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Objectives: This study investigates traumatic experiences in a sample of high-risk Taiwanese adolescents in rural areas of Taiwan; correlation with psychosocial factors is assessed with focus on social support and caregiver alcohol use. Materials and Methods: This was a cross-sectional study using stratified cluster sampling. Structured questionnaires were used to collect demographic characteristics, social support (Taiwan Relationship Inventory for Children and Adolescents), and posttraumatic stress disorder (PTSD) symptoms (Chinese version of UCLA-PTSD Reaction Index) from a sample of 751 adolescents (54.6% females) with 61.2% response rate in high schools in Hualien County, Taiwan. Results: Girls with trauma experiences manifested significantly higher PTSD scores, concurrent with higher number of traumatic events (TE), while the likelihood of reporting trauma and subsequent PTSD symptoms was similar in both genders. Increased risk of reported trauma and PTSD in adolescent Taiwanese is strongly associated with caregiver alcohol use and lack of social support, particularly in girls. Conclusion: We found that girls reported higher numbers of TE which was concurrent with significantly higher PTSD scores. Early detection of alcohol use disorders among caregivers as well as assessment of quality of family interaction would benefit at risk adolescents through specifically tailored interventions to address these factors.