Anxiety and Depression Among College Students in Taiwan: Testing the Betrayal Trauma Theory on Their Co-occurrence

Anxiety and depression among college students is a global mental health concern. Childhood trauma has been identified as an etiological factor that may contribute to their co-occurrence, but how the nature of childhood trauma could lead to different mental health outcomes remains unknown. This study aimed to examine the co-occurrence of probable anxiety and depression in a non-Western sample and whether childhood betrayal trauma (CBT) would be more associated with their co-occurrence. The sample consists of college students (N = 766) in a Taiwan survey project. Participants completed validated screening measures for childhood trauma, anxiety, and depression. Logistic regression analyses were then used to analyze the data. After controlling for demographic variables, the binary logistic regression model was statistically significant, χ² (6, N = 766) = 97.51, p <.001. Childhood non-betrayal trauma was first found to be associated with the co-occurrence of anxiety and depression, with each unit increase associated with 40.8% increase in its odds. Moreover, each unit increase in CBT was associated with 108.0% increase in the odds of co-occurring anxiety and depression. This study hence provides evidence that CBT was associated with a higher risk of developing anxiety and depression. More proactive screening for anxiety and depression is recommended in the field of mental healthcare and child protection, especially for those with childhood trauma. Further studies are needed to examine the causal relationship between CBT and psychiatric comorbidity.