Title: Associations between depressive symptoms, socio-economic factors, traumatic exposure
and recent intimate partner violence experiences among women in Zimbabwe: a cross-sectional
study
Version: 1 Date: 03 Dec 2021
Reviewer's report:
This paper carried out one study, using a wide community sample of Zimbabwe, to test
the relationships between socio-economic conditions and trauma exposures and depressive
symptom.  It has an interesting goal, population target, and cultural and socioeconomic context
where data are collected. However, I found the manuscript conceptually and methodologically
weak and unclear from the outset, and it does not became clear despite I read on many times. My
recommendations, therefore, focus on making the central logic more accessible and to improve
some methodological issues across the studies. Here are some substantive thoughts about the
manuscript.
Substantial issues
Theory
First, I think a high numbers of indicators are introduced regarding different trauma and
abuse experiences, and socio-economic background. In general, they are related to depressive
symptoms and this fact has been justified correctly. However, some variables such as “Alcohol
past year” are introduced in some analysis (e.g., structural equation model) but this variable was
not mentioned anytime in the introduction or method.
In addition, authors propose a SEM model with mediators, which are not justify as such in
the introduction. For example, food security or non-partner rape. I miss a stronger theoretical
support.
I recommend clarify the relationships between variables and the theoretical foundation of the
relationships. In this sense, authors should provide more specific objectives and hypotheses at
the end of the introduction. In this sense, readers can have clear which variables are proposed
such as predictors, mediators and dependent, as well as the way such variables will be related
each others.
Methodology
In general, I miss information in order to assess the generalization and reliability of the results.
For example:
- Cronbach alphas are not shown for some scales. For example, Childhood abuse experience.
- Aggregated scores (i.e., to sum to get only one general score about the construct) is
recommended when construct validity evidence support it. Did the unidimensionality of used
scale check?
-Which method was used to adapt original version of the question and scales to Zimbabwe
linguistic and cultural context?
- Which were the measurement scales for the items related to women’s experiences of emotional,
sexual, physical, economic and IPV and non-partner rape?
- Is “seeking support” a socioeconomic indicator? You should consider it another variable. It
should not be included in Socio-economic data.
- The fit of the SEM model is not clear for me. I would like to know which error authors correlated
and why (as they wrote in data analysis section). In addition, standard errors are not included in
the Table 3. Neither direct nor indirect effects in the SEM model are shown.
In the spirit of open science, transparency, reproducibility, I would strongly like to encourage
you to upload the datasets and materials to an online repository, such as the Open Science
Framework.
Other comments
Method
- In the section “Survey design and sampling”, authors could consider to introduce information
about data source. For example: which official organization organized the collection of data?
How did authors have access to the data? What was the technique to collect data (e.g., interview
face-to-face, CAPI)? Some information is in other sections but it could be better here.
- I recommend authors to introduce a new section: “study population” where, according to their
objectives, they would specify inclusion criteria to select final sample and the characteristics
of such final sample.
- Data analysis section is confusing for me. Authors mix the steps to perform the analysis with
other type of information. For example, making reference to inclusion criteria for participants,
referring to Tables, hypotheses (they did not mention before) etc.
- To clarify model specification.
-  Otherwise, why did authors use maximum likelihood estimation?
-  To explain what indices were used to test the fit of the model to data and cut points.
Results
Authors should show the sequence of results by sections that corresponds to each specific
objective.
These sentences are not totally clear for me: “Higher depressive symptom scores were positively
associated with having attained secondary or tertiary education, experiencing IPV in the past
year, history of childhood and other traumatic events, non-partner rape, HIV positive status self-
report and seeking emotional support” (line 245-248); “Women who had relative ease in finding
money in an emergency and those who sought either informal or professional emotional support
were less at risk of high depressive symptom scores” (line 251 – 252).
You should add in the text unstandardized coefficients, standard error and p-values as a result
o regression analysis.
Authors should start showing whether the SEM model has a good fit to data and then, they should
explain the relationships in detail. For example, how one variable influence on other variable
positive o negatively and what that really means.
Discussion
I recommend authors to discuss the results more deeply and following the specific objective
and/or hypotheses that I recommended to enunciate before.
Minor issues
Authors should explain acronyms from the first time they appear. For example, IPV, GBV,
PTSD and so on.
Line 97-100: This sentence does not make sense for me: “Yet, abused women are less likely
to have strong informal social support compared to non-abused women. This suggests that
other than mitigating the negative impacts of abuse, higher social support may be protective to
women’s IPV experiences (44, 47)”