# Gaining the Upper Hand? Further Evidence of Pain as a Pleasurable Experience and the Unexpected Relationship Between Sadomasochistic Sexual Preference and Chronic Pain

## TL;DR

People with sadomasochistic sexual preferences have higher rates of chronic pain, suggesting a possible link between pain and this behavior.

## Contribution

This study replicates and extends findings on the link between sadomasochism and chronic pain, using a matched sample and identifying psychological predictors.

## Key findings

- Chronic pain prevalence was 47.2% in sadomasochistic individuals versus 29.4% in non-sadomasochistic individuals.
- A model explained 42% of the variance in sadomasochistic preference, including chronic pain, sensation seeking, and viewing pain as a challenge.
- The relationship between sadomasochism and chronic pain was not explained by age or sex differences.

## Abstract

A growing body of research reports positive consequences of acute pain, including emotional self‐regulation. Pain as a pleasurable experience has also been regarded in the context of sadomasochistic (SM) interest, albeit quantitative empirical evidence is scarce. Recently, an elevated prevalence of chronic pain (CP) has been reported in SM practitioners; however, in absence of a control group. To contribute to research in the field, we strove to see whether we could replicate the finding and further aimed to identify psychological predictors of SM.

A total of 617 participants (N = 242 with SM sexual preference) completed an online questionnaire battery comprising psychometric instruments for the measurement of pain attitudes, sensation seeking and pain sensitivity. An age‐ and sex‐matched sample was created to control for their respective influence.

CP prevalence in the SM subsample was 47.2%, which we found to be significantly increased compared to the prevalence in the non‐SM subsample (29.4%). Neither sex nor age seemed to explain the relationship. There were no interaction effects of SM × CP on pain attitudes. A hierarchical logistic regression model explained around 42% of the variance in SM, with CP, sensation seeking, and viewing pain as a challenge as significant predictors.

We replicated an increased CP prevalence in SM and ruled out previous sampling biases. We further extended evidence on factors predicting SM sexual preference. Large‐scale, representative and prospective studies are needed to corroborate the idea of SM as a coping strategy used by some CP patients.

We demonstrated a significantly elevated chronic pain prevalence of around 47% in individuals with sadomasochistic sexual preference, ruling out previously discussed sampling biases. Possibly, sadomasochistic practise is used as a coping strategy by some chronic pain patients. We further presented a model of pain‐related and psychological variables explaining around 42% of variance in sadomasochistic sexual preference in general. The results are discussed in terms of their potential to inform pain management strategies.