title: Mediators of the relation between war experiences and suicidal ideation among former child soldiers in Northern Uganda: the WAYS study.
abstract: BACKGROUND
  Globally, suicide is a public health burden especially in the aftermath of war. Understanding the processes that define the path from previous war experiences (WE) to current suicidal ideation (SI) is crucial for defining opportunities for interventions. We assessed the extent to which different types of previous WE predict current SI and whether post-war hardships and depression mediate the relations between WE and SI among former child soldiers (FCS) in Northern Uganda.
  
  
  METHODS
  We performed cross-sectional analyses with a sample of 539 FCS (61% male) participating in an on-going longitudinal study. The influence of various types of previous WE on current SI and mediation by post-war hardships and depression were assessed by regression analyses.
  
  
  RESULTS
  The following types of war experiences: "witnessing violence", "direct personal harm", "deaths", "Involvement in hostilities", "sexual abuse" and "general war experiences" significantly predicted current SI in a univariable analyses whereas "direct personal harm", "involvement in hostilities", and "sexual abuse" independently predicted current SI in a multivariable analyses. General WE were linked to SI (β = 0.18 (95% CI 0.10 to 0.25)) through post-war hardships (accounting for 69% of the variance in their relationship) and through depression/anxiety (β = 0.17 (95% CI 0.12 to 0.22)) accounting for 65% of the variance in their relationship. The direct relationship between previous WE and current SI reduced but remained marginally significant (β = .08, CI: (.01, .17) for depression/anxiety but not for post-war hardships (β = .09, CI: (-.03, .20).
  
  
  CONCLUSIONS
  Types of WE should be examined when assessing risks for SI. Interventions to reduce SI should aim to alleviate post-war hardships and treat depression/anxiety.
authors.forename: Kennedy
authors.initials: K
authors.lastname: Amone-P'Olak
authors.forename: Tlholego Molemane
authors.initials: TM
authors.lastname: Lekhutlile
authors.forename: Richard
authors.initials: R
authors.lastname: Meiser-Stedman
authors.forename: Emilio
authors.initials: E
authors.lastname: Ovuga
mesh_terms: D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000523:psychology; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000523:psychology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008889:Military Personnel / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology; D014454:Uganda; D014754:Violence / Q000523:psychology; D014857:Warfare; D055815:Young Adult