I am not sure if it is possible to obtain a difference of 6 or more between sadistic and masochistic levels without cheating or masochistic starting bonus when playing in Prison Mode. Some of the passives are contradictory if you realise what they are awarded for. One fine example is Fearless, which Karryn receives for subduing 100 prisoners. Doesn't matter if they were well and truly beaten black and blue or satisfied sexually through masochistic rimjobs for example. Thus, you will receive a masochistic passive Eats Ass Naturally as She Breathes and at the same time your successful rimjobs will add to Karryn's win statistics that will grand you the Fearless passive. I have only hit one of her foes once early in my gameplay (as I run out of possible moves) and still have this sadistic passive, although all her battles were won sexually. I even made a couple of thugs cum from excitement they got from slapping her butt! It is not possible to play this game without winning encounters with inmates to restore order, so regardless whether Karryn wins those by force or being a passive fucktoy, she will receive a sadistic level up eventually.
Other problematic sadistic passives are related to active participation in most sex act apart from rimjobs and oral sex. As I play an anal-only virgin slut run, it is not possible for me not to engage Karryn's sex partners anally, just to keep them off her pussy. In case of nerds, I just need to occupy them with something asap, so they do not impose sadistic footjobs on her. The best choice is either a masochistic rimjob or a neutral blowjob, but that's not always an option. It is so frustrating to receive sadism up just for these. Also, to make sure you receive a masochistic passive for cum enemas, you need to provide the Warden with a lot of anal sex and more often than not, high butt and cock desires are not enough for this to happen, as certain types of inmates are not interested in anal that much, so in order to maximize your chances Karryn needs to put their cocks in her butt herself, the sadistic bitch.
Increase in sadism for active titjobs and pussy sex is just as silly. Handjobs... For me, that would depend on the way that a handjob is given. If it's just an enthusiastic, happily accommodating handjob then no. However, if it involved edging and orgasm denial for the inmates, meaning bringing them close to ejaculation just to kick their erect cocks in the end, then yes - that's even two levels of sadism up. But since there is no option to disengage from a sex act in any way other than making the head sex mate cum, it is not possible to employ such a combo. Which also could be reworked to make battles more interesting by allowing Karryn to change sex positions, head partners or switch from sex to battle. Of course she would need certain passives/training to be able to do that.