• Violence;
  • sadistic fantasy;
  • children and adolescents;
  • causation;
  • interventions;
  • prevention

This paper provides a review of the social impact, life course, and origins of violent and sadistic acts in children and adolescents. Origins of violent acts include child-centred factorstemperamental, emotional, and cognitive family factors and contextual factors. Drawing from the available adult forensic literature, the evolution of sadistic fantasy culminating in sadistic violent acts is explored. The current range and effectiveness of psychosocial, family-based, and psychodynamic interventions are described. A possible programme for breaking the cycle of violence is proposed, drawing on the knowledge and expertise of child mental health care professionals.