Nearly half of the individuals who experience Posttraumatic Stress Disorder (PTSD) will also have a Substance Use Disorder (SUD) in their lifetimes. Prolonged Exposure Therapy (PE), considered the “gold standard” in treating PTSD, has been increasingly used and studied as an intervention for PTSD, yet little is known about the mechanisms of change in this type of treatment. In PE for PTSD, participants tell and re-tell the story of their primary trauma many times over. This re-telling is called an “Imaginal Exposure.” When efficacious, this type of treatment allows for habituation, and PTSD symptom severity begins to dissipate. This paper seeks to better understand the psychological and linguistic processes that occur in such a treatment in order to contemplate for whom such a treatment might be beneficial, and why, (This article is a distillation of the doctoral dissertation by Zachary Kahn, “Words of Change: How Linguistic Shifts Over the Course of a Short-Term Exposure Therapy Represent Movement Towards Psychological Health” (2017).) by exploring the clinical and linguistic differences in the narratives of a treatment responder (decreased PTSD and SUD severity) and a treatment non-responder. A qualitative analysis of portions of the narratives (which were recorded and transcribed) demonstrated that there were clear clinical differences between the responder and non-responder. A linguistic analysis of the narratives using measures of the referential process showed that the treatment responder increasingly engaged in the referential process during exposures over the course of treatment, whereas the non-responder engaged in the referential process less frequently over the course of the treatment and less consistently throughout.

近一半经历过创伤后应激障碍 (PTSD) 的人在其一生中也会患上物质使用障碍 (SUD)。延长暴露疗法 (PE) 被认为是治疗 PTSD 的“金标准”，已越来越多地被用作和研究作为 PTSD 的干预措施，但对此类治疗的变化机制知之甚少。在 PTSD 的 PE 中，参与者多次讲述和重述他们的主要创伤的故事。这种重新讲述被称为“想象曝光”。当有效时，这种类型的治疗允许习惯化，并且 PTSD 症状的严重程度开始消散。本文旨在更好地理解这种治疗中发生的心理和语言过程，以便思考这种治疗可能对谁有益，以及为什么，（本文是 Zachary Kahn 博士论文的精华，“Words of Change: How Linguistic Shifts Over the Course of a Short-Term Exposure Therapy Represent Movement Towards Psychological Health”（2017）。）通过探索临床和语言差异在治疗反应者（降低 PTSD 和 SUD 严重程度）和治疗无反应者的叙述中。对部分叙述（被记录和转录）的定性分析表明，反应者和非反应者之间存在明显的临床差异。使用参考过程的测量对叙述进行语言分析表明，在治疗过程中，治疗反应者在暴露期间越来越多地参与参考过程，