Rd. Alarcon et al., SHOULD THERE BE A CLINICAL TYPOLOGY OF POSTTRAUMATIC-STRESS-DISORDER, Australian and New Zealand Journal of Psychiatry, 31(2), 1997, pp. 159-167
Objective: The current classification of posttraumatic stress disorder
in acute, chronic and delayed-onset types is incomplete and of limite
d usefulness. The present paper explores the possibilities of a clinic
ally-based typology that would reflect both the patients' syndromic pr
esentation and modern research findings. Method: Review of current cli
nical and research literature, with a critical examination of proposed
typologies, parameters utilised, applicability and relevance; elabora
tion of theoretical and practical bases of a clinical typology of post
traumatic stress disorder. Results: None of the existing posttraumatic
stress disorder typologies presents a clinically comprehensive scope.
A typology supported by literature findings and clinical observations
is proposed. The six clinical types are depressive, dissociative, som
atomorphic, psychotomorphic, organomorphic and 'neurotic-like'. Substa
nce abuse and personality disorder-like variants remain as areas of in
vestigation. Conclusions: The proposed typology, while accepting the n
uclear manifestations of posttraumatic stress disorder, highlights pro
minent coexisting symptoms that define the clinical appearance of diff
erent patients. The typological approach in posttraumatic stress disor
der does not carry the ambiguities of comorbidity, and facilitates a m
ore specific and appropriate management of the cases.