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Is Psychological Distress Among Former Cult Members Related to Psychological Abuse in the Cults


International Journal of Cultic Studies, Vol. 9, 2018, pages 43-54

Is Psychological Distress Among Former Cult Members Related to Psychological Abuse in the Cult?

Maria Göransson and Rolf Holmqvist


Linköping University, Sweden

Abstract

There is a need for more knowledge about mental health among former members of cults. The aim of this study was to examine the level and characteristics of psychological distress among former cult members and to analyze whether this distress was related to the extent of psychological abuse in the group, duration of cult participation, time since defection, and whether or not the informant was born into the cult. Participants were 66 former cult members from nine different Swedish religious movements. They were primarily recruited from organizations for former cult members. The participants answered an Internet questionnaire. The results showed that former cult members had more psychological problems, measured with the Clinical Outcome in Routine Evaluation—Outcome Measure (CORE–OM) scale, than a nonclinical comparison sample. In particular, the results indicated an increased risk of destructive behavior toward self and others, with Risk to Self being the predominant factor. A higher level of psychological abuse, measured with the Group Psychological Abuse (GPA) scale, was related to more psychological distress. However, no relationship was found between psychological distress and the number of years in the group, the number of years since leaving the group, or whether or not the individual belonged to the group from childhood. The conclusion is that former cult members have an increased level of reported psychological problems, particularly concerning the risk of hurting themselves and others, an outcome healthcare personnel should be aware of.

Keywords: cult, former cult members, psychological abuse, psychological well-being

It may be difficult to decide which group is a cult and which is not, and there have been many suggestions in the literature about how to define a cult. To do this, Woody (2009) emphasized the importance of focusing on the conditions in the group and the consequences of being a member, irrespective of the professed thought model. Because of the difficulties in defining a cult, Chambers, Langone, Dole, & Grice (1994) developed the Group Psychological Abuse (GPA) scale to measure the extent of abuse within a group. The GPA was developed by factor analysis of 308 former cult members’ answers about characteristics shown in their groups. This scale is a self-report questionnaire that can be helpful for healthcare personnel, social workers, and others who interact with former cult members.

An important question in cultic studies is whether membership influences members’ and past members’ psychological health. Aronoff, Lynn, and Malinoski (2000) made a critical review of research about whether cult membership is psychologically harmful. Their conclusions were that (a) persons entering cults do not necessarily exhibit psychopathology; (b) current cult members appear psychologically well-adjusted generally, but psychopathology may be masked by pressure from the group and demand characteristics; (c) recent research indicates that a substantial minority of former cult members show adjustment difficulties.

Aronoff et al. (2000) pointed out weaknesses in many studies in this research field, such as demand characteristics, lack of standardized measures, conformity pressures associated with the cultic environment, bias from the researchers, lack of comparison groups, and small sample sizes. The researchers also mentioned the importance of taking into account that the doctrine in some groups makes it difficult for the members to report psychological problems—for example, when such problems are thought to be attacks from evil forces.

Consequently, there is no consensus among researchers about what effects cultic affiliation may have on individuals’ well-being. The research field is controversial (Buxant & Saroglou, 2008; Latkin, 1995), and the results of studies vary. As noted in the following content, it also is important to distinguish studies of current members from studies of former members (Buxant & Saroglou, 2008; Winocur-Craig, 1995).

Graham and Haidt (2010) argued that there is no difference between the social interaction in religious groups and other groups, and that the social interaction is the same regardless of the doctrine. Other researchers, however, have argued that processes of social influence may be stronger in religious groups than in others (e.g., Paloutzian, Richardson, & Rambo, 1999; Ysseldyk, Matheson, & Anisman, 2010); and religious groups have been the focus in the majority of the literature on cults (Aronoff et al., 2000). The current study also focuses on religious groups, although a few of the participants were members of nonreligious groups.

Psychological Well-Being Among Current Cult Members

Results from studies carried out with current members seldom have shown any signs of psychopathology among the participants (Aronoff et al., 2000). These studies sometimes even have shown an improvement in the current members’ psychological well-being, especially during the earliest periods of their participation in the group (e.g., Buxant, Saroglou, Casalfiore, & Christians, 2007). Winocur-Craig (1995) suggested that current members may feel conformity pressures to report a good psychological well-being. Some studies also have suggested that current members tend to report a better psychological well-being than they actually experience (Ungerleider & Wellisch, 1979, as noted in Winocur-Craig, 1995). Furthermore, in some studies with current members, the recruitment of study participants was handled by leaders of the groups (e.g., Buxant et al., 2007; Day & Peters, 1999). Even if the leaders promised not to be selective in recruitment, as in the study by Buxant et al. (2007), the features of cultic and manipulative environments give one reason not to fully trust such a promise. Therefore, it is important to reflect upon bias when one is analyzing questionnaires from current members of manipulative groups (Aronoff et al., 2000; Gasde & Block, 1998; Winocur-Craig, 1995).

Psychological Well-Being Among Former Cult Members

In contrast, results from studies of former cult members often show an impaired psychological well-being in these former members. Such findings also may be hard to interpret.

For instance, Buxant and Saroglou (2008) suggested that former cult members might overlook their positive experiences from the cult and report more psychological problems in an attempt to avoid cognitive dissonance about their decision to leave the group. In this study, the former cult members reported high levels of psychological distress. The authors suggested that the psychological distress was caused by the defection, arguing that the defection was the only factor that separated former members from current members. The psychological distress among their participants peaked right after the defection. The researchers’ conclusion was also based on the fact that, for 14 of their 20 participants, the defection led to a separation from families and friends, which is, of course, a factor of great importance for former members’ psychological well-being. At the same time, previous research stressed that only after the defection could former members realize what they had been subjected to and fully react to the stress they experienced in the cult (e.g., Swartling & Swartling, 1992). Consequently, there might be several different explanations for the psychological distress found among former cult members.

Swartling and Swartling (1992) found that psychological problems were common among former members who had attended the Bible School of Livets Ord (Word of Life) in Sweden. These former members did not have those problems before they entered the group. The most prominent problems were anxiety, especially panic anxiety disorder, and feelings of guilt. Forty-seven percent of the 43 participants had had symptoms similar to psychotic symptoms, and almost 25 percent of them had tried to commit suicide. The study participants were recruited mainly from a support group.

In a study with 61 former members of the CUT, Gasde and Block (1998) found that former cult members had more psychological problems than the normal population. These problems decreased as a function of the time that had passed since the former members had defected. There was no correlation between the level of psychological problems and length of time each was a member of the group. The authors argued that it was not only the defection itself that might have been a cause of psychological distress, but also the individuals’ experiences during the time spent as members of the group.

In addition to psychological well-being, the personality traits of former cult members have also been subject to analyses. Walsh, Russell, and Wells (1995) found that former cult members had higher levels of neuroticism, sociotropy, and autonomy than the normal population. However, the results of another study (Gasde & Block, 1998) did not support these findings. Walsh et al. (1995) found no correlation between the length of membership in the group and any personality traits. However, their results showed that the level of neuroticism decreased as a function of the time that had passed since the defection. Psychological well-being and personality traits are indeed different areas; personality traits are usually considered to be constant, but the personality trait of neuroticism might have similarities to psychological distress, which may occur more intermittently.

Psychological Distress Among Former Cult Members Related to Experiences in the Group

Gasde and Block (1998) found that, among the former members of the CUT, those who reported the highest level of experienced psychological abuse as measured with the GPA scale were not necessarily those who had the most psychological problems. However, Winocur-Craig (1995) found a positive correlation between the level of psychological distress of participants and their scores on the Cult Experience Index (CEI), an instrument that measures the degree of control the group and its leaders have had in an individual's life. The results of data from 75 former cult members from different religious groups showed that those who reported high levels of cult tendencies in their groups had more psychological problems.

Former Cult Members and Healthcare

As mentioned earlier, most researchers agree that former cult members have more psychological problems than the normal population (Aronoff et al., 2000). Despite this fact, it is often difficult for those former members to get appropriate help from the healthcare sector (Järvå, 2009). Many former cult members report psychological problems that are similar to those of people who have been subjects of brainwashing or mind control (Robbins & Anthony, 1982). According to Järvå, former cult members are sometimes classified as psychotic because they may have, among other symptoms, thoughts that are similar to psychotic thoughts, although those thoughts are just reflections of the doctrines in the group (Swartling & Swartling, 1992). Järvå has argued that former cult members’ symptoms should instead be classified as trauma symptoms. The treatments for psychosis and trauma are very different, and the wrong treatment may aggravate the symptoms (Järvå, 2009). This fact points to the need for better diagnoses in this patient group.

Purpose of This Study

Many studies concerning psychological well-being among current members of religious and cultic groups have been completed. However, less research has been undertaken with former cult members and on factors that may influence their psychological health. Findings from previous research that suggest former cult members have more psychological problems than other individuals (Aronoff et al, 2000; Buxant & Saroglou, 2008; Gasde & Block, 1998) spark interest in investigating the psychological well-being among former cult members, particularly with regard to factors that may have caused the psychological distress.

Accurate diagnoses of former cult members might be facilitated if one has knowledge about associations between psychological distress and experiences from the time former members spent in the group and deeper knowledge about the characteristics of the psychological problems among former cult members. Associations between psychological distress among former cult members and the conditions in their respective groups have not been sufficiently studied previously. Consequently, the purpose of this study was to investigate the psychological well-being among former cult members and to assess whether there were any associations between psychological distress and experiences from the time in the group.
Hypotheses

We based this study on four underlying hypotheses:
The first hypothesis of the study was that former cult members have more psychological problems than the normal population (e.g., Aronoff et al., 2000; Gasde & Block, 1998; Walsh et al., 1995), but fewer such problems than a clinical group.
The second hypothesis was that, the more psychological abuse former cult members have experienced in the group, the more psychological problems they have, which is in line with the results of Winocur-Craig's (1995) study.
A third hypothesis was that former cult members would have more psychological problems the longer they had been active in the group (Gasde & Block, 1998).
The fourth hypothesis was that psychological well-being was expected to be better the more time that had passed since the defection (Gasde & Block, 1998; Walsh et al., 1995).

No difference in psychological well-being was expected between those who had been born into the group and those who had joined as adults (Buxant & Saroglou, 2008).

Method
Participants

We located study participants mainly through two Swedish support organizations for former cult members, Hjälpkällan (The Help Spring) and Föreningen Rädda Individen (FRI; The Organization for Saving the Individual). Hjälpkällan initially was formed to help former members of the Jehovah's Witnesses, but now former members from other organizations also turn to this support organization.

Sixty-seven people completed the questionnaire. One of them did not answer any of the questions about psychological well-being and was therefore excluded. Of the 66 remaining participants, 34 identified themselves as women and 31 as men. One participant did not answer the question about gender. The mean age of the participants was 41.2 years (median, 40.5; SD = 12.4; range, 17–69).

The participants were asked to choose what to call the group they had been members of. They reported that they had been members of The Jehovah's Witnesses (41); The Pentecostal Church (8); Word of Life (5); Arken/Faith Movement (1); The Faith Movement (2); Balanced View (1); The Family/Children of God (1); Life Center 2 (1); The Mormons (1); Sahaja Yoga (1); Folkkyrkan (1); “Unnamed” (1); and Osho/Baghwan Shree Rajneesh (1). Word of Life and Arken are both parts of the Swedish Faith Movement and therefore eight participants can be considered as representing the Faith Movement. Folkkyrkan and Life Center 2 are both parts of the Pentecostal Church, which gives a total of 10 participants from this organization.
Procedure and Informed Consent

A questionnaire was distributed through the Internet sites of the two Swedish support organizations. Participants completed and submitted the questionnaires using these websites. Some participants were identified by personal contact. The participants were informed that their participation was voluntary, that it would take about 10 minutes to answer the questions, and that the participants would be anonymous. They were also offered a copy of the final report. They were considered to have given their consent to participate by submitting the questionnaire.
Instruments

The questionnaire consisted of four parts. The first part contained questions about age, gender, the cult or group that the person had left, and current religious engagement. It also contained questions about the number of years in the group, the number of years since the defection, and whether the participant had been born into the group or joined it as an adult. On this last question, participants were asked to decide themselves, similar to the procedure used in Buxant and Saroglou’s (2008) study.

The second part of the questionnaire consisted of the GPA scale (Chambers et al., 1994). This self-administered questionnaire consists of 28 items, with seven items for each of four subscales: Compliance, Exploitation, Mind Control, and Anxious Dependency. The items are rated from 1 to 5 on a Likert scale ranging from 1 = not at all characteristic to 5 = very characteristic. The possible range for each subscale is from 7 to 35, and for the global measure the range is from 28 to 140. The total score is often used to assess the full extent of the experienced psychological abuse. A high score indicates high levels of psychological abuse. The group is considered as being abusive if the mean value on the total is higher than 3.

We used the Swedish translation of the Spanish version (GPA-S; Almendros, Carrobles, Rodriguez-Carballeira, Gámez-Guadix et al., 2012) that was made for a planned Swedish validation. For the current study, we made one minor change, explained in the following content. The Swedish Psychologist Håkan Järvå did the translation. Ingrid Eng, a professional translator with English as her main language, performed the back translation. Then Håkan Järvå and Ingrid Eng examined the new version together.

To question 23, “The group believes or implies its leader is divine,” we added for this study
“. . . or is God's spokesperson.” We did this to get adequate answers from those who had been members of groups that would never say a person can be divine, but in which the leader or leaders are thought to be able to discern God’s will and are therefore given a divine authority.

The third part of the questionnaire consisted of 24 questions that were intended to give a broader picture about the conditions in the group and how the former members’ lives had been affected by membership. We did not use these data in the present study.

The fourth part of the questionnaire consisted of the Clinical Outcomes in Routine Evaluation–Outcome Measure (CORE–OM; Evans et al., 2002). The CORE–OM consists of 34 questions and has four subscales: Subjective Well-Being, Problems/Symptoms, Life/Social Functioning, and Risk. The Risk scale can be divided into Risk to Self and Risk to Others. Participants rate the items on a 5-point scale ranging from “not at all” to “most or all the time.” Before the analyses, the verbal scale was converted to numbers. Higher scores indicate more psychological problems. CORE–OM measures a broad range of psychiatric, social, and functional aspects of an individual’s life situation (Elfström et al., 2012) making it suitable for this group.
Comparison Data

To compare the results on CORE–OM in this study with relevant ratings from other groups, we used data from two other studies:
In Elfström, Evans, Lundgren, & Johansson et al. (2012), we analyzed CORE–OM data from 229 university students without known problems. This was a convenience sample in a university setting.
In Holmqvist, Ström, and Foldemo (2014), we reviewed available data from 1,107 patients receiving psychological therapy in primary care. These patients were referred from their medical doctors at their primary care units, or in some cases self-referred. Common problems were depression and anxiety disorders.

Results

The internal consistency (Cronbach’s alpha) for the whole GPA scale was alpha = .86. For the subscale Compliance, it was alpha = .71, for Exploitation, alpha = 0.60, for Mind Control, alpha = .61, and for Anxious Dependency, it was alpha = .60. Because of the low internal consistency in the subscales, their use is limited in further analyses.

In Table 1, means and distribution characteristics are presented for GPA, CORE–OM, years active in the cult, and years since defection.

The score on CORE–OM is just below the Swedish cut-off for the clinical range (Holmqvist et al., 2014).

Table 2 shows comparisons between the psychological well-being of the participants and other groups, using data from the Swedish study of psychological well-being in a nonclinical sample mentioned earlier (Elfström et al., 2012), and from a Swedish clinical sample (Holmqvist et al., 2014) also mentioned earlier.

The results presented in Table 2 show significant differences between the former cult sample and the nonclinical sample on the total scale and on the four subscales. In the comparison between


Table 1

Mean, Standard Deviation and Range for GPA, COREOM, Number of Years Active and Number of Years Since Defection (N = 66)

Variable

Total Mean

SD

Range

GPA

   3.47

  0.52

1.7–04.52

CORE–OM

   1.25

  0.83

0.0–03.32

Years active

 18.30

11.80

2.0–60.00

Years since defection

 10.10

8.00

0.0–27.00

Note. SD = standard deviation

 

 

 


Table 2

Comparisons Between COREOM Ratings in the Former Cult Sample (n = 66) Compared With Swedish Nonclinical (n = 229) and Clinical (n = 1095) Samples

 


Samples (means and SD)

Former Cult

vs Nonclinical

Former Cult

vs Clinical

 

Former Cult

Nonclinical

Clinical

t (p)

ES

t (p)

Total score

1.25 (0.83)

0.90 (0.52)

1.71 (0.57)

4.16 (<.001)

0.52

37.10 (<.001)

SWB

1.40 (0.66)

1.15 (0.75)

2.30 (1.10)

2.45 (  .020)

0.36

76.10 (<.001)

Problems

1.67 (1.02)

1.15 (0.73)

2.28 (0.73)

4.26 (<.001)

0.59

41.40 (<.001)

Functioning

1.26 (0.85)

0.94 (0.60)

1.61 (0.60)

3.45 (<.001)

0.42

19.20 (<.001)

Risk

0.34 (0.51)

0.14 (0.32)

0.30 (0.42)

3.86 (<.001)

0.48

0.63 (ns)

Note. SD = standard deviation; t = t-value; p = probability; ES = effect size (Cohen’s d); ns = nonsignificant; SWB = subjective well-being

 




the former cult sample and the clinical sample, significant differences were found on the total scale and on the subscales except the Risk scale. On this scale, there was no difference between the clinical score and the score in the former cult group.

Because the difference between the clinical and the former cult samples on the Risk dimension was not significant, it was of interest to analyze the differences between the clinical group and the former cult group on the subscales Risk to Self and Risk to Others. On the Risk to Self-scale, the mean score in the former cult group was 0.57 (SD = 0.93), in the clinical group the mean score was 0.48 (SD = 0.68). The difference was not significant [t(1159) = .91, ns]. On the Risk to Others scale, the mean score in the former-cult group was 0.12 (SD = 0.36), and the mean score in the clinical group was 0.14 (SD = 0.39). The difference was not significant [t(1159) = .16, ns].

Table 3 shows correlations between GPA, CORE–OM, years active, and years since defection.

Table 3

Pearson Correlations (r) Between GPA, COREOM, Years Active, and Years Since Defection

 

GPA

CORE–OM

Years Active

Years Since Defection

GPA

1

      .33**

  -.23

   .01

CORE–OM

 

1.00

  -.13

   .12

Years Active

 

 

 1.00

  -.08

Years Since Defection

 

 

 

 1.00

** = p < .01


As Table 3 shows, the correlation between GPA and CORE–OM was significant. The correlations between GPA and the CORE subscales were as follows: Subjective Well-Being r = .29 (p < .05); Function r = .34 (p < .01); Problems r = .34 (p < .01); Risk to Self r = .20 (ns); Risk to Others r = .05 (ns); The correlations between CORE–OM and the GPA subscales were as follows: Compliance r = .21 (ns); Exploitation r = .31 (p < .05); Mind Control r = .25 (p < .05); and Anxious Dependency r = .30 (p < .05).

To further analyze the influence of GPA, years in the cult and years since defection on psychological distress, we did a multiple regression (MR) analysis using the stepwise method, with CORE–OM regressed on the three independent variables. The results of the analysis showed that only GPA was included in the model. The model was significant, with F = 9.1 (p < .01), accounting for 11 percent of the variance (adjusted R2).

To analyze the regression weights of the nonsignificant independent variables, we used the Enter method in a MR. Results are shown in Table 4.

The results in Table 4 indicate that the regression weights of Years Active and Years Since Defection played a negligible part in accounting for psychological distress as measured by CORE–OM, whereas GPA showed a significant association.

Of the participants, 36 had entered the cult at birth or when they were children, and 30 had entered as adults. Table 5 presents differences in results on GPA, CORE–OM, years as active, and years since defection between men and women, and between those who were born into or raised in the cults and those who joined as adults.

A trend in the results suggested that men had been active in the cults longer than women. Cohen’s d for this difference was .44. No other differences between men and women were found. Individuals who were born into the cults had been active more years (d = .77) than other participants in the study. There also was a trend indicating that more years had passed since the individuals who were born into the cult had left it than for those who had joined as adults (d = .50).

Table 4

Results From a Multiple Regression Analysis Using the Enter Method, With COREOM Regressed on GPA, Years in the Cult, and Years Since Defection

Variables in the Model

B

SE B

β

GPA

0.55

0.20

     0.35**

Years Active

0.00

0.01

-0.01

Years Since Defection

0.01

0.01

 0.12


Note. SE B = standard error B
** = p < .01


Table 5

Differences on GPA, COREOM, Years As Active, and Years Since Defection Between Men and Women and Between Those Who Were Born Into the Cults and Those Who Joined As Adults

Variable

Men

Mean and SD

Women

Mean and SD

t (p)

Born Into Cult

Mean and SD

Joined As Adults

Mean and SD

t (p)

GPA

3.45 (00.59)

3.47 (0.46)

0.022 (0.88)

3.49 (00.52)

3.43 (00.52)

0.24 (.630)

CORE-OM

1.24 (00.81)

1.25 (0.86)

0.003 (0.96)

1.28 (00.81)

1.21 (00.87)

0.14 (.710)

Years Active

20.50 (13.40)

15.60 (9.30)

2.930 (0.09)

21.50 (11.50)

13.00 (10.50)

9.41 (.003)

Years Since Defection

9.40 (07.40)

11.00 (8.60)

0.660 (0.42)

11.60 (08.30)

7.80 (06.80)

3.80 (.060)

Note. SD = standard deviation; t = t-value; p = probability



Discussion

The aim of this study was to analyze the psychological well-being among former cult members and to assess whether there was any correlation between the psychological distress of former members and their experiences in the group. The results from participants indicated that the former cult members expressed more psychological problems than those from a nonclinical group, which was in line with the first hypothesis, but that the former members experienced fewer problems than a sample of patients in primary care. On the Risk subscale, however, the former cult members did not differ from the primary-care patients, and the lack of difference was valid for both Risk to Self and Risk to Others.

The study also found that the level of psychological distress in former cult members was associated with the degree of psychological abuse these persons had suffered during their time in the group, which supported our second hypothesis. Psychological distress was not, however, associated with the number of years that participants had been active in the group nor the number of years since their defection, which was not in accordance with the third and fourth hypotheses. Neither was the psychological distress associated with whether former members were raised in the group or had entered it as adults, which was as expected.
Psychological Distress Related to Psychological Abuse Experienced in the Group

The finding that psychological distress was associated with the amount of psychological abuse that the former members had suffered supports the results from Winocur-Craig (1995). Gasde and Block (1998), however, did not find such associations.

A possible explanation of the difference between our results and the results in Gasde and Block (1998) could be the difference in measurement methods (SCL-90 versus CORE–OM). Another important difference is that, in the Gasde and Block study, participants were from only one religious group. The answers of those participants, therefore, reflect only differences in how they had comprehended the conditions in one organization, while in the present study and the Winocur-Craig (1995) study, many different movements were represented. The different results may suggest that the type of group or cult may be important for the psychological and even psychiatric consequences on those participating in a cult.
Psychological Distress Related to the Number of Years As Active Members in the Group

In this study we found no association between number of years participants were active in a group and their levels of psychological distress. These findings are in line with the main result in Gasde and Block (1998) and in Walsh et al. (1995).

Walsh et al. (1995) argued that the longer the time one spent active in the group, the more pervasive the psychological problems of the individual would be, provided that the conditions in the group had caused the psychological distress. This provision is important because the greater number of years in the group does not imply that the psychological abuse has been worse. Another caveat is that the number of years in the group does not represent how much time has been spent in the group's activities and how important the group, its doctrine, and the leaders have been to the individual. Furthermore, it is possible that the influence of the psychological abuse on the individual's psychological well-being occurs quite early, after the initial attention and “love-bombing” that new members sometimes experience. The first stage in the indoctrination process (Baron, 2000), which is a common feature of cultic or abusive groups, contains several aspects that can break down a person’s identity and create fear and mental exhaustion. These processes may be less influential after the initial period.
Psychological Well-Being and Years Since Defection

In the present study, the number of years since their defection could not predict the psychological well-being among former cult members. This finding differs from those in Gasde and Block (1998) and Walsh et al. (1995).

In the present study, most of the participants were identified through two Swedish support groups for former cult members, which was not the case for the participants in Gasde and Block (1998) and Walsh et al. (1995). It is a reasonable assumption that those who are active in support groups, even if many years have passed since their defection, still have problems they attribute to their time in the group. Therefore, the participants in this study were probably those who had problems they attributed to their time in the group, irrespective of whether they had left the group recently or a long time ago. The results might have been different if the participants had represented both former cult members who sought support and those who did not. Moreover, in the present study, most of the participants had been members of the Jehovah’s Witnesses. Individuals with that orientation were not represented in previous studies (Gasde & Block, 1998; Walshe et al., 1995), and this might have contributed to the different results. However, the result that the number of years since their defection could not predict the psychological well-being among former cult members shows that some former cult members need support, either from support groups or healthcare, even if many years have passed since their defection, a conclusion that Järvå (2009) also pointed out.
Psychological Well-Being Among Former Cult Members Compared With Normal Population and Clinical Group

We found in this study that former cult members had more psychological problems than the normal population. This result supports previous research (e.g., Aronoff et al., 2000; Buxant & Saroglou, 2008; Gasde & Block, 1998). The difference between the former cult members and the normal population was greatest as reflected in the Risk subscale. Although the participants reported better psychological well-being than a clinical group on three subscales, they reported the same level on the Risk scale, where both Risk to Self and Risk to Others results were on the level of a clinical group. For both the former cult members and for the clinical group, Risk to Self was the predominant factor of these two aspects. Healthcare personnel, social workers, and others who interact with former cult members should be aware of the fact that some former members may have thoughts of hurting themselves and may even have suicidal thoughts.

Interestingly, the correlation between the GPA scale and CORE–OM was not higher for the Risk scale than for the other subscales. The increased risk might be associated with other factors than the abuse experienced in the group.

In this study, as noted, the majority of the participants were former members of the Jehovah’s Witnesses, and it cannot be ruled out that the questions in the GPA scale do not fully capture the features of this organization. More likely, however, the Risk to Self and Others results might be explained by the participants’ social and familial break-up, which former members of the Jehovah’s Witnesses often experience.
Comparison Between Those Who Were Raised in the Group and Those Who Joined As Adults

In the present study, there was no significant difference in psychological well-being between those who were raised in the cultic group and those who had joined as adults. As mentioned earlier, Buxant and Saroglou (2008) pointed out that, for 14 of their 20 participants, the disaffiliation from the group led to a social or familial break-up, or both. In some organizations, families and friends are strongly encouraged to break all contact with the one who leaves the group. This phenomenon could serve as an example of how important the doctrine for social interaction in the group is, which contradicts the view of Graham and Haidt (2010), who claimed that social interaction between the members is the same, whatever the doctrine is.

The social and familial break-up, which will inevitably be the result of members leaving certain groups, will probably lead to considerable psychological distress for the former members. Therefore, it could have been expected that former members who were raised in such groups and whose families are still members would show more psychological distress than those former members who had joined the group as adults and might also have a social network outside the group. However, the results in the present study did not support such an expectation, despite the fact that 41 of the 66 participants were former members of the Jehovah’s Witnesses, who are very strict when it comes to encouraging members to break the connection with anyone who leaves the group. Therefore, this result is in line with the result from Buxant & Saroglou (2008). Differences between adult and second-generation members could be of interest for further studies.
Limitations

In this study, we found most of the participants through the website of the Swedish support organization Hjälpkällan, whose visitors are, to a great extent, former members of the Jehovah’s Witnesses. Both the fact that the visitors feel the need of support from other former cult members and that 41 of the 66 participants had been members of the Jehovah’s Witnesses may indicate that the participants were less representative of former members in general. However, in many of the studies carried out with former cult members (e.g., Buxant & Saroglou, 2008; Gasde & Block, 1998; Walsh & Russell, 1995), the participants were active in only a few organizations. It is, however, important to be aware of potential differences in the characteristics of psychological problems among former members of different cults because of their different experiences (Swartling & Swartling, 1992). Another limitation is that the participants in the present study were recruited through websites. It is hard to know to what extent former cult members use sites on the Internet as support tools. It should also be noted that the results are based on self-rated questionnaires. There may thus be a risk of method covariance. Furthermore, the results from the analysis that pertain to the GPA scale should be taken with caution because the GPA scale is not validated in Sweden.

Conclusions

The results in this study show that former cult members have more psychological problems than participants from a normal sample, particularly with regard to the risk of hurting oneself and others, with a focus on hurting oneself. Because of the correlation between the GPA scale and psychological distress, we suggest that the psychological abuse they have experienced in the group causes, to a great extent, the psychological distress among former cult members, although the social consequences of the defection should not be overlooked. Furthermore, since the results from this study show that former cult members have high levels of risk, healthcare personnel, social workers, and staff in support groups should pay extra attention to risk tendencies among this population, in particular, the risk of former members hurting themselves. This finding might be relevant even if a long time has passed since the defection, and even if the former members were active in the group only for a short period.

The findings underline recommendations to healthcare providers to be observant about sequelae of cult participation in the assessment and treatment of these persons. We believe that personnel who have dealings with former cult members would be better prepared to help this patient group if they have more knowledge of cultic environments and the specific doctrines of each group former members left, and also if they explore different aspects of the former members’ experiences, including the thoughts and feelings that being a member may create and how former members are treated. The GPA scale could be of great help in this respect, in combination with information about the cult from support groups for former cult members. Furthermore, such knowledge would make it easier for treatment personnel to fully comprehend the sometimes-incredible experiences that these patients or clients may reveal to them.

Acknowledgements

We thank all the individuals who responded the questionnaire. Thanks to CORE IMS for permission to reproduce CORE–OM electronically for this study. Special thanks also to Öjvind Jörgensen, Lund University, for all the support to the first author when doing the first version of this study as a thesis. Thanks also to Gillie Jenkinson, Hope Valley Counselling, for comments on the manuscript.

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About the Authors

Maria Göransson, BSc in psychology, is a medical student at Linköping University, Sweden. She has studied psychology with a special interest in cultic environments and their possible effect on their members. She was a member of the Swedish Pentecostal church during her adolescence. She can be reached through e-mail: margo306@student.liu.se or through Rolf Holmqvist, Department of Behavioral Sciences and Learning, Linköping University; phone +46 13 28 25 60; e-mail: rolf.holmqvis@liu.se.

Rolf Holmqvist, PhD, is a Professor of Clinical Psychology, Department of Behavioral Sciences and Learning, Linköping University, Sweden.

International Journal of Cultic Studies Vol. 9, 2018