Background <p>Childhood trauma and impulsive behaviors are frequently observed in clinical pathologies, such as borderline personality disorder and bipolar disorder. This study aimed to investigate the intricate interplay between childhood trauma and impulsive behaviors, the mediating roles of neuroticism, stress perception, and depressive symptoms, and sought to discern the distinct effects of emotional and physical trauma on impulsive behaviors.</p> Methods <p>A cohort of 637 clinical patients completed scales assessing childhood trauma, impulsive behaviors, neuroticism, perceived stress, and depressive symptoms. Structural equation modeling (SEM) was conducted to investigate the relationships among these variables. Additionally, emotional and physical trauma were treated as independent variables in the SEM, respectively.</p> Results <p>Childhood trauma exhibited both direct and indirect paths to impulsive behaviors. The total indirect effect was 0.210, arising from three distinct indirect statistical pathways: (1) childhood trauma → depressive symptoms → impulsive behaviors; (2) childhood trauma → neuroticism → depressive symptoms → impulsive behaviors; (3) childhood trauma → neuroticism → perceived stress → depressive symptoms → impulsive behaviors. Emotional trauma and physical trauma both showed direct and indirect paths to impulsive behaviors. Specifically, emotional trauma had a direct effect of 0.210(47.19% of total effects) and an indirect effect of 0.235(52.81% of total effects), while physical trauma had a direct effect of 0.288(65.16% of total effects) and an indirect effect of 0.154(34.84% of total effects).</p> Conclusions <p>Childhood trauma had associations with impulsive behaviors that were statistically mediated by neuroticism, stress perception, and depressive symptoms. Specifically, emotional trauma had both direct and indirect effects on impulsive behaviors, whereas physical trauma mainly had a direct effect.</p>