Reviewer’s report
Title: 
A pathway to negative acculturation: Marital maladjustment mediates the relationship between the
length of residency and depressive symptoms in immigrant women in Taiwan
Version: 
0 
Date: 
20 Oct 2020
Reviewer's report:
The study examines immigrant women in Taiwan to determine the mediational effect that marital
adjustment has on the correlation between acculturation stress and depressive symptoms. The topic is
interesting, but I am struggling to understand the logic of the paper. 
The manuscript text is a bit difficult to follow at some points. When reading the title I was already
wondering how to interpret "marital adjustment mediated acculturation on depressive symptoms". 
In the abstract, the word "acculturation" does not appear in the results nor in the conclusions. The only
result reported in the abstract is that "the length of residency alleviated depressive symptoms (
β
 = -0.62, p
= 0.03) and marital adjustments have a mediational effect on the relationship between years in Taiwan and
depressive symptoms." From this I would conclude that with a longer length of residency (better
acculturation?) depressive symptoms decrease, and I would also expect marital adjustment to increase.
However, the authors conclude that "Marital adjustment deteriorates with the length of residency, thereby
causing the occurrence of depressive symptoms." In other words, depressive symptoms increase when
length of residence increases. Does this not contradict the reported result?
In the background section, on page 6, the authors write: "Mona et al. [18] found that longer residence in
the U.S. was associated with grater acculturation to U.S. society, but with reduced family satisfaction, a
measure highly correlated with marital adjustment. This finding implied that good acculturation may be
helpful for developing marital adjustment, which further decreases the risk of occurrence of depressive
symptoms, and vice versa." Mona et al. [18] indeed find that length of residence is positively associated
with acculturation but negatively associated with both family life satisfaction and marital satisfaction.
However, I do not understand how this implies that good acculturation is helpful for marital adjustment.
Perhaps the authors could elaborate this issue further.
Because I did not understand how the authors used Mona et al. [18] for justifying their research question,
it was difficult to evaluate the contribution of this paper to previous research. This does not mean that
there is none, but either the current justification needs to be elaborated further, or the research question
has to be framed differently. 
Table 2 presents correlations between variables and Figure 1 some regression coefficients. If I understand
correctly, the authors have first fitted a model that has acculturation (years in Taiwan) as the independent
variable, and depressive symptoms as the dependent variable. The second model then includes marital
adjustment as a covariate, and the Sobel test is used to test whether the regression coefficient of
acculturation changes between these two models. The detailed results of these regression models could be
presented instead of correlations. It is particularly difficult to understand that in Table 2 the correlation
between acculturation and depressive symptoms is positive, suggesting that longer time in Taiwan
increases depressive symptoms, but in Figure 1 the regression coefficient (model c, total effect) for
acculturation is negative, suggesting the opposite. If this is correct, it must result from the adjustment for
control variables. This needs to be discussed if correlations are presented first.
When marital adjustment is included as a control variable in the regression model, the previously negative
coefficient of acculturation turns slightly positive and is no longer statistically significant. However, if
marital adjustment mediated the previously observed negative total effect of acculturation on depression
(more years in Taiwan make people less depressed), then I would expect acculturation to be positively
associated with marital adjustment (more years in Taiwan make people more satisfied), and marital
adjustment to be negatively associated with depressive symptoms (satisfied people are less depressed).
However, in Figure 1 both associations are negative, meaning that more years in Taiwan make people less
satisfied, which makes them more depressed. Thus in the second model both the indirect effect
(acculturation -> marital adjustment -> depression) and the direct effect (acculturation -> depression) are
positive (or non-existing), whereas the total effect was negative. This simply cannot be true. 
Is it possible that c and c' were accidentally mixed up? It would make more sense that a slightly positive
total effect would decompose into a positive indirect effect and a negative direct effect, although I would
not interpret this as mediation but rather as two competing mechanisms. Perhaps consulting an expert of
mediation analysis would be of value.
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Is the study design appropriate to answer the research question (including the use of appropriate controls),
and are the conclusions supported by the evidence presented?
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