Trauma Type and Gender Differences in Adolescent PTSD: Insights for Community Mental Health in Rural Taiwan

Background Adolescent trauma and posttraumatic stress disorder (PTSD) are growing global public-health concerns, yet evidence from non-Western, community-based settings remains limited. Gender and trauma type both influence PTSD risk, but their interaction within culturally diverse populations has been underexplored. This study investigated how trauma type and gender jointly shape PTSD likelihood among adolescents in rural eastern Taiwan—a region characterized by limited mental-health resources and strong Indigenous and Confucian cultural influences. Methods A cross-sectional survey was conducted in 2012 among 751 junior-high students aged 12–15 years, selected through stratified cluster sampling from eight schools in Hualien County. The Chinese version of the UCLA PTSD Reaction Index assessed trauma exposure and symptom severity. Descriptive statistics, χ² tests, t tests, and gender-stratified logistic regressions were used to identify predictors of trauma exposure and probable PTSD (score ≥ 38). Ethical approval was obtained from the Research Ethics Committee of Hualien Tzu Chi Hospital (IRB No. 100 − 61). Results Among the 751 adolescents surveyed, 60% reported at least one traumatic experience. The most common events were accidents, witnessing family assault, and witnessing community violence. Girls experienced more trauma events and reported higher PTSD symptom scores than boys, although overall PTSD prevalence did not differ by gender. For boys, being cared for by non-parent caregivers was linked to higher trauma exposure, and PTSD was most strongly associated with witnessing violence and the death or injury of significant others. For girls, PTSD was primarily associated with sexual trauma and painful medical treatment. These findings indicate that trauma exposure was pervasive but shaped by distinct gendered and relational pathways. Conclusions Adolescent PTSD in rural Taiwan reflects the intersection of gender, trauma type, and sociocultural context. Findings underscore the need for trauma-informed, gender-responsive, and culturally safe mental-health strategies integrated within schools and community health systems. Embedding early detection, family engagement, and inter-sectoral collaboration can strengthen equitable, community-based mental-health care in line with global health-promotion frameworks.