In an article entitled 'Life on a Knife Edge' in the January online edition of Psychology Today, Dr Mark Griffiths of Nottingham Trent University recounts episodes of "piquerism", the mainly male perversion which is defined as "paraphilic sexual arousal which hinges on the sadistic piercing and stabbing of another person, especially in the breast, buttocks and groin, which may cause enough bleeding to be fatal".
Dr Griffiths refers to one episode in 2007 in which a 25-year-old man was arrested in New York on charges of assault. He was accused of paying large amounts of money to at least five young females in exchange for poking their buttocks with sharp objects such as pens, pins and nails while masturbating.
The man was also charged with two counts of second-degree assault as a sexual felony for paying a 17-year-old boy about $6,000 to be his "erotic pin cushion for about a year-and-a-half".
New York police had encountered another such episode involving a man who had shot darts at the backsides of an estimated 53 women in the Midtown area before being arrested in 1990.
In another episode, several women reported they had been stabbed while shopping in a mall in Fairfax, Virginia by a man who was subsequently dubbed the "Serial Butt Stabber" and "Butt Slasher".
Piquerism (from the French "piquer" - "to prick") is a sexual desire to penetrate the skin of another person, sometimes seriously enough to cause death.
Piquerism is a paraphilia and form of sadism.
Dr Griffiths states: "Given the relatively regular incidence of piquerism in the popular media, I was quite surprised to find next to nothing academically. There are passing references to piquerism in the clinical and forensic science literature but nothing (as far as I could find) on the prevalence or etiology of the disorder."
He cites a definition:"Piquerism is sometimes performed post-mortem. It generally refers to the penetration of human flesh, although it is sometimes practiced against animals. The piquer's range of activities for sating his or her needs can be a purposeful single prick with a pin or knife, multiple stab wounds to an eroticized area, or elaborate cutting, stabbing, biting and mutilation of a victim. Piquerism becomes part of the repertoire of many sadists, depending on their progress along the 'sadistic learning curve'.
"Often the sexual mechanisms inherent in piquerism are ignored during the assessment of sexually sadistic crimes. The prevalence rate of piquerism is unknown".
A particularly gruesome case involving piquerism was described by Vernon Geberth, former Commander, Bronx Homicide, NYPD, in an article 'The Anatomy of Lust Murder' in a 1998 issue of Law and Order magazine.
Mr Gerberth wrote: "The two victims were a mother and her fourteen-year-old daughter . . . Once his victims were unconscious and dead he engaged in hours of sexual deviance with their bodies."
Dr Griffiths further refers to a study on the murders of Jack the Ripper, the notorious serial killer who stalked Victorian London.
A paper by Dr Robert Keppel and his colleagues in a 2005 issue of the Journal of Investigative Psychology and Offender Profiling concluded that "the injuries sustained by the victims displayed the signature characteristic of piquerism".
The Russian mass murderer Andrei Chikatilo, "The Butcher of Rostov", was known to be impotent but derived sexual satisfaction from stabbing and cutting his many victims.
American serial killer Albert Fish, also known as "The Brooklyn Vampire" and "The Moon Maniac" amongst many other names, was known to have engaged in piquerism with many of his victims.
Dr Griffiths said some experts associate piquerism with cultural construction of femininity, with its association with the body, bleeding and birth, which links women with a mortality that provokes a dual reaction: anxious fear accompanied by erotic desire. If the duality slips out of control, the consequences can be horrific.
Dr Griffiths also cited FBI psychiatrist George Huang, who commented under cross-examination in the trial of a man who had raped and stabbed to death a software company employee, saying of the accused: "He suffers from piquerism, counsellor. The knife represents his penis. It is not disposable".