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: 
18 Nov 2020
Reviewer: 
Jeremy Yorgason
Reviewer's report:
The manuscript entitled, "Marital adjustment mediated acculturation on depressive symptoms among
immigrant women: a cross-sectional study in Taiwan" presents a study of the lives of immigrant women in
Taiwan, and how acculturation stress may spill over to their mental health through marital adjustment.
This manuscript addresses an interesting and important question. The authors provide a compelling case
for why this research needs to be done, along with appropriate literature to support their study. Although
this study has many strengths, I also have some suggestions for improving the manuscript.
The marital adjustment measure in this paper addresses some element of relationships in the household
outside of the marriage. In certain cultures, relationships such as with in-laws who share the same
household, may be seen as part of the marriage relationship. In other cultures, this might be called family
relationship adjustment rather than marital adjustment. Perhaps the authors could speak to why they chose
to include a question about other family members in their measure of the marriage relationship.
I appreciate that the authors used a bootstrapping approach to calculate appropriate confidence intervals
for the c-c' coefficient. 
It isn't clear to me how divorced and widowed women were included in the analysis, as I'm not sure if
single women completed the marital adjustment scale. If they did, who were they referring to - their
former husband? If they didn't complete the marital adjustment measure perhaps they should not be
included in the analysis? They would likely be dropped from the analysis (list-wise deletion) if they don't
have a marital adjustment score.
The snowball approach is not my favorite as it is a convenience approach that leaves questions about to
whom the findings can be generalized. That said, the sample in the current study is unique, with nearly
1/3rd of the women having very low education levels. I'm not sure of a better way to collect the current
sample. I applaud the authors for their work in obtaining data from this group of women whose voices are
not often heard in our society.
In Table 1, under jobs of immigrant women, change "Businessman" to "Businesswoman".
Since the study is cross-sectional, we are relying on theory to guide the placement of marital adjustment as
a mediator rather than depression as the mediator. Maybe immigrants become depressed and this effects
their marriage. The authors do a good job explaining why marital adjustment should be the mediator, but
it would still be a good idea for the authors to give more details about this issue in the limitations section
of the manuscript.
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Is the study design appropriate to answer the research question (including the use of appropriate controls),
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