Malignant post-Vietnam stress syndrome.

Abstract
A particularly severe form of Post-Vietnam Stress Syndrome is described. Its most distinctive clinical characteristic is the mutually escalating interaction among four psychological and social features: explosive, violent behavior; social ostracism and isolation; extreme self-loathing; and the exceptionally vivid and persistent reexperiencing of psychological war trauma. Recognition of these features, and consideration of their diagnostic significance and etiologic background, are essential in meeting the clinical challenge posed by these veterans.

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