Hello my name is Victoria Schraeder and I am in a research class at San Francisco State University. I have a project were I have to administer a survey on a research topic. I am interested in studying the effects of cults on former cult members. These surveys will be completely confidential, therefore I would greatly appreciate it if you could answer the questions without reservation however please do not put your name on it. Thank you so much for your help in my project. I have also posted this on the Movingon.com site and other ex-cult sites and have got a good response I hope some of you can help me also. Thank you for your time, and if any of you who participate want me to post the final product of my research I would gladly do so.
1. What were your reasons for joining the cult,? Check all that apply ( ) feelings of loneliness, rejection, sadness, and lack of belonging ( ) drifting through life and feeling that life lacks meaning ( ) personal or family crisis or unpleasant situation ( ) recruited by a member of the cult ( ) other:______________________________________________ 2. What was your overall cultic experience? positive ( ) negative ( ) neutral ( ) mixed 3. What was the level of physical abuse you experienced in the cult? ( ) severe physical abuse ( ) moderate physical abuse ( ) minimal physical abuse ( ) no physical abuse 4. What was the level of mental and emotional abuse (name calling, public ridicule, humiliation, dominance, etc.) you experienced in the cult? ( ) severe mental abuse ( ) moderate mental abuse ( ) minimal mental abuse ( ) no mental abuse 5. What was the level of sexual abuse you experienced in the cult? ( ) severe sexual abuse ( ) moderate sexual abuse ( ) minimal sexual abuse ( ) no sexual abuse 6. What had more of an affect on you life after leaving the cult? ( ) physical abuse ( ) mental abuse ( ) emotional abuse ( ) sexual abuse ( ) neither had an affect ( ) both had some substantial affect
7. What, if any, symptoms followed your exit from the cult? Check all that apply. ( ) anxiety/fear/worry ( ) anger toward leader ( ) low self-confidence ( ) flashbacks ( ) depression ( ) hopelessness ( ) other:___________________________________ 8. After exiting the cult what, if any, type of help or support did you receive? Check all that apply. ( ) voluntary deprogramming ( ) voluntary exit counseling ( ) involuntary deprogramming ( ) involuntary exit counseling ( ) outside support groups ( ) family support ( ) no support at all 9. How long did you participate in any support services? ( ) 1-6 months ( ) 7-12 months ( ) 1-3 years ( ) more than three years ( ) none 10. I have built new and positive relationships, who are unaffiliated with the cult I belonged to, after leaving the cult. ( ) strongly agree ( ) agree ( ) disagree ( ) strongly disagree ( ) no answer 11. I have become part of a community and actively participate in community services. ( ) strongly agree ( ) agree ( ) disagree ( ) strongly disagree ( ) no answer 12. After leaving the cult, I received more education were I earned: ( ) high school diploma ( ) 2-year college degree ( ) 4-year college degree ( ) masters degree ( ) PhD or doctorate ( ) Other 13. After leaving the cult, I received vocational training for a specific job: ( ) yes, _______________________________ ( ) no 14. Sex ( ) Female ( ) Male 15. Age:_____ 16. The name of the cult that you were involved with: _____________________________
