscale (sadism), and a second time in the passive voice for the submission subscale (masochism). Participants are provided with statements and are asked to indicate their prior experience with 0=not at all and 2=tried out, as well as the pleasure they gain out of each activity with 0=not at all and 4=extremely. Items are categorized as either “Soft play”, “Domination/submission”, “Beating”, “Toys”, “Breath”, or “Bodily fluids”. The SMCL was found to have excellent psychometric properties with α= .96 for the submission (masochism) subscale and α=.89 for the dominance (sadism) subscale. Procedure This cross-sectional study was conducted online and was approved by the Institutional Review Board (IRB) of our institution. An invitation text was posted on different social media platforms (I.e.: LinkedIn, Instagram, Facebook, and Twitter), inviting interested participants to take part in the study. The text contained a link redirecting participants to the consent form as well as the survey which was hosted on Microsoft Form. All collected data were analyzed using SPSS. Results In terms of adverse childhood experiences, 37.2% (n= 42) of the sample reported having been sexually abused during childhood. Physical abuse was experienced by 63.7 % (n= 72) of participants at least once, with 15% (n= 17) who reported experiencing it frequently during childhood. Moreover, 85% (n= 96) of the sample reported being emotionally abused at least once, with 38.1% (n= 43) having experienced it several times. As for neglect, 54.9 % (n= 62) of participants reported having been exposed to emotional neglect, and 18.6 % (n= 21) of participants reported having been physically neglected at least one, with 3.5% (n=4) who reported experiencing it several times (Table 1). Mother-child attachment was characterized by secure attachment ( M =11.76; SD = 4.44), dependent attachment ( M =9.72; SD = 3.38), fearful attachment ( M = 8.92; SD = 3.64), parentified attachment ( M =12.31, SD = 4.08), and distant attachment ( M = 10.26, SD = 4.14). Father-child attachment was also characterized by secure attachment ( M =9.22, SD = 4.01), dependent attachment ( M =9.34, SD = 3.69), fearful attachment ( M =9.01, SD =4.14), parentified attachment ( M =10.71, SD = 4.23), and distant attachment ( M = 10.53, SD = 4.64). Finally, sadomasochism was scored based on prior submission/masochism experience ( M= 10.71; SD =9.25), and prior dominance/sadism experience ( M= 9.86; SD =9.26) (Table 1). Table 1. Descriptive Statistics (N=113) F % M SD ACE-Abuse Sexual abuse 42 37.2 Physical abuse 72 63.7 Emotional abuse 96 85 ACE-Neglect 12 11.2 Emotional neglect 62 54.9 Physical neglect 21 18.6 Attachment-mother Secure 11.76 4.44 Dependent 9.92 3.38 Fearful 8.92 3.64 Parentified 12.31 4.08 Distant 10.26 4.14 Attachment-father Secure 9.22 4.01 Dependent 9.34 3.69 Fearful 9.01 4.14 Parentified 10.71 4.23 Distant 10.53 4.64 Sadomasochism Submission/Masochism 10.71 9.25 Dominance/Sadism 9.86 9.26 To evaluate whether adverse childhood experiences predicted sadomasochism, we ran simple linear regressions with dominance/sadism and submission/masochism as the dependent variables, and sexual abuse, physical abuse, emotional abuse, emotional neglect, and physical neglect as the independent variables. Physical and emotional abuse did not seem to predict sadism nor masochism. While sexual abuse did not predict sadism, it was found to predict masochism with F (1,111) = 5.841, p =.017 and accounted for 4.1% of the variance. Similarly, emotional neglect did not predict sadism but was found to predict masochism with F (1,111) = 6.878, p = .010 and accounted for 5% of the variance. Finally, physical neglect did not seem to predict sadism nor masochism (Table 2). We then ran additional simple linear regressions in order to evaluate whether attachment predicted sadomasochism, with dominance/sadism and submissiveness/masochism as the dependent variables, and mother-secure, mother-dependent, mother-fearful, mother-parentified, mother-distant, father-secure, father-dependent, father-fearful, father-parentified, and father-distant as the independent variables. In terms of mother-infant attachment, secure, dependent, and fearful attachment did not seem to predict sadomasochism. Parentified attachment, however, negatively predicted dominance with F( 1,111) = 4.562; p =.035 and accounted for 3.1% of the variance, and distant attachment predicted submission with F (1, 111) = 5.551, p =.020, accounting for 3.9% of the variance. As for father-infant attachment, secure attachment was found to negatively predict submissiveness with F (1,111) = 7.052, p =.009, accounting for 5.1% of the variance, and parentified attachment negatively predicted submissiveness with F (1,111) = 5.3, p=.023, accounting for 3.7% of the variance. Finally, dependent, fearful, and distant attachment did not seem to predict sadomasochism (Table 2). Table 2. Linear Regression Analyses Variable B SE B Β t R R 2 Δ R 2 Masochism Sexual abuse .859 .355 .224 2.417* .224 .050 .041 Emotional neglect 1.191 .454 .242 2.623** .242 .058 .050 Mother-distant attachment .487 .207 .218 2.356* .218 .048 .039 Father-secure attachment -.564 .212 -.244 -2.656** .244 .060 .051 Father-parentified attachment -.466 .203 -.213 -2.302* .213 .046 .037 Sadism Mother-parentified attachment -.450 .211 -.199 -2.136* .199 .039 .031 Note *p < .05, **p ≤ .01, ***p ≤ .001 Discussion This study evaluates the extent to which sadomasochistic behaviors and activities during adulthood are related to childhood events and relational dynamics. Our results confirm the association between sadomasochism, parental attachment, and adverse childhood experiences. In terms of adverse childhood experiences, sexual abuse and emotional neglect both predicted masochism but not sadism. This suggests that experiencing such adverse experiences during childhood places individuals at a higher risk of surrendering themselves to humiliation and pain during sexual activities and deriving pleasure out of it. Our findings are in accordance with previous research showing higher rates of sexual abuse among masochistic women (Frías et al. 2017). Moreover, the association between sexual abuse and masochism suggests that masochistic behaviors could consist of a coping mechanism. Indeed, individuals with traumatic experiences could be chasing after sexual behaviors previously experienced in an attempt to integrate and transform humiliation and pain into pleasurable experiences (Abrams & Stefan, 2012). The association between emotional neglect and masochism also confirm previous findings (Berber Çelik & Odacı, 2012). Therefore, it can be argued that emotionally neglected children may cultivate submissive behaviors as a form of self-identification (Gilbert et al., 2003; Kaya et al., 2004). Nevertheless, our results failed to establish an association between sadism and abuse/neglect, although research shows that these adverse experiences could lead to sadistic tendencies (Frías et al., 2017), with individuals inflicting and imposing on others what was once imposed on them during childhood. As for attachment, our results show that distant attachment to one’s mother predicted masochism. These findings go hand in hand with previous studies showing that adults with sadomasochistic tendencies are more likely to have an insecure attachment (Festa, 2001; Russell, 2016). In reverse, secure attachment to one’s father was shown to decrease one’s chances of developing masochistic behaviors. This also confirms the literature on the protective role of secure attachment, specifically when it comes to romantic, intimate, and sexual behaviors (Feeney, 2008; Mikulincer & Shaver, 2007). Surprisingly, parentified attachment to both mother and father was shown to decrease one’s chances of developing sadomasochistic behaviors. Parentification, which is understood as a behavior in which children take on parental roles as they feel that it is their responsibility to do so, usually develops in the context of insecure attachment (Byng-Hall, 2002; Michael & Snow, 2019). Hence, our results seem to contract the literature on the association between insecure attachment and sadomasochism. However, since parentified individuals are more likely to feel important and satisfied upon offering what they believe their parents need (Michael & Snow, 2019), this could better explain the inverse relationship with sadomasochism. In other words, parentified attachment could constitute a protective factor, an adaptive type of insecure attachment. Moreover, since parentified individuals are more likely to focus on satisfying their parents’ needs, they would less likely derive pleasure out of others’ pain. Nevertheless, this does not explain why parentified attachment to the mother was found to negatively predict sadism, while parentified attachment to the father negatively predicted masochism. This difference could be a reflection of societal gender norms in the Middle East and Lebanon, a country in which mothers are perceived as homemakers and caretakers -passive, gentle, submissive, while fathers are perceived as breadwinners -active, aggressive, dominant. To sum up, this research found that childhood sexual abuse, emotional neglect, and attachment could predict sadomasochism in adulthood. Despite the study’s contribution to the literature on sexual behaviors and it being the first to evaluate sadomasochism in Lebanon, several limitations are to be acknowledged. First, data was collected using self-report measures, which increases the risk of desirability bias, especially since sadomasochism is classified as a paraphilia. Moreover, the small sample size make it difficult for our results to be generalized. Future research should replicate this study with a bigger sample size in order to confirm our results, possibly using longitudinal designs to examine causal pathways. Finally, since adverse childhood experiences and attachment mainly predicted masochism, future studies should take other factors into consideration, in order to better understand what contributes to sadistic sexual behaviors. Sample 2 Methods Participants The sample consisted of N=121 participants aged between 18 to 64. Due to the high number of missing responses in the first study, we opted for not collecting any demographic information in our second study, in the hopes that this will reassure participants about anonymity and potentially control for desirability bias, given the sensitive nature of the topic and sexuality being a taboo in Lebanon. Measures The Sadomasochism Checklist (SMCL; Weierstall & Giebel, 2017) is a 24-item checklist that evaluates sadomasochistic practices. Each item is presented twice, once in the active voice for the dominance subscale (sadism), and a second time in the passive voice for the submission subscale (masochism). Participants are provided with statements and are asked to indicate their prior experience with 0=not at all and 2=tried out, as well as the pleasure they gain out of each activity with 0=not at all and 4=extremely. Items are categorized as either “Soft play”, “Domination/submission”, “Beating”, “Toys”, “Breath”, or “Bodily fluids”. The SMCL was found to have excellent psychometric properties with α= .96 for the submission (masochism) subscale and α=.89 for the dominance (sadism) subscale (Weierstall & Giebel, 2006). The Childhood Trauma Questionnaire (CTQ; Bernstein et al., 2003) is a 25-item self-report scale that retrospectively evaluates childhood trauma based on five subscales: “Physical abuse”; “Emotional abuse”; “Emotional neglect”; “Sexual abuse”, and “Physical neglect”. Participants are provided with statements and are asked to retrospectively rate each statement on a 5-point Likert scale with 1= never true to 5= very often true. The Childhood Trauma Questionnaire has shown good psychometric properties with internal consistency reliabilities ranging between α= .66 to α= .92 across subscales. Procedure This cross-sectional study was approved by the Institutional Review Board (IRB) of our university. Participants were recruited online, using snowball sampling. An invitation text was posted on different social media platforms (E.g: Instagram) with a link redirecting participants to the study hosted on Google Forms. All participants read the online informed consent prior to participating. All collected data were analyzed using SPSS. Results In this study, our variables of interest consisted of childhood trauma and sadomasochism. Sadomasochism consisted of prior sadism experience and prior masochism experience (Table 3). T-test showed a significant difference between sadism and masochism means with the sample significantly engaging in sadistic behaviors more than masochistic behaviors: t (120) = -2.120, p =.036. Table 3. Measures used (N=121) M SD Childhood trauma 57.01 10.66 Sadomasochism 18.11 25.39 Prior sadism experience 10.30 17.24 Prior masochism experience 7.66 10.81 To evaluate whether childhood trauma predicts sadomasochism, we ran several linear regressions with childhood trauma as the independent variable, and sadomasochism (total score), sadism, and masochism and the dependent variables. Childhood trauma was found to predict sadomasochism with F (1,118) = 12.374, p =.001 and accounted for 8.7% of the variance. More specifically, childhood trauma predicted masochism with F (1,119) = 20.128, p <.001, accounting for 13.7% of the variance. Similarly, sadomasochism was found to predict sadism with F (1,119) = 5.953, p =.016 and accounted for 4% of the variance (Table 3). Table 3. Linear Regression Analyses Variable B SE B Β t R R 2 Δ R 2 Childhood Trauma Sadomasochism .732 .208 .308 3.518*** .308 .095 .087 Sadism .353 .145 .218 2.440* .218 .048 .040 Masochism .386 .086 .380 4.486*** .380 .145 .137 Note *p < .05, **p ≤ .01, ***p ≤ .001 Discussion As expected, childhood trauma was found to predict sadomasochism. However, it was found to predict masochism at a higher rate and more significantly than sadism. Our results confirm the literature on the negative impact of childhood trauma on sexual behaviors during adulthood (Levenson & Grady, 2016; Sansone et al., 2012). Childhood trauma has been shown to be associated with earlier onset of sexual behaviors. It has also been shown to contribute to more aggressive and hostile behaviors with others. The fact that childhood trauma triggers aggression and impacts sexual behaviors could explain why it contributes to masochism. While childhood trauma encompasses a wide array of experiences, the literature mostly focuses on the association between sexual abuse and sadomasochism (Abrams et al., 2022). Most of the studies previously conducted have established a relationship between experiencing sexual abuse during childhood and developing sadomasochistic tendencies in adulthood. However, our results suggest that other traumatic experiences encountered during childhood could also be associated with sadomasochistic tendencies, such as physical/emotional neglect and abuse. This suggests that the process through which adverse childhood experiences and trauma could be linked with sadomasochistic tendencies does not necessarily depend on the nature of the event itself, but the lived experience. To explain, one does not necessarily have to experience an adverse sexual experience to develop certain sexual behaviors and attitudes such as sadomasochism. Instead, the way that adverse childhood experiences or childhood trauma impact sexual behaviors and attitudes in adulthood could be related to the subjective experience of the event. For example, having experienced an event during which the child felt helpless (whether sexual abuse or other types of abuse) could have led the child to either identify with that feeling (masochism), or to develop an urge to impose on others what was once inflicted by others (sadism). Further studies are needed to evaluate the impact of other types of child maltreatment on sadomasochistic behaviors and to better understand this process and phenomenon. Moreover, the association between childhood trauma and sadomasochism further confirms the hypothesis that sadomasochism is a coping mechanism and a behavior that is adopted to reenact what was once painfully experienced during childhood, transforming it into a pleasurable or recreational activity (McCann, 2018). Sadomasochistic behaviors also allow individuals to control pain and aggression (Grossman, 1991), which might not have been possible for children who forcibly experienced violence and abuse. Therefore, it can be argued that a child who experienced trauma voluntarily inflicts or seeks pain, in an attempt to control what was once imposed and experienced passively during childhood. In the case of masochism, adults may unconsciously choose to revictimize themselves in their sexual and intimate relationships with chosen partners, as they could have identified with the victimized aspect of the self (Lord, 2008). This could better explain why abused children seek and reenact such experiences again during adulthood. In addition, children who experience trauma tend to adopt dissociation as a coping mechanism (Schlessinger, 2006; Van der Kolk et al., 2007; Weingarten, 2000, 2003). In the literature, masochistic or submissive individuals describe a state -subspace, in which they experience a “high-like” or “float-like” feeling after having experienced extreme levels of pain (Pitagoria, 2017). Therefore, masochistic behaviors could create moments of dissociation, a defense used in an attempt to cope with childhood trauma and induce pleasure out of experiences and acts others would consider to be painful. Despite the study being the first in evaluating the association between childhood trauma and sadomasochism in Lebanon and the Middle-East, it is not without limitations. The small sample size imposes a careful interpretation of the results. However, knowing that the topic is considered a taboo in this region, our results can be seen as a stepping stone for future studies investigating the same topic. Moreover, while childhood trauma was found to predict sadism, this association was not as strong as the association between childhood trauma and masochism. This calls for more studies evaluating the factors that could contribute to sadistic sexual behaviors, a psychoanalytic concept known as identification with the aggressor (Freud, 1936). This becomes especially important since our results showed that the sample engaged in sadistic behaviors more significantly than masochistic behaviors. Conclusion In conclusion, one study with two different samples was conducted in order to evaluate predictors of sadomasochistic sexual behaviors during adulthood. With a specific interest in childhood relational dynamics and factors, parental attachment and adverse childhood experiences were evaluated in the first sample, and childhood trauma was explored in the second sample. The study’s results suggest that adverse and traumatic experiences during childhood could indeed be associated with sadomasochism during adulthood. In terms of attachment, while secure attachment to the father constituted a protective factor and distant attachment to the mother a risk factor, parentified attachment to both parents was found to be negatively linked with sadomasochistic activities. Future studies should further explore these association, as they shed light on the impact of attachment on sexual behaviors in adulthood. Finally, given that most of the variables in this study predicted masochism but failed to predict sadism, future research should focus on examining predictors of sadism, as well as the subjective meaning behind sadomasochistic activities. Declarations Funding: None. Conflict of interest: None. Ethical approval: Received IRB approval. Informed consent: Included at the beginning of the survey. Consent for publication: All authors have read and approved the final version of the manuscript and consent to its submission for publication. 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The term \u0026lsquo;sadism\u0026rsquo; was named after the infamous Marquis de Sade (1740-1814), known for writing about sexual cruelty and eroticizing pain. Sadism is defined as the act of inflicting pain, suffering, and humiliation on others and deriving pleasure out of it. The term \u0026lsquo;masochism\u0026rsquo; was named after von Sacher-Masoch (1836-1905), a writer whose novels described pleasure in personal humiliation and submission. Masochism is thus defined as the act of receiving pain, suffering, and humiliation and deriving pleasure and arousal out of it (Weierstall \u0026amp; Giebel, 2017). As a sexual practice, sadomasochism encompasses a wide array of acts such as pinching, beating, strangling, raping, burning, or stabbing.\u003c/p\u003e\n\u003cp\u003eDue to the nature of sadomasochistic activities as well as the violence that can accompany such acts, non-consensual sadomasochism is classified as a psychopathology in diagnostic manuals, referred to as a sexual perversion, paraphilia, or sexual disorder (American Psychiatric Association, 2022; World Health Organization. 2021). In the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR; American Psychiatric Association, 2022), sadomasochism is classified as two distinct paraphilic disorders, under the name of \u0026lsquo;sexual sadism disorder\u0026rsquo; and \u0026lsquo;sexual masochism disorder\u0026rsquo;. In order for sadomasochistic practices to be considered a pathology rather than a sexual preference such as the case of consensual BDSM (Bondage, discipline, dominance, submission, sadism and masochism) activities, sadomasochism should cause distress to the person exhibiting them, rendering them unable to function and perform daily tasks.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eScholars investigating the etiology of sadomasochism, sexual aggression, and sexual violence have evoked different factors associated with childhood such as the early caregiver-infant relationship (Chavis, 2018; Russell \u0026amp; King, 2016; Smallbone \u0026amp; Dadds, 2000), as well as adverse childhood experiences and/or childhood trauma, abuse, or neglect (Abrams \u0026amp; Stefan, 2012; Abrams et al., 2022; Grossman, 1991; Nordling et al., 2000). This line of research is grounded in the understanding that adult sexuality begins to develop in early childhood (Abrams et al., 2022), and that sexual desires are significantly influenced by environmental factors and events (Cornwallis \u0026amp; Uller, 2010). Consequently, individuals exposed to adverse or traumatic experiences during childhood may experience disruptions in sexual development and functioning (Fuss et al., 2019; Pedneault et al., 2020), which could, in some cases, contribute to the emergence of sadomasochistic tendencies. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSadomasochism and attachment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAttachment theory was first developed by Bowlby (1982) positing that children have an innate biological need to form close relationships with others. Over the years, Bowlby (1982) and Ainsworth (1978) developed the concept of attachment styles; patterns\u0026nbsp;of behavior and ways in which one relates to others. Attachment styles are developed during childhood as a result of early caregiver-child interactions and are thought to remain stable across time (Wismeijer \u0026amp; van Assen, 2013). Attachment styles, which can be secure, insecure-anxious, insecure-avoidant, or disorganized (Ainsworth, 1978), have been shown to have profound implications on adult attachment, interpersonal relationships, and sexual behaviors (Wismeijer \u0026amp; van Assen, 2013).\u003c/p\u003e\n\u003cp\u003eFor instance, initial research has shown that secure attachment is highly correlated with pleasurable sexual behavior (Hazan et al., 1994). More recent studies revealed that securely attached individuals are more likely to have balanced relationships characterized by intimacy and satisfaction compared to insecurely attached individuals (Feeney, 2008; Mikulincer \u0026amp; Shaver, 2007). Insecure attachment, on the other hand, is associated with more maladaptive sexual and romantic patterns and behaviors. Studies have shown that individuals with an insecure-avoidant attachment style are more likely to engage in casual sex (Gentzler \u0026amp; Kerns, 2004) and engage in coercive sexual behaviors (Smallbone \u0026amp; Dadds, 2000).\u003c/p\u003e\n\u003cp\u003eWhile insecure attachment has been shown to foster maladaptive and deviant sexual behaviors, few studies have studied sadomasochism from an attachment framework. Festa (2001) established an association between attachment and sadomasochism, showing that women with an insecure-anxious attachment style are more likely to exhibit masochistic tendencies. More recently, Russell (2016) showed that the subclinical type of sadism -everyday sadism, and insecure attachment predicted sexual aggression. Chavis (2018) argued that sadomasochistic tendencies originate from early mother-infant attachment and are precisely triggered when children develop an insecure organized or disorganized attachment style. It can thus be argued that early experiences of distress in the caregiver-child relationship may give rise to self-defeating or destructive behaviors in adulthood, as individuals attempt to regain control and transform pain into pleasure. While theoretical links have been proposed, a direct association between attachment and sadomasochism has yet to be empirically established. Further research is therefore needed to deepen our understanding of how attachment dynamics may shape the development of sadomasochistic tendencies. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSadomasochism, adverse childhood experiences, and childhood trauma\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAdverse childhood experiences refer to harmful events that occur during childhood. Examples include separation from caregivers, abandonment, neglect, physical, sexual and/or emotional abuse (Jones et al., 2020). Such experiences can be overwhelming for the child, potentially leading to childhood trauma that hinders the child\u0026rsquo;s ability to cope effectively and interferes with normative development and the acquisition of age-appropriate experiences. These potentially traumatic events may have a significant impact on physical and mental health, leading to negative outcomes such as poor life satisfaction, depression, anxiety, and substance use (Mersky et al., 2013).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIndeed, a relationship between adverse childhood experiences and aggression/hostility in adulthood has been established in the literature (Halle \u0026amp; Darling-Churchill, 2016; Letourneau et al., 2018). In the context of sexual violence, childhood abuse has been shown to be associated with sadomasochistic tendencies (Abrams, 2022). More specifically, men who were sexually abused during childhood were found to be more likely to exhibit sadistic tendencies, while females exhibited more masochistic tendencies. This relationship confirms previous findings (Fr\u0026iacute;as et al., 2017) showing that women with comorbid sexual masochism disorder and borderline personality disorder reported greater sexual abuse during childhood and higher insecure-avoidant attachment. Such drawn conclusions can be explained by the fact that previously abused individuals are more likely to develop helplessness and apprehension towards uncontrollable punishment and aggression (Békés et al., 2017; Novick \u0026amp; Novick, 2004). Thus, it can be argued that individuals with masochistic tendencies escape their perceived vulnerabilities by voluntarily subjecting themselves to pain and suffering (Gabbard, 2012), thus actively acting out what was once experienced passively. Conversely, previously abused individuals with sadistic tendencies tend to mirror and reenact the behavior that they were subjected to during childhood (Levy, 2000) in an attempt to gain control over prior trauma (Lindemann, 2011).\u003c/p\u003e\n\u003cp\u003eSo far, the literature has focused on the association between childhood sexual abuse and sadomasochism, possibly due to the fact that these variables both fall under the umbrella of sexuality. However, sadomasochism may not solely be associated with adverse sexual experiences during childhood, but other traumatic events as well, such as physical or psychological abuse (Abrams et al., 2022). Hence, it could be argued that other forms of averse childhood experiences, whether physical or emotional abuse, or physical or emotional neglect, could also be associated with sadomasochistic tendencies in adulthood.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAttachment, adverse childhood experiences, and childhood trauma\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAttachment patterns and dynamics develop early on in life, through the nature and quality of the child-caregiver bond (Bowlby, 1969). If the quality of care is harmful, neglectful, abusive, or traumatic, this can negatively impact the attachment bond, possibly leading to an insecure attachment style. Indeed, studies have shown that adverse childhood experiences can disrupt the infant-caregiver bond and attachment relationship (Choi et al., 2020). More specifically, among the different adverse childhood experiences, forced separation from a parent or caregiver was shown to most significantly predict problematic pediatric emotional and behavioral symptoms, and the need for children to seek behavioral health services (Choi et al., 2020). A possible explanation would be the fact that adverse childhood experiences such as neglect or abuse can lead to children developing a negative internal working model of themselves and/or of others. This, in turn, may foster insecure attachment (Howard et al., 2023). These effects can be long-lasting, as attachment anxiety and avoidance have been shown to mediate the relationship between adverse childhood experiences and adverse health and wellbeing status in adults (Howard et al., 2023).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAs for childhood trauma, a large body of research has established a relationship between experiencing childhood trauma and developing an insecure attachment. In fact, the term \u0026ldquo;attachment trauma\u0026rdquo; (Allen, 2013) was developed to describe the nature of the attachment that is formed between an infant and a caregiver in the context of trauma. To explain, while experiencing childhood trauma can place children at risk of developing an insecure attachment, this process becomes more complex when the childhood trauma relates to the person of the caregiver and when the child realizes that the attachment figure is in fact the cause of the distress and source of trauma (Lahousen et al., 2019). Thus, when a child is exposed to a traumatizing attachment figure, whether through omission trauma such as neglect, or commission trauma such as abuse (Fonagy et al., 2002), this often leads to significant emotional distress, an inability to effectively regulate emotions, and a disorganized attachment pattern (Fonagy et al., 2002).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn sum, while the literature has established an association between adverse childhood experiences, childhood trauma, and sadomasochism, most of the studies focus on sexual abuse as the adverse or traumatic event. Research has yet to examine whether other childhood adverse events such as physical abuse, emotional abuse, abandonment, or neglect can contribute to sadomasochistic tendencies. Moreover, research on sadomasochistic tendencies in the Arab world is scarce. This phenomenon is especially crucial to examine given that psychological and physical violence against children is a prevalent issue in the Arab world (El-Ghossain et al., 2019). Indeed, childhood maltreatment is not uncommon in Lebanon (Himaya, 2018, 2019). In 2018, \u0026ldquo;Himaya\u0026rdquo;, a local NGO, reported 1,939 cases of child abuse, with 45% consisting of neglect, 25% of physical abuse, 21% of psychological abuse, 8% of sexual abuse, and 1% of exploitation.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThus, this study aims to fill this gap by evaluating whether attachment, adverse childhood experiences, and childhood trauma could predict sadomasochistic tendencies in Lebanese adults. Examining this association would allow mental health professionals to plan on prevention and intervention. To evaluate these associations, two studies were conducted. The first study evaluated attachment and adverse childhood experiences as predictors of sadomasochism, while the second study evaluated childhood trauma as a predictor of sadomasochism.\u003c/p\u003e"},{"header":"Sample 1","content":"\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eParticipants\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe sample consisted of N=113 participants aged between 18 and 65. All participants were recruited online, using snowball sampling. \u0026nbsp;Most participants (94.7%) were Lebanese, and 5.3% were Syrian. As for gender, 39.8% (n=45) identified as men, 58.4% (n=66) as women, and 1.8% (n=2) as non-binary. Most participants were 77% (n=87) aged between 18-24, 21.2 % (n=24) between 25-39, and 1.8 % (n=2) between 40-65. Finally, 64.6 % (n=73) of the participants were single, 31% (n=35) in a relationship, and 4.4% (n=5) married.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eMeasures\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe \u003cem\u003eAdverse Childhood Experiences International Questionnaire\u0026nbsp;\u003c/em\u003e(ACE-IQ; WHO, 2009)\u003cem\u003e\u0026nbsp;\u003c/em\u003eis a 43-item self-report scale developed following the World Health Organization\u0026rsquo;s model of adverse childhood experiences (WHO, 2009). The scale contains a demographics section, followed by 6 sections: \u0026ldquo;Marriage\u0026rdquo;, \u0026ldquo;Relationship with parents/guardians\u0026rdquo;, \u0026ldquo;Family environment\u0026rdquo;, \u0026ldquo;Peer violence\u0026rdquo;, \u0026ldquo;Witnessing community violence\u0026rdquo;, and \u0026ldquo;Exposure to war/collective violence\u0026rdquo;. Participants are provided with questions and are asked to respond retrospectively, by remembering life events up until the age of 18. Questions are classified into the following 14 categories: \u0026ldquo;Emotional abuse\u0026rdquo;; \u0026ldquo;Physical abuse\u0026rdquo;; \u0026ldquo;Sexual abuse\u0026rdquo;; \u0026ldquo;Violence against household members\u0026rdquo;; \u0026ldquo;Living with household members who were substance abusers\u0026rdquo;; \u0026ldquo;Living with household members who were mentally ill or suicidal\u0026rdquo;; \u0026ldquo;Living with household members who were imprisoned\u0026rdquo;; \u0026ldquo;One or no parents\u0026rdquo;, \u0026ldquo;Parental separation or divorce\u0026rdquo;; \u0026ldquo;Emotional neglect\u0026rdquo;; \u0026ldquo;Physical neglect\u0026rdquo;; \u0026ldquo;Bullying\u0026rdquo;; \u0026ldquo;Community violence\u0026rdquo;; and \u0026ldquo;Collective violence\u0026rdquo;. The ACE-IQ was found to have good psychometric properties with \u0026alpha; \u0026ge; .8 for the total scale (Ho et al., 2019; Kazeem, 2015). \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe \u003cem\u003eAdult Scale of Parental Attachment-Short Form\u0026nbsp;\u003c/em\u003e(ASPA-SF; Snow et al., 2005) is a 40-item self-report scale evaluating adults\u0026rsquo; perception of their childhood attachment relationship with their parents based on the 5 following categories: \u0026ldquo;Safe\u0026rdquo;, \u0026ldquo;Dependent\u0026rdquo;, \u0026ldquo;Parentified\u0026rdquo;, \u0026ldquo;Fearful\u0026rdquo; and \u0026ldquo;Distant\u0026rdquo;. The scale contains 20-items for mother-child attachment and 20-items for father-child attachment. Participants are provided with statements and are asked to rate each one on a 5-point Likert scale with 1=never and 5=constantly. The ASPA-SF was found to have good psychometric properties with \u0026alpha; \u0026ge; .7 for most subscales, \u0026alpha;= .68 for the mother-parentified subscale, and \u0026alpha;= .69 for the father-dependent subscale (Michael \u0026amp; Snow, 2019).\u003c/p\u003e\n\u003cp\u003eThe \u003cem\u003eSadomasochism Checklist\u0026nbsp;\u003c/em\u003e(SMCL; Weierstall \u0026amp; Giebel, 2017)\u003cem\u003e\u0026nbsp;\u003c/em\u003eis a 24-item checklist that evaluates sadomasochistic practices. Each item is presented twice, once in the active voice for the dominance subscale (sadism), and a second time in the passive voice for the submission subscale (masochism). Participants are provided with statements and are asked to indicate their prior experience with 0=not at all and 2=tried out, as well as the pleasure they gain out of each activity with 0=not at all and 4=extremely. Items are categorized as either \u0026ldquo;Soft play\u0026rdquo;, \u0026ldquo;Domination/submission\u0026rdquo;, \u0026ldquo;Beating\u0026rdquo;, \u0026ldquo;Toys\u0026rdquo;, \u0026ldquo;Breath\u0026rdquo;, or \u0026ldquo;Bodily fluids\u0026rdquo;. The SMCL was found to have excellent psychometric properties with \u0026alpha;= .96 for the submission (masochism) subscale and \u0026alpha;=.89 for the dominance (sadism) subscale. \u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eProcedure\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThis cross-sectional study was conducted online and was approved by the Institutional Review Board (IRB) of our institution. An invitation text was posted on different social media platforms (I.e.: LinkedIn, Instagram, Facebook, and Twitter), inviting interested participants to take part in the study. The text contained a link redirecting participants to the consent form as well as the survey which was hosted on Microsoft Form. All collected data were analyzed using SPSS.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn terms of adverse childhood experiences, 37.2% (n= 42) of the sample reported having been sexually abused during childhood. Physical abuse was experienced by 63.7 % (n= 72) of participants at least once, with 15% (n= 17) who reported experiencing it frequently during childhood. Moreover, 85% (n= 96) of the sample reported being emotionally abused at least once, with 38.1% (n= 43) having experienced it several times. As for neglect, 54.9 % (n= 62) of participants reported having been exposed to emotional neglect, and 18.6 % (n= 21) of participants reported having been physically neglected at least one, with 3.5% (n=4) who reported experiencing it several times (Table 1).\u003c/p\u003e\n\u003cp\u003eMother-child attachment was characterized by secure attachment (\u003cem\u003eM\u003c/em\u003e=11.76; \u003cem\u003eSD\u003c/em\u003e= 4.44), dependent attachment (\u003cem\u003eM\u003c/em\u003e=9.72; \u003cem\u003eSD\u003c/em\u003e= 3.38), fearful attachment (\u003cem\u003eM\u003c/em\u003e= 8.92; \u003cem\u003eSD\u003c/em\u003e= 3.64), parentified attachment (\u003cem\u003eM\u003c/em\u003e=12.31, \u003cem\u003eSD\u003c/em\u003e= 4.08), and distant attachment (\u003cem\u003eM\u003c/em\u003e= 10.26, \u003cem\u003eSD\u003c/em\u003e= 4.14). Father-child attachment was also characterized by secure attachment (\u003cem\u003eM\u003c/em\u003e=9.22, \u003cem\u003eSD\u003c/em\u003e= 4.01), dependent attachment (\u003cem\u003eM\u003c/em\u003e=9.34, \u003cem\u003eSD\u003c/em\u003e= 3.69), fearful attachment (\u003cem\u003eM\u003c/em\u003e=9.01, \u003cem\u003eSD\u003c/em\u003e=4.14), parentified attachment (\u003cem\u003eM\u003c/em\u003e=10.71, \u003cem\u003eSD\u003c/em\u003e= 4.23), and distant attachment (\u003cem\u003eM\u003c/em\u003e= 10.53, \u003cem\u003eSD\u003c/em\u003e= 4.64). Finally, sadomasochism was scored based on prior submission/masochism experience (\u003cem\u003eM=\u003c/em\u003e10.71; \u003cem\u003eSD\u003c/em\u003e=9.25), and prior dominance/sadism experience (\u003cem\u003eM=\u003c/em\u003e9.86; \u003cem\u003eSD\u003c/em\u003e=9.26) (Table 1).\u003c/p\u003e\n\u003cp\u003eTable\u0026nbsp;1. Descriptive Statistics (N=113)\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"618\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 187px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003eF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eSD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eACE-Abuse\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; Sexual abuse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e37.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; Physical abuse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e63.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eEmotional abuse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eACE-Neglect\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e11.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eEmotional neglect\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e54.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Physical neglect\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e18.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAttachment-mother\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eSecure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e11.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e4.44\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eDependent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e9.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e3.38\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; Fearful\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e8.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e3.64\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; Parentified\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e12.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e4.08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eDistant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e10.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e4.14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAttachment-father\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eSecure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e9.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e4.01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eDependent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e9.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e3.69\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; Fearful\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e9.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e4.14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; Parentified\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e10.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e4.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eDistant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e10.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e4.64\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSadomasochism\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003eSubmission/Masochism\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e10.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e9.25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; Dominance/Sadism\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e9.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e9.26\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTo evaluate whether adverse childhood experiences predicted sadomasochism, we ran simple linear regressions with dominance/sadism and submission/masochism as the dependent variables, and sexual abuse, physical abuse, emotional abuse, emotional neglect, and physical neglect as the independent variables. Physical and emotional abuse did not seem to predict sadism nor masochism. While sexual abuse did not predict sadism, it was found to predict masochism with \u003cem\u003eF\u003c/em\u003e(1,111) = 5.841, \u003cem\u003ep\u003c/em\u003e=.017 and accounted for 4.1% of the variance. Similarly, emotional neglect did not predict sadism but was found to predict masochism with \u003cem\u003eF\u003c/em\u003e(1,111) = 6.878, \u003cem\u003ep\u003c/em\u003e= .010 and accounted for 5% of the variance. Finally, physical neglect did not seem to predict sadism nor masochism (Table 2).\u003c/p\u003e\n\u003cp\u003eWe then ran additional simple linear regressions in order to evaluate whether attachment predicted sadomasochism, with dominance/sadism and submissiveness/masochism as the dependent variables, and mother-secure, mother-dependent, mother-fearful, mother-parentified, mother-distant, father-secure, father-dependent, father-fearful, father-parentified, and father-distant as the independent variables. In terms of mother-infant attachment, secure, dependent, and fearful attachment did not seem to predict sadomasochism. Parentified attachment, however, negatively predicted dominance with \u003cem\u003eF(\u003c/em\u003e1,111) = 4.562; \u003cem\u003ep\u003c/em\u003e=.035 and accounted for 3.1% of the variance, and distant attachment predicted submission with \u003cem\u003eF\u003c/em\u003e(1, 111) = 5.551, \u003cem\u003ep\u003c/em\u003e=.020, accounting for 3.9% of the variance. As for father-infant attachment, secure attachment was found to negatively predict submissiveness with \u003cem\u003eF\u003c/em\u003e(1,111) = 7.052, \u003cem\u003ep\u003c/em\u003e=.009, accounting for 5.1% of the variance, and parentified attachment negatively predicted submissiveness with \u003cem\u003eF\u003c/em\u003e (1,111) = 5.3, p=.023, accounting for 3.7% of the variance. Finally, dependent, fearful, and distant attachment did not seem to predict sadomasochism (Table 2).\u003c/p\u003e\n\u003cp\u003eTable 2. Linear Regression Analyses\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eVariable\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cem\u003eSE B\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026Beta;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cem\u003eR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cem\u003eR\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026Delta; R\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMasochism\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Sexual abuse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.859\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.355\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.224\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e2.417*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e.224\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.050\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.041\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Emotional neglect\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e1.191\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.454\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.242\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e2.623**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e.242\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.058\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.050\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Mother-distant attachment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.487\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.207\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.218\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e2.356*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e.218\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.048\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.039\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eFather-secure attachment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-.564\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.212\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-.244\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e-2.656**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e.244\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.060\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.051\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Father-parentified attachment\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-.466\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.203\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-.213\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e-2.302*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e.213\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.046\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.037\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSadism\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Mother-parentified attachment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-.450\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.211\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-.199\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e-2.136*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e.199\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.039\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.031\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eNote\u003c/em\u003e \u003cem\u003e*p \u0026lt; .05, **p \u0026le; .01, ***p \u0026le; .001\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDiscussion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study evaluates the extent to which sadomasochistic behaviors and activities during adulthood are related to childhood events and relational dynamics. Our results confirm the association between sadomasochism, parental attachment, and adverse childhood experiences.\u003c/p\u003e\n\u003cp\u003eIn terms of adverse childhood experiences, sexual abuse and emotional neglect both predicted masochism but not sadism. This suggests that experiencing such adverse experiences during childhood places individuals at a higher risk of surrendering themselves to humiliation and pain during sexual activities and deriving pleasure out of it. Our findings are in accordance with previous research showing higher rates of sexual abuse among masochistic women (Fr\u0026iacute;as et al. 2017). Moreover, the association between sexual abuse and masochism suggests that masochistic behaviors could consist of a coping mechanism. Indeed, individuals with traumatic experiences could be chasing after sexual behaviors previously experienced in an attempt to integrate and transform humiliation and pain into pleasurable experiences (Abrams \u0026amp; Stefan, 2012). The association between emotional neglect and masochism also confirm previous findings (Berber \u0026Ccedil;elik \u0026amp; Odacı, 2012). Therefore, it can be argued that emotionally neglected children may cultivate submissive behaviors as a form of self-identification (Gilbert et al., 2003; Kaya et al., 2004). Nevertheless, our results failed to establish an association between sadism and abuse/neglect, although research shows that these adverse experiences could lead to sadistic tendencies (Fr\u0026iacute;as et al., 2017), with individuals inflicting and imposing on others what was once imposed on them during childhood.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAs for attachment, our results show that distant attachment to one\u0026rsquo;s mother predicted masochism. These findings go hand in hand with previous studies showing that adults with sadomasochistic tendencies are more likely to have an insecure attachment (Festa, 2001; Russell, 2016). In reverse, secure attachment to one\u0026rsquo;s father was shown to decrease one\u0026rsquo;s chances of developing masochistic behaviors. This also confirms the literature on the protective role of secure attachment, specifically when it comes to romantic, intimate, and sexual behaviors (Feeney, 2008; Mikulincer \u0026amp; Shaver, 2007).\u003c/p\u003e\n\u003cp\u003eSurprisingly, parentified attachment to both mother and father was shown to decrease one\u0026rsquo;s chances of developing sadomasochistic behaviors. Parentification, which is understood as a behavior in which children take on parental roles as they feel that it is their responsibility to do so, usually develops in the context of insecure attachment (Byng-Hall, 2002; Michael \u0026amp; Snow, 2019). Hence, our results seem to contract the literature on the association between insecure attachment and sadomasochism. However, since parentified individuals are more likely to feel important and satisfied upon offering what they believe their parents need (Michael \u0026amp; Snow, 2019), this could better explain the inverse relationship with sadomasochism. In other words, parentified attachment could constitute a protective factor, an adaptive type of insecure attachment. Moreover, since parentified individuals are more likely to focus on satisfying their parents\u0026rsquo; needs, they would less likely derive pleasure out of others\u0026rsquo; pain. Nevertheless, this does not explain why parentified attachment to the mother was found to negatively predict sadism, while parentified attachment to the father negatively predicted masochism. This difference could be a reflection of societal gender norms in the Middle East and Lebanon, a country in which mothers are perceived as homemakers and caretakers -passive, gentle, submissive, while fathers are perceived as breadwinners -active, aggressive, dominant.\u003c/p\u003e\n\u003cp\u003eTo sum up, this research found that childhood sexual abuse, emotional neglect, and attachment could predict sadomasochism in adulthood. Despite the study\u0026rsquo;s contribution to the literature on sexual behaviors and it being the first to evaluate sadomasochism in Lebanon, several limitations are to be acknowledged. First, data was collected using self-report measures, which increases the risk of desirability bias, especially since sadomasochism is classified as a paraphilia. Moreover, the small sample size make it difficult for our results to be generalized. Future research should replicate this study with a bigger sample size in order to confirm our results, possibly using longitudinal designs to examine causal pathways. Finally, since adverse childhood experiences and attachment mainly predicted masochism, future studies should take other factors into consideration, in order to better understand what contributes to sadistic sexual behaviors.\u003c/p\u003e"},{"header":"Sample 2","content":"\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eParticipants\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe sample consisted of N=121 participants aged between 18 to 64. Due to the high number of missing responses in the first study, we opted for not collecting any demographic information in our second study, in the hopes that this will reassure participants about anonymity and potentially control for desirability bias, given the sensitive nature of the topic and sexuality being a taboo in Lebanon.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eMeasures\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe \u003cem\u003eSadomasochism Checklist\u0026nbsp;\u003c/em\u003e(SMCL; Weierstall \u0026amp; Giebel, 2017)\u003cem\u003e\u0026nbsp;\u003c/em\u003eis a 24-item checklist that evaluates sadomasochistic practices. Each item is presented twice, once in the active voice for the dominance subscale (sadism), and a second time in the passive voice for the submission subscale (masochism). Participants are provided with statements and are asked to indicate their prior experience with 0=not at all and 2=tried out, as well as the pleasure they gain out of each activity with 0=not at all and 4=extremely. Items are categorized as either \u0026ldquo;Soft play\u0026rdquo;, \u0026ldquo;Domination/submission\u0026rdquo;, \u0026ldquo;Beating\u0026rdquo;, \u0026ldquo;Toys\u0026rdquo;, \u0026ldquo;Breath\u0026rdquo;, or \u0026ldquo;Bodily fluids\u0026rdquo;. The SMCL was found to have excellent psychometric properties with \u0026alpha;= .96 for the submission (masochism) subscale and \u0026alpha;=.89 for the dominance (sadism) subscale (Weierstall \u0026amp; Giebel, 2006).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe Childhood Trauma Questionnaire (CTQ; Bernstein et al., 2003) is a 25-item self-report scale that retrospectively evaluates childhood trauma based on five subscales: \u0026ldquo;Physical abuse\u0026rdquo;; \u0026ldquo;Emotional abuse\u0026rdquo;; \u0026ldquo;Emotional neglect\u0026rdquo;; \u0026ldquo;Sexual abuse\u0026rdquo;, and \u0026ldquo;Physical neglect\u0026rdquo;. Participants are provided with statements and are asked to retrospectively rate each statement on a 5-point Likert scale with 1= never true to 5= very often true. The Childhood Trauma Questionnaire has shown good psychometric properties with internal consistency reliabilities ranging between \u0026alpha;= .66 to \u0026alpha;= .92 across subscales. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eProcedure\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThis cross-sectional study was approved by the Institutional Review Board (IRB) of our university. Participants were recruited online, using snowball sampling. An invitation text was posted on different social media platforms (E.g: Instagram) with a link redirecting participants to the study hosted on Google Forms. All participants read the online informed consent prior to participating. All collected data were analyzed using SPSS. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn this study, our variables of interest consisted of childhood trauma and sadomasochism. Sadomasochism consisted of prior sadism experience and prior masochism experience (Table 3). T-test showed a significant difference between sadism and masochism means with the sample significantly engaging in sadistic behaviors more than masochistic behaviors: \u003cem\u003et\u003c/em\u003e(120) = -2.120, \u003cem\u003ep\u003c/em\u003e=.036.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 3. Measures used (N=121)\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"431\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eSD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChildhood trauma\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e57.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e10.66\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSadomasochism\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e18.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e25.39\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003ePrior sadism experience\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e10.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e17.24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; Prior masochism experience\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e7.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e10.81\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTo evaluate whether childhood trauma predicts sadomasochism, we ran several linear regressions with childhood trauma as the independent variable, and sadomasochism (total score), sadism, and masochism and the dependent variables. Childhood trauma was found to predict sadomasochism with \u003cem\u003eF\u003c/em\u003e(1,118) = 12.374, \u003cem\u003ep\u003c/em\u003e=.001 and accounted for 8.7% of the variance. More specifically, childhood trauma predicted masochism with \u003cem\u003eF\u003c/em\u003e(1,119) = 20.128, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001, accounting for 13.7% of the variance. Similarly, sadomasochism was found to predict sadism with \u003cem\u003eF\u003c/em\u003e(1,119) = 5.953, \u003cem\u003ep\u003c/em\u003e=.016 and accounted for 4% of the variance (Table 3).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 3. Linear Regression Analyses\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eVariable\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cem\u003eSE B\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026Beta;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cem\u003eR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cem\u003eR\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026Delta; R\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChildhood Trauma\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Sadomasochism\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.732\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.208\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.308\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e3.518***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e.308\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.095\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.087\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Sadism\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.353\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.218\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e2.440*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e.218\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.048\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.040\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Masochism\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.386\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.086\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.380\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e4.486***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e.380\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e.137\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eNote\u003c/em\u003e \u003cem\u003e*p \u0026lt; .05, **p \u0026le; .01, ***p \u0026le; .001\u003c/em\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDiscussion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAs expected, childhood trauma was found to predict sadomasochism. However, it was found to predict masochism at a higher rate and more significantly than sadism. Our results confirm the literature on the negative impact of childhood trauma on sexual behaviors during adulthood (Levenson \u0026amp; Grady, 2016; Sansone et al., 2012). Childhood trauma has been shown to be associated with earlier onset of sexual behaviors. It has also been shown to contribute to more aggressive and hostile behaviors with others. The fact that childhood trauma triggers aggression and impacts sexual behaviors could explain why it contributes to masochism.\u003c/p\u003e\n\u003cp\u003eWhile childhood trauma encompasses a wide array of experiences, the literature mostly focuses on the association between sexual abuse and sadomasochism (Abrams et al., 2022). Most of the studies previously conducted have established a relationship between experiencing sexual abuse during childhood and developing sadomasochistic tendencies in adulthood. However, our results suggest that other traumatic experiences encountered during childhood could also be associated with sadomasochistic tendencies, such as physical/emotional neglect and abuse. This suggests that the process through which adverse childhood experiences and trauma could be linked with sadomasochistic tendencies does not necessarily depend on the nature of the event itself, but the lived experience. To explain, one does not necessarily have to experience an adverse sexual experience to develop certain sexual behaviors and attitudes such as sadomasochism. Instead, the way that adverse childhood experiences or childhood trauma impact sexual behaviors and attitudes in adulthood could be related to the subjective experience of the event. For example, having experienced an event during which the child felt helpless (whether sexual abuse or other types of abuse) could have led the child to either identify with that feeling (masochism), or to develop an urge to impose on others what was once inflicted by others (sadism). Further studies are needed to evaluate the impact of other types of child maltreatment on sadomasochistic behaviors and to better understand this process and phenomenon.\u003c/p\u003e\n\u003cp\u003eMoreover, the association between childhood trauma and sadomasochism further confirms the hypothesis that sadomasochism is a coping mechanism and a behavior that is adopted to reenact what was once painfully experienced during childhood, transforming it into a pleasurable or recreational activity (McCann, 2018). Sadomasochistic behaviors also allow individuals to control pain and aggression (Grossman, 1991), which might not have been possible for children who forcibly experienced violence and abuse. Therefore, it can be argued that a child who experienced trauma voluntarily inflicts or seeks pain, in an attempt to control what was once imposed and experienced passively during childhood.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn the case of masochism, adults may unconsciously choose to revictimize themselves in their sexual and intimate relationships with chosen partners, as they could have identified with the victimized aspect of the self (Lord, 2008). This could better explain why abused children seek and reenact such experiences again during adulthood. In addition, children who experience trauma tend to adopt dissociation as a coping mechanism (Schlessinger, 2006; Van der Kolk et al., 2007; Weingarten, 2000, 2003). \u0026nbsp;In the literature, masochistic or submissive individuals describe a state -subspace, in which they experience a \u0026ldquo;high-like\u0026rdquo; or \u0026ldquo;float-like\u0026rdquo; feeling after having experienced extreme levels of pain (Pitagoria, 2017). Therefore, masochistic behaviors could create moments of dissociation, a defense used in an attempt to cope with childhood trauma and induce pleasure out of experiences and acts others would consider to be painful.\u003c/p\u003e\n\u003cp\u003eDespite the study being the first in evaluating the association between childhood trauma and sadomasochism in Lebanon and the Middle-East, it is not without limitations. The small sample size imposes a careful interpretation of the results. However, knowing that the topic is considered a taboo in this region, our results can be seen as a stepping stone for future studies investigating the same topic. Moreover, while childhood trauma was found to predict sadism, this association was not as strong as the association between childhood trauma and masochism. This calls for more studies evaluating the factors that could contribute to sadistic sexual behaviors, a psychoanalytic concept known as identification with the aggressor (Freud, 1936). This becomes especially important since our results showed that the sample engaged in sadistic behaviors more significantly than masochistic behaviors.\u0026nbsp;\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn conclusion, one study with two different samples was conducted in order to evaluate predictors of sadomasochistic sexual behaviors during adulthood. With a specific interest in childhood relational dynamics and factors, parental attachment and adverse childhood experiences were evaluated in the first sample, and childhood trauma was explored in the second sample. The study\u0026rsquo;s results suggest that adverse and traumatic experiences during childhood could indeed be associated with sadomasochism during adulthood. In terms of attachment, while secure attachment to the father constituted a protective factor and distant attachment to the mother a risk factor, parentified attachment to both parents was found to be negatively linked with sadomasochistic activities. Future studies should further explore these association, as they shed light on the impact of attachment on sexual behaviors in adulthood. Finally, given that most of the variables in this study predicted masochism but failed to predict sadism, future research should focus on examining predictors of sadism, as well as the subjective meaning behind sadomasochistic activities.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eNone.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest:\u0026nbsp;\u003c/strong\u003eNone.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval:\u0026nbsp;\u003c/strong\u003eReceived IRB approval.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed consent:\u0026nbsp;\u003c/strong\u003eIncluded at the beginning of the survey.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u0026nbsp;\u003c/strong\u003eAll authors have read and approved the final version of the manuscript and consent to its submission for publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contribution:\u0026nbsp;\u003c/strong\u003eAuthor 1: Conceptualization, Data Analysis, Writing \u0026ndash; Editing \u0026amp; Review, Supervision; Author 2: Conceptualization, Data Collection, Data analysis, Writing \u0026ndash; Original Draft; Author 3: Conceptualization, Data Collection, Data analysis, Writing\u0026ndash; Original Draft\u003cstrong\u003e;\u0026nbsp;\u003c/strong\u003eAuthor 4: Data Analysis, Writing \u0026ndash; Editing \u0026amp; Review.\u003cstrong\u003e\u003cbr\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAbrams, M., \u0026amp; Stefan, S. (2012). Sexual abuse and masochism in women: etiology and treatment. \u003cem\u003eJournal of Cognitive and Behavioral Psychotherapies, 12\u003c/em\u003e(2), 231-239\u003c/li\u003e\n\u003cli\u003eAbrams, M., Chronos, A., \u0026amp; Grdinic, M. M. (2022). Childhood abuse and sadomasochism: New insights. \u003cem\u003eSexologies. \u003c/em\u003eDOI:10.1016/j.sexol.2021.10.004\u003c/li\u003e\n\u003cli\u003eAinsworth, M. (1978). Patterns of attachment: A psychological study of the strange situation. Hillsdale, NJ: ErlbauAllen, J. G. (2013). \u003cem\u003eMentalizing in the development and treatment of attachment trauma\u003c/em\u003e. London: Karnac Books.\u003c/li\u003e\n\u003cli\u003eAmerican Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.)\u003c/li\u003e\n\u003cli\u003eB\u0026eacute;k\u0026eacute;s, V., Perry, J. C., \u0026amp; Robertson, B. M. (2017). Masochism: A Mixed-Method Analysis of Its Development, Psychological Function, and Conceptual Evolution. \u003cem\u003ePsychoanalytic review\u003c/em\u003e, \u003cem\u003e104\u003c/em\u003e(1), 33\u0026ndash;63. https://doi.org/10.1521/prev.2017.104.1.33\u003c/li\u003e\n\u003cli\u003eBerber \u0026Ccedil;elik, \u0026Ccedil;, \u0026amp; Odacı, H. (2012). The effect of experience of childhood abuse among university students on self-perception and submissive behavior. \u003cem\u003eChildren and Youth Services Review,\u003c/em\u003e \u003cem\u003e34\u003c/em\u003e(1), 200-204. doi:10.1016/j.childyouth.2011.09.017\u003c/li\u003e\n\u003cli\u003eBernstein, D. P., Stein, J. A., Newcomb, M. D., Walker, E., Pogge, D., Ahluvalia, T., Stokes, J., Handelsman, L., Medrano, M., Desmond, D., \u0026amp; Zule, W. (2003). 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International statistical classification of diseases and related health problems (11th ed.).\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Sadomasochism, attachment, adverse childhood experiences, childhood trauma, Arab world","lastPublishedDoi":"10.21203/rs.3.rs-6924906/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6924906/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eSadomasochism (SM) is a sexual behavior that involves sadistic and masochistic practices. While SM has been widely studied in the literature, little is known about its expression and predictors in the Arab world. This study aims to identify predictors of sadomasochism, by evaluating attachment (Sample 1), adverse childhood experiences (Sample 1), and childhood trauma (Sample 2). Sample 1 consisted of 113 participants aged between 18 and 65 and revealed that attachment insecurity and adverse childhood experiences predicted sadomasochistic tendencies in adulthood. Sample 2, consisting of 121 participants within the same age range, showed that childhood trauma predicted engagement in sadomasochistic behaviors. Our findings suggest that adverse and traumatic childhood experiences may shape adult sexual behaviors, with sadomasochism potentially serving as a coping mechanism used to transform previously painful experiences into sources of control or pleasurable. Future research should explore the role of protective factors, and the psychological meaning of sadomasochistic behaviors among adults with histories of childhood adversity.\u003c/p\u003e","manuscriptTitle":"Attachment, childhood trauma, and adverse childhood experiences as predictors of sadomasochism","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-08-11 09:40:29","doi":"10.21203/rs.3.rs-6924906/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"0311b2bd-b11e-4e7b-9745-e45650f326de","owner":[],"postedDate":"August 11th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-10-15T22:23:34+00:00","versionOfRecord":[],"versionCreatedAt":"2025-08-11 09:40:29","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6924906","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6924906","identity":"rs-6924906","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}