Four syndromes of post‐traumatic stress disorder: Stressors and conflicts of the traumatized with special focus on the Vietnam combat veteran

Four clinical syndromes of post‐traumatic stress disorder (PTSD) are described in this paper. These syndromes can be observed in many Vietnam veterans who have combat‐related stress disorders. Each syndrome has its own independent stressor and central emotional conflict. These conflicts are: (1) survival guilt secondary to losing a close friend, (2) fear and anxiety secondary to life‐threatening situations, (3) guilt and related conflicts secondary to participation in acts of abusive violence, (4) mistrust secondary to the experience of betrayal of trust, especially by persons in authority. The four syndromes and their associated central emotional conflicts are compared with each other across the following five psychological dimensions of behavior: (1) types of emotional symptoms of distress, (2) disturbances in interpersonal relationships, (3) problems with aggression, (4) alterations in self‐concepts, and (5) characteristic changes in the manifest content of dreams. Comparisons are also made with other survivor/victim populations in which similar emotional conflicts have been described.