Abstract
Sadistic ritual abuse, including satanic cult abuse, is emerging as a syndrome among people with severe dissociative disorders, including multiple personality disorder. This article discusses the essential features that compose the clinical picture of sadistic ritual abuse in adults, adolescents, and children. Particular attention is paid to the differences between adolescents who may have been victimized by adults in sadistic and ritualized ways and disenfranchised "teenage dabblers" who may temporarily adopt a ritualized lifestyle as a way of expressing or acting out. The article also covers guidelines for appropriate medical, pharmacologic, and referral interventions. The controversy surrounding sadistic ritual abuse is discussed thoroughly, and primary care physicians are advised of the current status of understanding and validation in this area.
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