Reviewer's report
Title:A cross-sectional analysis about women's mental health problems.
Exploring the associations with different types of violence in a sample of Brazilian
mothers
Version: 1Date:15 November 2012
Reviewer: Jean Martial MARI
Reviewer's report:
Recommendation: Major Revision.
General comments : the authors are presenting a study which aims at studying
the relationship between violence and mental health problems in women from the
perspective of the ecological model proposed by the World Health Organization
in a Brazilian population sample.
The paper is well written, and of great interest for the study of the consequence
of violence to women, and as such for the society. However some point must be
clarified before publication, and possibly rewritten, which is why I recommend
Major Revision.
Major Compulsory Revisions:
In particular are missing the conclusions and analysis related to the choice of the
World Health Organization model and its ability to reflect the consequences of
the violence experienced by women in their life. Citing other studies is interesting
and supports the study, but considerations must be made on the model itself,
and proposal of a better approach would improve the future studies.
Please number lines in abstract.
Minor Essential/Discretionary Revisions:
- Abstract: the conclusion of the abstract is a recommendation. The paper should
conclude on the hypotheses of the paper first, derive the sociologic conclusion,
and then make recommendations.
- P3: “Also, despite the little....” the point of the sentence is not clear to the
reviewer; such levels of violence would probably affect everyone. Does the
authors mean to say that such levels of violence increase the risk for women and
has impact on the society ?
- P3: “de sexual”: is that a typo (maybe not !) ?
- P3 “the gaps address”: it may be appropriate, but it wounds weird to the
reviewer to say that something missing can address something. Does the
authors mean, for example, “the gaps include…”
- P4” with lower per capita income” does the authors mean something like “with
world’s lower per capita income”
- P4: are there any statistics of local violence to further support the choice of the
population studied ? please include if possible.
- P5: to the reviewer, sentence “were interviewed individually by trained
researchers” should read “were interviewed individually by the trained
researchers”.
- P5: “C/D/_E” typo ?
- P5/6: to the reviewer, sentence “b) she was beating by her parents when she
did something wrong; c) she was harshly beating by her parents;” would read
better “b) if she was beaten by her parents when she did something wrong; c) if
she was harshly beaten by her parents;”
- P6 “threatening or using a gun or knife” should maybe read: “threatening or
using a weapon such as a gun or knife”
- P7” and in others carried out in the country and abroad.” Does the authors can
quote a few refs to support their statement ? If the papers were already cited,
reviewer believes it’s ok to cite them again.
- P7 “P-values <0.05 indicated significant differences in the statistical tests
applied”. Does the authors means that the p-values obtained were lower than
0.05 and that they consider they test significant (which is then to the reviewer a
Result) or does they mean that the threshold used for significance was 0.05. And
BTW what was the p-value obtained ?
- P7 “Statistical Package for Social Sciences - SPSS version 16.0” please
mention between parenthesis the editing company , town and country.
- P12: Discussion begins with conclusion, which sounds inappropriate. At least
the authors should exchange sentence 1 and 2, and begin now second sentence
by “As such the study contributes to …”
- P12: “Second, the sense of non-productivity, dissatisfaction, and financial
dependence of housewives can impact their mental health.” Can the authors
support the statement by a number? Otherwise such statement truly appears as
obvious, without requiring a full study to reach it.
- P12 “Third, as staying at home, their universe of emotional support and
information is reduced, leading to less protection from mental problems.” Same
comment.
- P13 “Although the violence experienced in childhood is significant to mental
health problems only in the bivariate analysis, the finding that this victimization,
still remembered in adulthood, is quite serious, which can impair women's health
in later years, affecting the way they feel and relate to others.” Sentence
structure appears to be broken. Please rephrase.
- P13 “It also refers to the lack of support from health and social services and to
the invisibility of violence and its consequences to health [29]” it is not clear to the
reviewer if the statement is derived from the present study, and then should read
“ as observed by [29]” or if [29] is the author of the statement. Please rephrase to
avoid misunderstanding.
- P13 : “In Brazil and other countries, although there are significant progress,
including in the legislative scope, many health professionals still appear to be
little insensitive to provide assistance in violence matters, which contributes to
the perpetuation of the problem and the severity of its effects.” The authors
should be careful to statements such as “appear”, because it raises the question
“to whom”. Either the authors report that the trained researcher all commented
(how many ?) poor sensitivity to violence matters, or such conclusion has been
reached by another study (ref?).
- P13: “Moreover, although violence in the community has not shown to be
related to women´s mental health problems, structurally disorganized
communities stimulate offending and delinquent behavior, which steps in the
private space and in closer relationships [33].” The authors should analyse the
ability of the ecological model to reflect the consequences of violence to women.
Showing that the relationship exists based on other studies is not sufficient. The
present study is partly successful, but such conclusion shows that it is hard to
make a test which reflects it. Paper should conclude/recommend also on this to
allow future studies to improve understanding of the problem.
- P14 “but slightly higher than in other countries, around 30%” the reviewer fail to
understand if it was of 30 % or higher by 30 %.
- P15: “It is suggested that the women” the authors should not make their
conclusion weak. “The present study shows…” sounds better. If precautions
must be taken or models improved, it should simply be added. The authors
should also put the conclusion in comparison with the other model. Please
conclude of the interest of choosing the ecological model, what it brought and
what it eluded. Perform recommendations in terms of study/model and then in
terms of society improvement.
Level of interest: An article of outstanding merit and interest in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests