Linguistic processing and Script-Driven Imagery for trauma exposure: A proof of concept pilot trial

While several empirically supported treatments for posttraumatic stress disorder (PTSD) have been developed, these treatments are neither widely available nor universally efficacious. This pilot, proof of concept study evaluated a computerized imaginal exposure Script-Driven Imagery Training (SDI-T) for individuals with elevated trauma reactivity. The training was supplemented with two forms of linguistic processing, affect labeling (SDI-T + AL) and distraction (SDI-T + D), to determine whether linguistic inhibitory regulation augmented the effects of SDI-T.

Participants (n = 64) with trauma-related distress were randomized to SDI-T, SDI-T + AL, or SDI-T + D. Physiology and self-reported trauma distress were measured at pre- and post-training.

The training was acceptable to participants and effective at reducing self-reported distress (d = -0.41), and physiological activation from pre- to post-training (d = -0.49, ps < .01), with some evidence that linguistic processing (SDI-T + AL and SDIT-T + D) conferred a benefit over SDI-T. The linguistic processing groups had significantly steeper reduction in physiology relative to the non-linguistic processing group (p < .05, d = 0.59). There was no benefit of SDI-T + AL over SDI-T + D.

This pilot study provides initial support for the acceptability and efficacy of computerized imaginal exposure training for PTSD. Clinical implications and future directions are discussed.