This article is an electronic version of an article originally published in Cultic Studies Journal, 1997, Volume 14, Number 2, pages 290-306. Please keep in mind that the pagination of this electronic reprint differs from that of the bound volume. This fact could affect how you enter bibliographic information in papers that you may write.
The Individual Cult Experience Index: The Assessment of Cult Involvement and Its Relationship to Postcult Distress
Nadine Winocur, Psy.D.
Los Angeles, California
Jonibeth Whitney, M.A.
California School of Professional Psychology
Carol Sorensen, Psy.D.
Newport Beach, California
Peggy Vaughn, Psy.D.
United States Air Force
David Foy, Ph.D.
Research has suggested, but not yet quantitatively demonstrated, a relationship between cult involvement and postcult distress. This study addresses this problem with the development of the Individual Cult Experience (ICE) Index. Designed to tap group experiences associated with subsequent distress as reported in the cult and trauma literature, the ICE Index was tested on 76 support-seeking former cult members and two comparison groups (14 non-support-seeking former cult members and 13 distressed individuals who were not current or former cult members). Preliminary psychometric analyses show strong internal consistency (coefficient alpha ‘ .89), and an overall correct classification rate of 84%. A correlation of .45 (p < .001) was found between the ICE Index and current distress as assessed with the Los Angeles Symptom Checklist (LASC). Thus, a relationship between extent of cult involvement and current distress in former cult members is demonstrated by the ICE Index, along with a differentiation between cult-involved and non-cult-involved individuals.
Psychological distress is frequently reported by former cult members (Chambers, Langone, Dole, & Grice, 1994), and has been documented by many clinicians and researchers (Clark, 1979; Conway & Siegelman, 1982; Galanter, 1983; Goldberg & Goldberg, 1982; Langone, 1993; West & Singer, 1980). Distress severity often reaches clinical significance (Galanter, 1983; Martin, Langone, Dole, & Wiltrout, 1992; Spero, 1984; Swartling & Swartling, 1992), and may be widespread among former cult members, even those who have not sought treatment (Chambers et al., 1994). Recent research demonstrates that many former cult members perceive themselves to have been psychologically abused during their cult involvement (Chambers et al., 1994). Empirical support exists for a relationship between specific practices used in many cults and subsequent distress (Martin et al., 1992; Yalom & Lieberman, 1971); for example, time spent in group rituals and average length of rehabilitation (Conway, Siegelman, Carmichael, & Loggins, 1986).
Alternative theories linking postcult distress to experiences before and after cult involvement have been advanced as well. Possible factors include family history (Maron, 1988; Sirkin & Grellong, 1988), level of precult adjustment (Galanter, 1978, 1980), and method of cult disaffiliation, including extent of contact with cult awareness resources (Kim, 1979; Lewis, 1986; Ungerleider & Wellisch, 1979). However, it is more likely that postcult psychological adjustment is multidetermined (Dubrow-Eichel, 1989; Tobias & Lalich, 1994; West & Singer, 1980), with variables from across the lifespan interacting with cult experiences to create individual patterns of adjustment in former cultists.
The extent to which these and other factors are related to current adjustment in former cult members has yet to be explored. Also lacking is firm empirical evidence that demonstrates a relationship between cult involvement and subsequent distress. As a result, competing theories regarding the etiology of postcult distress continue to circulate, thus hindering appropriate therapeutic responses to many former cult members seeking treatment.
The Individual Cult Experience (ICE) Index was developed as part of a larger study of ex-cult members that examines the relationships among precult, cult, and postcult factors to current functioning. The model employed in this study has been used to successfully examine the etiology of distress in combat veterans (Foy, Sipprelle, Rueger, & Carroll, 1984), battered women (Houskamp & Foy, 1991), adult survivors of childhood sexual assault (Rowan, Foy, Rodriguez, & Ryan, 1994), and adolescent victims of violence (Burton, Foy, Bwanausi, Johnson, & Moore, 1994). Applying this model to former cult members offers the advantage of utilizing standard instruments which, for the pre- and posttrauma time frames, are easily adapted to different populations. Current distress has been measured with the Los Angeles Symptom Checklist (LASC), a standard instrument which has proven useful in clinical and research settings (King, King, Leskin, & Foy, 1995).
The central phenomenon of interest in each of the above-mentioned studies was exposure to a specific, theoretically distressing set of experiences. In the case of cultism, there was no preexisting instrument that measured individual exposure to stressful events in the cult milieu. Thus, the ICE Index was developed. Consequently, the ICE Index provided a quantitative measure for studying the relationship between cult involvement and postcult distress. The ICE Index has the potentiality of being a clinical instrument as well.
Development of the Individual Cult Experience Index
Because people can have very different experiences even within the same group, the ICE Index was not designed to characterize groups. Such has already been achieved with the development of the Group Psychological Abuse Scale (GPAS) by Chambers et al. (1994), which examines a group’s “cultishness.” Rather, the aim of this instrument has been primarily to tap group experiences that are hypothesized to have a negative effect on members’ psychological adjustment, and secondarily to distinguish between cult-involved and non-cult-involved individuals. Items were developed to assess for those experiences that were either mentioned repeatedly in the literature on cultism or were suggested by empirical research. They were worded to be as clear and unambiguous as possible, and to describe events and practices that were potentially observable by all group members.
Themes of psychological manipulation in the cult literature were examined for their theoretical relationship to postcult distress (e.g., Boulette & Anderson, 1986; Clark, Langone, Schechter, & Daly, 1981; Conway & Siegelman, 1982, Conway et al., 1986; Hassan, 1988; MacHovec, 1991; Ofshe & Singer, 1986; Singer & Ofshe, 1990; West, 1990; West & Singer, 1980). Those that met criteria for inclusion in the ICE Index included techniques central to control of cult members -- for example, social isolation and alienation, information control, sensory overload, and suppression of critical thought. The ICE Index assesses for this type of manipulation by determining, for example, how much time members spent at lectures and sermons or practicing Anon-reflective, repetitive tasks,” and whether “members were free to live with non-members.”
The emotional manipulation of group members is also hypothesized to be problematic. It includes induction of guilt (Hassan, 1988), fear and uncertainty (West & Singer, 1980), double bind communication (Bloch & Shor, 1989), and unpredictable reward and punishment (Yalom & Leiberman, 1971). An example of an item relating to this aspect of cult involvement asked whether “Members were warned that if they did not perform as expected, they would fail all of humanity.”
Physical control over cult members may render them more susceptible to psychological manipulation (Hassan, 1988), deplete resources needed to leave the group, and lead to subsequent distress (Gaines, Wilson, Redican, & Baffi, 1984; Valatx, 1994). Therefore, some items were designed to assess the extent to which members were deprived of sleep, nutrition, or exercise; engaged in extended periods of inactivity or hyperactivity; and experienced exploitation of personal resources (i.e., money, time, and labor).
The ICE Index also assesses for abuse experiences that are known to create psychological distress and which, though not unique to cultism, may be fostered in a cultic milieu. These include verbal abuse, fear of bodily injury, physical or sexual abuse, and perceived life threat. Items were drawn from the Assessing Environments-III Questionnaire (Berger, Knutson, Mehm, & Perkins, 1988), Sexual Abuse Experiences Questionnaire (Rowan et al., 1994), and the Conflict Tactics Scale-Revised (Hornung, McCullogh, & Sugimoto, 1981), which have been psychometrically validated to assess for victimization and trauma. These instruments offer behavioral descriptions for traumatic events based upon previously operationalized definitions of the events. The ensuing clarity of language was expected to reduce subjective interpretation of these items by research participants. For example, rather than asking participants if they were Asexually abused,” the ICE Index asks, “Did someone in the group who was in a position of authority over you touch your genital area, direct another to do so, or direct you to offer yourself sexually to another? If yes, do you feel discomfort or regret over this experience?”
Other empirical literature provided material for several items. For example, Yalom & Lieberman’s (1971) study of encounter group casualties identified group leadership styles associated with psychological injury. This produced such items as, AThe group leader humiliated you by telling you in front of others what was wrong with you and what you needed to change.”
Several items were adapted from existing surveys of cult characteristics. For example, the GPAS item (Chambers et al., 1994), “The group explicitly taught that deceit was ethical when used for the group’s objectives” captured several important features of destructive cultism, including deception, alienation from nonmembers, and double bind communications. The item, “The group did not advocate the use of violence against those who publicly criticized its teachings or practices (false),” was adapted from Dole & Dubrow-Eichel (1985), where it was rated as highly damaging to cult members by the expert panel consulted in that study.
Validation and refinement of the ICE Index began with a review of items by a panel of 10 clinicians and researchers, each with at least 10 years of professional cult-related experience. Panel members were asked to decide if an item was “essential,” “useful but not essential,” or “not useful” with respect to its ability to (1) isolate experiences within a cultic milieu which may significantly predict postcult distress, and (2) discriminate cultic from noncultic group involvement. Panelists were also invited to propose alternate items and modify item wording. Subsequently, 16 graduate psychology students completed the instrument and provided feedback primarily regarding clarity of instructions and item wording, and on overall ease of instrument completion. Items were rewritten to minimize individual interpretation by test takers, and were worded in alternately positive and negative directions to control for test-taking bias.
The ICE Index was organized into four sections with a total of 47 structured items. Sections were organized by convenience, allowing subjects to respond to items with similar instructions and response sets in a consecutive manner. Section 1 inquired about elements of the group’s doctrine and practices. Items were worded to address behaviors, predicated on their beliefs, rather than the underlying philosophy of the group. Section 2 inquired about the behaviors and actions of either group leaders or other members, undertaken at the direction of the leaders. Section 3 inquired about actions and experiences of the respondent, undertaken at the group’s direction. Section 4 asked about respondents’ knowledge of severe abuse experienced by other cult members. Items were scored dichotomously (yes/no) for the purpose of preliminary psychometric analysis.
One hundred and four subjects participated in this study. The primary sample group (Cult 1) consisted of 77 self-identified former cult members, who were currently active in support groups for former cult members sponsored by a national cult awareness organization.
One comparison group (Cult 2) consisted of 14 self-identified former cult members who had never sought support for their cultic group experience. They were contacted for participation in this project by members of the primary sample group.
A second comparison group (Comparison) consisted of 13 former or present members of noncultic groups, who were current clients of a religiously sponsored psychotherapy clinic, and who had no detected previous affiliation with a cult.
As shown in Table 1, participants in this study were primarily Caucasian females with some college education. There were significantly more females and fewer males in the Comparison group than in either the Cult 1 or Cult 2 groups. Marital status differed significantly between groups; the Comparison group had the highest number of single participants, and Cult 2 had the highest number of married participants. There were also more participants in the Cult 1 and Comparison groups who judged themselves to be upper-class or upper-middle-class than in Cult 2.
Table 2 shows group-related demographics for the two groups of former cult members. Demographic differences between sample groups were not statistically significant. Former cult members tended to have joined their groups as young adults, and stayed in their groups for an average of 6 years. Subjects in this study were away from their groups an average of approximately 7 years.
Demographic and history information used in this study was gathered with the Vietnam Veterans History Questionnaire (VVHQ) (Foy et al., 1984), with minor adaptations for use with former cult members.
Current distress was measured with the Los Angeles Symptom Checklist (LASC), a standardized instrument for the assessment of distress, especially posttraumatic stress disorder (PTSD), in victimization populations (King et al., 1995). The LASC is a list of 43 symptoms of general psychological distress, each of which are rated on a scale of 0 (not a problem) to 4 (an extreme problem).
Using a multisample data set, the LASC responses has been shown to possess high internal consistency and test-retest reliability. Acceptable levels of concurrent and convergent validity have been demonstrated with comparisons to the Structured Clinical Interview for DSM-III-R (SCID) PTSD Module, and with consistently significant correlations between LASC scores and measures of trauma exposure severity (King et al., 1995).
Table 1. Demographic Information
A. Cult 1
B. Cult 2
+Based on participants’ self-categorization as per estimates of family income. Income figures were not reported.
1Group C significantly different from Groups A and B (p < .001).
2Group C significantly different from Group B; Group B signigicantly different from Group A (p < .001 for both).
3Group B significantly different from Groups A and C (p < .05).
4Group B significantly different from Groups A and C (p <.001).
Table 2. Group-related Demographic Information (Former Cult Members Only)
Age when entered group
Years in group
Years since leaving group
Participants in this study were volunteers who were contacted through fliers distributed at support meetings for former cult members (located throughout the United States), and at a religiously sponsored psychotherapy clinic in Southern California. Volunteers were invited to “participate in a research project about the psychological experiences of former members of philosophical and religious groups...that will help educate mental health professionals about the experiences and needs of those who have been involved in abusive groups.” Interest in participating in the study was expressed by 159 people, who were then sent questionnaire packets through the mail.
All participants received the same set of guidelines for selecting a group experience on which to base survey responses. If they had belonged to more than one cult, former cult members referred to their most distressing cult experience. Those who had not been cult members referred to their most distressing group experience, either past or current. All participants clearly indicated whether or not they perceived their reference group to have been cultic. The surveys took about 90 minutes to complete, and were returned by 104 people (65%). Those who returned a survey were paid 10 dollars. For Cult 1, the return rate was 74%; for Cult 2, the return rate was 50%; and for the Comparison group, the return rate was 59%. The rates of return for Cult 1 and Cult 2 were significantly different (X2 ‘ 12.22; a ‘ .01).
Analysis of the ICE Index was conducted with the primary sample group (Cult 1). One survey was excluded from analysis as the participant did not complete the ICE Index, reducing the sample to 76. Item response frequencies were calculated for the 47 items on the ICE Index. Three items, which were missing 14 or more responses, were subsequently excluded. For the remaining 44 items, the average number of missing responses per item was .89, with a range of 0 to 4. In all 23 cases in which there were missing item values, the values were replaced with the mean for the item.
Item analysis conducted on the 44 items revealed good internal consistency (Cronbach’s alpha ‘ .89). The average item-total correlation was .37. Thirty-eight items had item-total correlations above .25; and 33 of those had item-total correlations of .30 or more.
Using the K-S (Lilliefors) statistic (SPSS, 1992), ICE Index scores were found to be normally distributed for each group, and were found to meet assumptions for homogeneity of variance as per Levene’s test for equality of variances (SPSS, 1992). Therefore, additional planned analyses were conducted. The ability of the ICE Index to distinguish between cult-involved and non-cult-involved participants was tested with a 1-way ANOVA, which revealed significant differences between mean scores for the three groups (F ‘ 18.76; df ‘ 2; p < .001). Mean ICE Index scores for each group are shown in Table 3. Post-hoc analyses with t-tests showed significant differences between mean scores for Cult 1 and the Comparison group (t ‘ 6.09; p < .001), and between Cult 2 and the Comparison group (t ‘ 5.14; p < .001).
Table 3. Extent of Exposure to Cult Experiences, by Sample Group
ICE Index Scores
Cult 1 > Comparison (t ‘ 6.09; p < .001).
Cult 2 > Comparison (t ‘ 5.14; p < .001).
Using a cutoff score of 15 to discriminate between cult-involved and non-cult-involved individuals (see Table 4), the ICE Index correctly identified 84% of the cult involved cases as having been cult involved, and correctly identified 85% of the non-cult-involved cases as not having been cult involved. For this sample, the ICE Index had an overall correct classification rate of 84%.
Mean LASC scores for each group were X ‘ 40.0 for Cult 1 (SD ‘ 25.1); X ‘ 35.9 for Cult 2 (SD ‘ 25.3); and X ‘ 52.7 for the Comparison group (SD ‘ 21.1), with higher scores indicating greater levels of distress. Despite differences in help-seeking behavior between the three groups, an analysis of variance revealed no statistically significant difference between distress scores.
For Cult 1 (support-seeking former cult members), the relationship between scores on the ICE Index and the LASC were examined using Pearsons product-moment correlation. A significant positive correlation was found (r ‘ .45; p < .001).
Table 4. Distribution Frequencies of ICE Index Scores
ICE Index Scores
Cult 1 (support-seeking)
(n ‘ 76)
(n ‘ 14)
A total score on the ICE Index represents “extent of exposure to cult experiences” by the respondent. Preliminary psychometric analyses indicate the instrument may be useful for the assessment of cult involvement. First, average ICE Index scores for the two groups of former cult members were significantly higher than scores for the Comparison group. Further, there was no significant difference between ICE Index scores for the two groups of former cult members, regardless of their support-seeking status. Also, the ICE Index was effective in discriminating between participants who identified themselves as former members of cultic groups (Cult 1) and those who identified themselves as current or former members of noncultic groups (Comparison).
The present analyses also confirm that, for the support-seeking former cult members, postcult distress is positively correlated with extent of cult involvement as assessed by the ICE Index. The correlation between the two variables was moderate. While it does not fully account for the symptomatology of the former cult members who participated in this study, cult involvement appears to be a large contributing factor.
The former cult members in this study reported moderate levels of current distress (on average, 7 years after leaving their group). From among the other research populations assessed with the LASC, these support-seeking former cult members compared most closely with people who were currently experiencing marital distress (X ‘ 36.4) (King et al., 1995).
The extent to which the participants in this study are representative of former cult members in general is not known. One potentially confounding factor is that the participants were either affiliated with or had contact with members of a national cult-awareness association. Research has produced contradictory findings on whether or not such contact is associated with negatively biased evaluations of former cult experiences (Lewis, 1986; MacDonald, 1988).
Another consideration is that the percentage of the formerly cult-involved population that seeks support through cult-awareness resources is undetermined; yet, such behavior is limited to individuals to whom such support is known and accessible. Additionally, those former cult members who are most highly distressed may pursue professional psychological assistance over nonprofessional, peer support. The present study does agree with previous findings (Chambers et al., 1994) that support-seeking among former cult members is not necessarily related to level of distress. Nevertheless, it would be premature to generalize these findings to other groups of former cult members at this time.
Implications for Future Research
Development of the ICE Index is an important first step in the assessment of potentially destructive cult experiences, as measuring the extent of individual cult involvement is necessary to understand the interaction of variables that predict postcult distress. In addition, quantitative demonstration of the relationship between cult involvement and subsequent distress lends support to the literature which has established the abusive nature of cults on a theoretical basis.
The ICE was designed primarily for use in empirical studies. Secondarily, it was developed as a clinical screening instrument when former cult involvement is suspected, to identify cult involvement and/or to isolate an individual’s potentially abusive group experiences, which may be processed in psychotherapy. Further research is needed to confirm its usefulness for these purposes.
Psychometric analysis of the ICE Index was limited by small sample size, thereby excluding performance of a factor analysis and requiring further item analysis (Nunnally, 1978). This study provides some support for the reliability and validity of the ICE Index; however, larger samples are needed to establish the psychometric properties of the ICE Index. Assessment of other populations of former cult members (e.g., recently exited and clinical groups), as well as comparison groups, is needed to determine its robustness. Additional analyses might include test-retest reliability, cross-validation across samples of former cult members, and tests of concurrent validity with similar instruments such as the GPAS (Chambers et al., 1994).
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This study was undertaken as the dissertation project of the principal author, who wishes to express her heartfelt gratitude to the other members of the research team for their dedication and integral contributions to this work. Special thanks and acknowledgment go to Dr. David Foy, under whose expert guidance and supervision our research laboratory was formed, this study was conducted, and the article was written. The authors thank the following individuals who generously shared their time and expertise by reviewing an early version of the Individual Cult Experience Index: Susan Anderson, Ph.D., Chanon Bloch, L.C.S.W., Louis Cozolino, Ph.D., Arthur Dole, Ph.D., William Goldberg, M.S.W., A.C.S.W., Arnold Markowitz, M.S.W., C.S.W., Madeleine Tobias, M.S., R.N., C.S., Louis West, M.D., Doni Whitsett, Ph.D., and Philip Zimbardo, Ph.D. We are especially grateful to the former cult members who participated in this study for their willingness to remember and share their often painful life experiences.
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Nadine Winocur, Psy.D., has a doctorate from Pepperdine University. She is in private practice in Los Angeles, with professional interests in cult involvement and workplace harassment, abuse, and physical injury.
Jonibeth Whitney, M.A., is working toward a doctorate in multicultural community clinical psychology at the California School of Professional Psychology in Los Angeles.
Carol Sorensen, Psy.D., has a doctorate from Pepperdine University and is in private practice in Newport Beach, California. Her professional interests include body image, traumatic stress in refugees, stress management, and physical disabilities.
Peggy Vaughn, Psy.D., has a doctorate from Pepperdine University and is a licensed clinical psychologist on active duty in the U.S. Air Force.
David Foy, Ph.D., is Professor of Psychology, Graduate School of Education and Psychology, Pepperdine University.