Aphantasia and autism, ADHD, depression: what research shows

No, aphantasia is not a sign of autism. In self-selected groups, people with aphantasia had somewhat higher average scores on an autism questionnaire (Dance et al. 2021); among people with an autism diagnosis, visual aphantasia was not more common in another study (Arnold et al. 2026). No diagnosis can be derived from a test of imagery.

What points to a link

Dance et al. (2021) compared 118 people with aphantasia with 118 controls. On the Autism-Spectrum Quotient (AQ), scored without the question about mental images, the aphantasia group averaged 23.84 points and the control group 20.51 (effect size d = 0.45). The difference appeared only for imagination and social skills, not for communication, attention to detail or attention switching. The aphantasia group was self-selected, and the authors state that no conclusions about clinical autism diagnoses can be drawn from it.

Milton et al. (2021) found a similar picture in small groups: on average 22.04 points with aphantasia, 14.20 with typical imagery and 17.92 with hyperphantasia (24, 20 and 25 people).

The opposite direction has been studied too: in an online survey of 121 adults, autistic participants reported less vivid mental images on average than non-autistic participants (d = −0.44), and a larger share of them scored at or below the aphantasia cut-off (King, Buxton & Tyndall 2024). Diagnosed and self-identified autistic people formed one group there. A further survey found a weak association between autistic traits and the vividness of mental images (r = −0.20; Taylor et al. 2026).

What speaks against it

Across several surveys, Bouyer et al. (2025) found a weak association only in the largest one (308 people) that did not depend on the questionnaire's “imagination” scale. The authors warn of circular reasoning, because the AQ itself asks about imagination. Among 327 people with an autism diagnosis (by self-report), visual aphantasia was not more common than in a comparison group; their imagery was somewhat less distinct overall, and only missing imagery of smell and taste was more common (Arnold et al. 2026).

What is not supported

There is no evidence on how common autism diagnoses are among people with aphantasia in the population, nor on a cause in either direction. Monzel et al. (2023) state as their assessment that most people with aphantasia are not autistic; they did not count this.

Sources for this section: Dance, C. J., Jaquiery, M., Eagleman, D. M., Porteous, D., Zeman, A. & Simner, J. (2021). What is the relationship between Aphantasia, Synaesthesia and Autism? Consciousness and Cognition, 89, 103087. doi:10.1016/j.concog.2021.103087 — Milton, F., Fulford, J., Dance, C. et al. (2021). Behavioral and Neural Signatures of Visual Imagery Vividness Extremes: Aphantasia versus Hyperphantasia. Cerebral Cortex Communications, 2(2), tgab035. doi:10.1093/texcom/tgab035 — King, R., Buxton, H. & Tyndall, I. (2024). Aphantasia and autism: An investigation of mental imagery vividness. Consciousness and Cognition, 125, 103749. doi:10.1016/j.concog.2024.103749 — Taylor et al. (2026). Exploring the association between mental imagery, sensory sensitivity, and autistic traits. Scientific Reports, 16. doi:10.1038/s41598-026-38574-9 — Bouyer, L. N., Pellicano, E., Saurels, B. W., Schwarzkopf, D. S. & Arnold, D. H. (2025). The vividness of visualisations and autistic trait expression are not strongly associated. Consciousness and Cognition, 129, 103821. doi:10.1016/j.concog.2025.103821 — Arnold et al. (2026). Autism and Aphantasia. Consciousness and Cognition, 143, 104085. doi:10.1016/j.concog.2026.104085 — Monzel, Dance, Azañón & Simner (2023). Aphantasia within the framework of neurodivergence: Some preliminary data and the curse of the confidence gap. Consciousness and Cognition, 115, 103567. doi:10.1016/j.concog.2023.103567

That is not settled: we found a single peer-reviewed study on it, and it concerns acquired aphantasia and relies on a screening questionnaire rather than diagnoses (Gao, Nagai & Silvanto 2025).

Source for this section: Gao, Nagai & Silvanto (2025). Autonomic, neurodevelopmental, and early adversity correlates of acquired aphantasia. Neuropsychologia, 219, 109272. doi:10.1016/j.neuropsychologia.2025.109272

There is no robust evidence for that, neither for more nor for less intelligence. The only IQ comparison we found comes from small groups, and the authors list the difference there among the limitations of their study, not as a finding about intelligence (Milton et al. 2021). A test of imagery does not measure intelligence.

Milton et al. (2021) measured an average IQ of about 115 in 24 people with aphantasia, 110 in 20 people with typical imagery and 106 in 25 with hyperphantasia. The difference between aphantasia and hyperphantasia was statistically significant. The authors call it a complication for interpreting their other results; the groups were small and partly self-selected.

Another study matched its two groups for age and IQ from the outset. In tasks that call for imagery, they differed only in reaction time, not in accuracy (Pounder et al. 2022; 20 people each).

In a sample from the general population, imagery vividness was unrelated to school grades after correction for multiple tests (Monzel et al. 2023; 115 people, 9 subjects, 5 year levels). For working memory the findings contradict each other: equal capacity in one paper (Keogh, Wicken & Pearson 2021), weaker memory performance in another (Monzel, Vetterlein & Reuter 2022).

In a large survey, 67% of participants with aphantasia and 68% of those with hyperphantasia had a university degree or more than 15 years of education, compared with 51% in the control group (Zeman et al. 2020). This shows who comes forward for such a study and is not a measure of intelligence.

There is no evidence of an IQ difference in a population sample, nor a comparison of school or university grades between people with and without aphantasia.

Learning, university, work: what studies show

Sources for this section: Milton, F., Fulford, J., Dance, C. et al. (2021). Behavioral and Neural Signatures of Visual Imagery Vividness Extremes: Aphantasia versus Hyperphantasia. Cerebral Cortex Communications, 2(2), tgab035. doi:10.1093/texcom/tgab035 — Pounder et al. (2022). Only minimal differences between individuals with congenital aphantasia and those with typical imagery on neuropsychological tasks that involve imagery. Cortex, 148. doi:10.1016/j.cortex.2021.12.010 — Monzel, Dance, Azañón & Simner (2023). Aphantasia within the framework of neurodivergence: Some preliminary data and the curse of the confidence gap. Consciousness and Cognition, 115, 103567. doi:10.1016/j.concog.2023.103567 — Keogh, Wicken & Pearson (2021). Visual working memory in aphantasia: Retained accuracy and capacity with a different strategy. Cortex, 143. doi:10.1016/j.cortex.2021.07.012 — Monzel, Vetterlein & Reuter (2022). Memory deficits in aphantasics are not restricted to autobiographical memory. Journal of Neuropsychology, 16. doi:10.1111/jnp.12265 — Zeman, A., Milton, F., Della Sala, S. et al. (2020). Phantasia – The psychological significance of lifelong visual imagery vividness extremes. Cortex, 130, 426–440. doi:10.1016/j.cortex.2020.04.003

For depression, two situations must be distinguished:

1. 1Congenital aphantasia + depressionThere is no robust evidence that lifelong (congenital) aphantasia increases the risk of depression. Those who never had mental imagery don't appear more depression-prone for that reason.
2. 2Suddenly acquired aphantasia in the context of depressionThis is neurologically and psychiatrically significant. Severe depressive episodes can temporarily reduce imagery vividness — often accompanied by anhedonia, concentration problems, reduced affect regulation. Medical evaluation matters here.

Strongly expressed aphantasia correlates with Severely Deficient Autobiographical Memory (SDAM) — the tendency to remember one's life factually rather than scenically.

Not everyone with aphantasia has SDAM, and not everyone with SDAM has aphantasia, but there is substantial overlap between the two conditions — an exact, peer-reviewed prevalence figure is not yet established. The research team in Exeter reports having been contacted by over 14,000 people; in its large survey, participants with aphantasia more often called their memory “bad”, those with hyperphantasia more often “good” (Zeman et al. 2020).

People affected report remembering trips, birthdays and personal milestones more as a “list of facts” than as a “film sequence”. This isn't pathological but can be emotionally burdensome for some people who lack the feeling of “reliving” their memories.

Sources for this section: Zeman, A., Milton, F., Della Sala, S. et al. (2020). Phantasia – The psychological significance of lifelong visual imagery vividness extremes. Cortex, 130, 426–440. doi:10.1016/j.cortex.2020.04.003 — Milton, F., Fulford, J., Dance, C. et al. (2021). Behavioral and Neural Signatures of Visual Imagery Vividness Extremes: Aphantasia versus Hyperphantasia. Cerebral Cortex Communications, 2(2), tgab035. doi:10.1093/texcom/tgab035 — Dawes, A. J., Keogh, R., Robuck, S. & Pearson, J. (2022). Memories with a blind mind: Remembering the past and imagining the future with aphantasia. Cognition, 227, 105192. doi:10.1016/j.cognition.2022.105192

Aphantasia itself is not a reason for medical or psychotherapeutic help. But there are three situations where professional support makes sense:

1. 1If the discovery shakes self-worth or identity: psychotherapeutic counseling can help reframe one's own cognition.
2. 2If symptoms of depression, anxiety, ADHD, or autism become burdensome at the same time: address those symptoms specifically, not the aphantasia.
3. 3If aphantasia is sudden onset (previously normal imagery): neurological and psychiatric evaluation.

Some psychotherapy methods rely heavily on mental images, for example imagery rescripting, guided imagery or exercises with visual anchors.

If you cannot produce mental images, you can say so at the start and discuss with your therapist how to handle imagery-based exercises. One possible question: “How do you proceed when someone cannot produce mental images?”

This page makes no statement about how well individual methods work with aphantasia.