Opposing Autonomic Pathways Link Childhood Trauma to Mental Imagery Deficits

Abstract Although childhood trauma alters neurobiological systems supporting emotion regulation and autonomic function, mechanisms linking trauma to mental imagery deficits remain unexplored. Here we examined whether autonomic nervous system symptoms mediate trauma-imagery associations in a general population sample (n = 433). All trauma types showed associations with reduced imagery vividness (r = -.12 to -.23), with emotional neglect and emotional abuse demonstrating the strongest effects. Physical trauma types and emotional abuse correlated with increased autonomic symptoms (r = .35-.38). Parallel mediation analyses revealed that autonomic symptom burden (BPQ ANS subscale), but not anxiety, significantly mediated trauma-imagery relationships through opposing mechanisms. Physical trauma types and emotional abuse showed negative indirect effects through heightened autonomic reactivity, with complete mediation for emotional abuse and physical neglect. In contrast, emotional neglect showed a positive indirect effect through reduced autonomic reactivity (a pattern that emerged when controlling for other trauma types) alongside the strongest direct effect on imagery. These findings demonstrate that childhood trauma impacts mental imagery through distinct autonomic mechanisms—hyperreactive dysregulation for physical/emotional abuse versus hyporeactive blunting for emotional neglect—suggesting autonomic-targeted interventions should be tailored to trauma type.