Serial sexual murder by juveniles and the role of sexual sadism: An international study.

This is a descriptive study of 21 cases of serial sexual murder by children and adolescents spanning nearly the past century and a half. No earlier cases worldwide were identified. Each of these youth committed two or more sexual homicides prior to age 18. Their psychopathological, psychosocial, crime scene behaviors, and offender-victim relationship characteristics are presented. Additionally, the role of sexual sadism and its measurement using the SADSEX-SH rating scale is addressed. Nearly all of the sample had conduct disorder, a paraphilic disorder, and sadistic fantasies, and two-thirds had sexual sadism disorder. Family dysfunction, serious school problems, and average or above IQ levels were typical. Their modus operandi generally reflected predatory behavior and direct contact methods of killing were most common. Two case reports are provided to illustrate the breadth and complexity of these offenders. Juvenile Serial Sexual Homicide is an extremely rare but persistent phenomenon. Prognostic implications and future research directions are discussed.