Reviewer’s report
Title: 
Cumulative Risk Exposure and Emotional Symptoms among Early
Adolescent Girls
Version: 
1 
Date: 
16 Jul 2021
Reviewer's report:
Thank you for your thoughtful responses. 
The clarifications in the introduction, methods and discussion serve to better
place the authors' findings within the broader literature, and the simulations as
well as the bivariate exploration of neighborhood deprivation were both
informative additions. 
A few minor revisions are still indicated:
1) While the authors did make clarifications in the Participant section in
response to Reviewer 1, the number of refusals should be reported on page 9,
along with a description of whether the refusal rates varied significantly by
race/ethnicity. If any race/ethnicity differences in refusal rates occurred, this
should be addressed as a limitation.
2) On page 4, line 78 a specific cite is needed for the "sample of adolescent
girls" that provide the information related to which factors were selected for their
association with symptoms. 
3) The authors separated out gender from sex (see change made to page 6, lines
130-131), did they mean to change gender to sex? 
If they mean both gender and
sex, is gender self-identified in the referenced study (cite 25). 
Later, the authors
use "sex/gender" for a different cite (10) on page 7, line 165. This terminology
should be used consistently and with an initial explanation.
4) While ACEs are useful for context, the 'Child in Need' measurement should
not be referred to as ACEs but rather a measure of adversity. 
The CIN and ACEs
are not synonymous, at least in terms of measurement (as noted in the
discussion).
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