Journal of Traumatic Stress

, Volume 1, Issue 1, pp 57–78 | Cite as

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

  • Hillel Glover


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.

Key words

survival guilt fear and anxiety guilt mistrust 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Bandura, A. (1982). Self-efficacy mechanisms in human agency.Am. Psychologist 37: 122–147.Google Scholar
  2. Bernard, V., Ottenberg, P., and Redl, F. (1971). Dehumanization. In Sanford, N., and Comstock, C. (eds.),Sanctions for Evil Jossey-Bass, San Francisco.Google Scholar
  3. Blank, A. (1982). Stresses of war: The example of Vietnam. In Goldberger, L., and Breznitz, S. (eds.),Handbook of Stress: Theoretical and Clinical Aspects The Free Press, New York.Google Scholar
  4. Blos, P. (1979).The Adolescent Passage International Universities Press, New York.Google Scholar
  5. Bourne, P. (1971). From boot camp to My Lai. In Falk, R., Kilko, G., and Lifton, R. (eds.),Crimes of War Random House, New York.Google Scholar
  6. Bowlby, J. (1969).Attachment and Loss, Vol. 1, Basic Books, New York.Google Scholar
  7. Erikson, K. (1976). Loss of communality at Buffalo Creek.Am. J. Psychiat. 133: 302–305.PubMedGoogle Scholar
  8. Fleming, R., Baum, A., and Singer, J. E. (1984). Toward an integrative approach to the study of stress.J. Personal. Social Psychol. 46: 939–949.Google Scholar
  9. Folkman, S. (1984). Personal control, stress, and coping processes: A theoretical analysis.J. Personal. Social Psychol. 46: 839–852.Google Scholar
  10. Foy, D., Rueger, D., Siprelle, R., and Carroll, E. (1984). Etiology of post-traumatic stress disorder in Vietnam veterans: Analysis of premilitary, military, and combat exposure influences.J. Consult. Clin. Psychol. 52: 79–87.PubMedGoogle Scholar
  11. Glover, H. (1984a). Themes of mistrust and the post-traumatic stress disorder in Vietnam veterans.Am. J. Psychother. 37: 445–452.Google Scholar
  12. Glover, H. (1984b). Survival guilt in the Vietnam veteran.J. Nerv. Mental Dis. 172: 393–397.Google Scholar
  13. Glover, H. (1985). Guilt and aggression in Vietnam veterans.Am. J. Social Psychiat. 1: 15–18.Google Scholar
  14. Goldstein, R., and Breslin, P. (1986). Technicians of torture.The Sciences 26: 14–19.Google Scholar
  15. Haley, S. (1974). When the patient reports atrocities.Arch. Gen. Psychiat. 30: 191–196.PubMedGoogle Scholar
  16. Holloway, H., and Ursano, R. (1984). Vietnam veteran: Memory, social context and metaphor.Psychiatry 47: 103–108.PubMedGoogle Scholar
  17. Janis, I. (1982). Decision making under stress. In Goldberger, L., and Breznitz, S. (eds.),Handbook of Stress: Theoretical and Clinical Aspects The Free Press, New York.Google Scholar
  18. Keane, T. M. (1985). Defining traumatic stress: Some comments on the current terminological confusion.Behav. Ther. 16: 419–422.Google Scholar
  19. Kelman, H. (1973). Violence without moral restraint: Reflections on the dehumanization of victims and victimizers.J. Social Iss. 4: 25–61.Google Scholar
  20. Kilpatrick, D., Veronen, L., and Resick, P. (1979). The aftermath of rape: Recent empirical findings.Am. J. Orthopsychiat. 49: 658–669.PubMedGoogle Scholar
  21. Kolb, L., and Mutalipassi, L. (1982). The conditioned emotional response: A sub-class of the chronic and delayed post-traumatic stress disorder.Psychiatric Ann. 12: 979–987.Google Scholar
  22. Krell, R. (1979). Holocaust families: The survivors and their children.Comprehensive Psychiat. 20: 560.Google Scholar
  23. Laufer, R., Brett, E., and Gallops, M. (1985). Symptom patterns associated with post-traumatic stress disorder among Vietnam veterans exposed to war trauma.Am. J. Psychiat. 142: 1304–1311.PubMedGoogle Scholar
  24. Lidz, T. (1946). Psychiatric casualties from Guadalcanal.Psychiatry 9: 193.Google Scholar
  25. Lifton, R. J., and Olson, E. (1976). The human meaning of total disaster, The Buffalo Creek Experience.Psychiatry 39: 1–18.PubMedGoogle Scholar
  26. Luchterhand, E. G. (1971). Sociological approaches to massive stress in natural and man-made disasters.Int. Psychiat. Clin. 8: 29–53.Google Scholar
  27. Nadelson, C., Notman, M., Zackson, H., and Gornick, J. (1982). A follow-up study of rape victims.Am. J. Psychiat. 139: 1266–1270.PubMedGoogle Scholar
  28. Perry, W. G. (1970).Forms of Intellectual and Ethical Development in the College Years Holt, Rhinehart, and Winston, New York.Google Scholar
  29. Rachman, S. (1978).Fear and Courage Freeman, San Francisco.Google Scholar
  30. Santiago, J., McCall-Perez, F., Gorcey, M., and Beigel, A. (1985). Longterm psychological effects of rape in 35 rape victims.Am. J. Psychiat. 142: 1338–1340.PubMedGoogle Scholar
  31. Shatan, C. (1973). The grief of soldiers: Vietnam combat veterans self-help movement.Am. J. Orthopsychiat. 43: 640–653.PubMedGoogle Scholar
  32. Terr, L. C. (1981). Psychic trauma in children: Observations following the Chowchilla school bus kidnapping.Am. J. Psychiat. 138: 14–19.PubMedGoogle Scholar
  33. van der Kolk, B. (1985). Inescapable shock, neurotransmitters, and addiction to trauma: Toward a psychobiology of post-traumatic stress.Biol. Psychiat. 20: 314–325.PubMedGoogle Scholar
  34. Walker, J. I., and Cavenar, J. (1982). Vietnam veterans: Their problems continue.J. Nerv. Ment. Dis. 170: 174–179.PubMedGoogle Scholar
  35. Wolf, S., and Ripley, H. (1947). Reactions among allied prisoners of war subjected to three years of imprisonment and torture by the Japanese.Am. J. Psychiat. 104: 180.Google Scholar

Copyright information

© Plenum Publishing Corporation 1988

Authors and Affiliations

  • Hillel Glover
    • 1
  1. 1.East Orange, V.A. HospitalEast Orange

Personalised recommendations