![]() A “switch” is an individual who shifts between both the dominant and submissive roles, depending on the context and play partner. In this review, solely the terms “dominant” and “submissive” are used to respectively refer to either participants providing stimulation, orders, or structure or those being physically constrained, receiving stimulation, or following orders. ![]() 14 Terminologyĭifferent sources may refer variously to individual parties involved in a BDSM interaction. The current systematic review was conducted according to PRISMA-P (preferred reporting items for systematic review and meta-analysis protocols) guidelines. An integration of biologic, psychological, and social knowledge about BDSM may contribute to the understanding and destigmatization of this form of sexual expression, as well as challenge its place in psychopathological classifications. This increased availability of BDSM-related scientific literature inspired us to bring together the existing literature on biopsychosocial aspects of BDSM in the current systematic review, the first in its kind. Contemporary mainstream interest in BDSM is mirrored in the exponential growth seen during the last decade of scientific research focusing on all kinds of BDSM aspects and, as such, has enriched the existing literature, thereby nuancing its initial pathologic classification. The recent success of the Fifty Shades of Grey books and movies, among others, have led to an increased awareness of this expression of intimacy and sexuality. 10–13 Ever since, the BDSM community is subjected to misconceptions and stigmatization. 7–9 These historical views still have an impact on the most prominent contemporary psychiatric classification systems, the International Classification of Diseases (ICD 10th edition: ICD-10) on one hand the Diagnostic and Statistical Manual of Mental Disorders (DSM 5th edition DSM-5) on the other. The perception of BDSM as being pathologic influenced scientific articles from the 1970s and 1980s, which tended to focus on (non-consensual) sexual sadism from a forensic perspective and incidental SM-related fatalities. These views were later reflected in Freud’s 6 theories on sexuality. ![]() ![]() 1–3 Historically, these practices and interests have been pathologized (for review, see reference 4) Krafft-Ebing 5 pioneered in classifying sadism and masochism as pathologies in his Psychopathia Sexualis, a reference work of 19th century sexology. BDSM, Biopsychosocial, Kink, Masochism, Sadism, Sadomasochism IntroductionīDSM, previously known as sadomasochism (or SM), is an overarching abbreviation of bondage and discipline, dominance and submission, and sadism and masochism and refers to a physical, psychological, and sexual role-play involving power exchange between consensual participants. ![]()
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