Brief exposure to traumatic memories using script-driven imagery (SDI) has been proposed as a promising treatment for
posttraumatic stress disorder (
PTSD). This study investigated the effect of SDI plus active versus
sham deep
transcranial magnetic stimulation (TMS) in a secondary analysis of a randomized controlled trial for adults with
PTSD (N = 134). Linguistic features of scripts and self-reported distress during a 12-session deep TMS treatment protocol were examined as they related to (a) baseline
PTSD symptom severity, (b)
trauma characteristics, and (c) treatment outcomes. Linguistic Inquiry and Word Count (LIWC) software was used to analyze the following linguistic features of SDIs: negative emotion, authenticity, and cognitive processing. More use of negative emotion words was associated with less severe self-reported and clinician-rated baseline
PTSD symptom severity, r = -.18, p = .038. LIWC features did not differ based on index
trauma type, range: F(3, 125) = 0.29-0.49, ps = .688-.831. Between-session reductions in self-reported distress across SDI trials predicted
PTSD symptom improvement across both conditions at 5-week, B = -15.68, p = .010, and 9-week endpoints, B = -16.38, p = .011. Initial self-reported distress and linguistic features were not associated with treatment outcomes. The findings suggest that individuals with
PTSD who experience between-session habituation to SDI-related distress are likely to experience a corresponding improvement in
PTSD symptoms.