Reductions in reported persecutory ideation and psychotic-like experiences during exposure therapy for posttraumatic stress disorder.

•In a sample of active duty service members with PTSD, individuals receiving prolonged or virtual reality exposure experienced decreases in paranoia relative to wait-list control.•Report of hallucinations declined in both groups.•In this sample, symptoms of paranoia appear related to avoidance and numbing symptoms of PTSD, while hallucinations appear related to re-experiencing.•No psychotic-like experience measured in this study reduced the treatment impact of trauma-focused treatment for PTSD.