DSM-5 Diagnostic Category​

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Did you know that there is a DSM-5 Diagnostic Category for survivors of cults?

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The American Psychiatric Association's DSM-5 (2013) includes a diagnostic category, "Other Specified Dissociative Disorder (Diagnostic Criteria -- Code 300.15)," which can describe individuals who have experienced prolonged and intensive persuasion, leading to identity disturbance. This category encompasses experiences such as:​ brainwashing or thought reform, captivity or torture, long-term political imprisonment, recruitment by cults, sex trafficking rings, or terror organizations.

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Individuals affected by these experiences may exhibit persistent changes in or doubts about their identity, often experiencing dissociation as a result of the trauma.

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PTSD / CPTSD Diagnosis

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Individuals leaving such groups exhibit a spectrum of impacts, from mild anxiety to severe dissociation. Post-traumatic stress disorder (PTSD), as defined by the DSM-5, typically stems from a single traumatic event. It's characterized by intrusive symptoms like distressing dreams, memories, and flashbacks, coupled with avoidance behaviors—evading reminders of the trauma, including thoughts and feelings. This avoidance serves as a coping mechanism.

 

Trauma can also negatively affect mood, self-perception, and worldview, leading to negative emotions and hypervigilance. Cults often instill fear, creating conditioned fear responses to specific triggers after leaving. This heightened nervous system activation can result in concentration and sleep disturbances, all common PTSD symptoms.

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Cult Experiences as Complex Trauma

 

Dr. Erin Falconer describes cult experiences as complex trauma. Complex PTSD (C-PTSD), while not officially recognized in the American DSM-5, is acknowledged in Europe's ICD. C-PTSD encompasses core PTSD symptoms along with additional challenges related to identity, self-concept, emotional regulation, and relationships. These arise from prolonged or repeated trauma, narcissistic abuse, and are often seen in individuals exiting highly controlled environments.​

 

“Traumatic stress can change your brain’s chemistry and structure. Studies suggest that trauma is associated with permanent changes in key areas of your brain, including your: ​​Amygdala: The part of your brain that processes fear and other emotions. Hippocampus: The part of your brain that’s largely responsible for learning and memory. Prefrontal cortex: The part of your brain that’s involved in executive functions, such as planning, decision-making, personality expression and controlling social behavior.​ Some neuroimaging studies show that brain changes are more severe in people with CPTSD compared to people with PTSD.” (Source)

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Long-Term Psychological Effects

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Survivors of cultic environments often face significant challenges in establishing a new identity after leaving the group. Research, such as that by Rod Dubrow-Marshall (2010), indicates that these individuals are more likely to experience varying degrees of depression and anxiety.

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The Role of Identity Investment

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Dubrow-Marshall's research also highlights the correlation between the degree of identity investment within a cultic system and the risk of psychological harm. Individuals who hold positions of power or influence within the cult, such as those climbing the leadership ladder or serving as assistants to a guru, are at a higher risk of severe psychological impact. This increased vulnerability stems from the deeper integration of their sense of self with the cult's ideology and structure.​​​​