Reviewer: Hanna Denysenko

Completed: 8.09.2026

Recommendation: Resubmit for Review – Significant improvements are needed before the article meets publication standards.

	Yes	No	N/A
Is the research question clearly defined?	✓
Are the methods appropriate and sufficiently detailed?		✓
Is the data analysis robust and replicable?		✓
Are the conclusions supported by the results?		✓
Is the manuscript well organised and clearly written?	✓
Are tables, figures, and supplementary material informative and necessary?	✓
Is the abstract an accurate summary of the study?		✓
Does the manuscript contribute meaningfully to the field?	✓
Is it relevant to the field of mental health or related disciplines that are connected to the scope of the Journal?	✓
Are ethical approvals and participant consents adequately described?		✓
Have competing interests, funding, and data availability been transparently declared?	✓

Bottom of Form

Comments for the authors:

The study addresses an important and underexplored topic and provides potentially valuable data on a hard-to-reach migrant population. The field-based recruitment strategy and the inclusion of participants who may not necessarily be engaged with healthcare or social services represent notable strengths. Nevertheless, in its current form, the manuscript is not yet ready for publication and requires substantial revision.

One of the main methodological limitations concerns the sampling strategy. The use of convenience and time-location sampling substantially limits the generalisability of the findings to the broader population of sub-Saharan African migrants. In addition, only 97 participants were included in the final analysis despite nearly 300 individuals being approached, raising a separate concern regarding potential non-response and self-selection bias. The magnitude of this bias cannot be determined from the information provided. The findings should therefore be interpreted as pertaining primarily to the specific sample recruited in Greater Tunis rather than to the wider migrant population.

A more fundamental methodological concern relates to the validity of the measurement instruments. The six-item composite scales were developed specifically for this study and have not undergone formal psychometric or cross-cultural validation. Although internal consistency coefficients are reported and provide useful information regarding reliability, internal consistency alone does not establish that these newly developed scales validly measure the intended psychological constructs. Particular attention should be given to the equivalence of the different language versions and to the discriminant validity of the measures. For example, the strong association between social isolation and acculturative stress may partly reflect conceptual overlap between these newly developed measures rather than solely a substantive relationship between two distinct psychological constructs.

The statistical findings also require more cautious interpretation and more transparent reporting. Multiple comparisons were conducted without adjustment for multiplicity; consequently, individual findings, particularly those with p-values close to .05, should be clearly treated as exploratory. Effect sizes and 95% confidence intervals should be reported more consistently for the principal analyses. Furthermore, the adequacy of the sample size should not be justified post hoc on the basis that some statistically significant associations were detected.

The cluster analysis warrants particular reconsideration. The three-cluster solution yielded a low silhouette coefficient (approximately 0.18), indicating weak cluster separation and providing limited support for interpreting the clusters as clearly distinct psychological or clinical profiles. Moreover, ANOVA comparisons conducted on the same variables used to derive the clusters do not constitute independent validation of the cluster solution. These findings should therefore be presented as preliminary and exploratory rather than as evidence of established psychological profiles.

The overall conclusions also extend beyond what can be supported by the cross-sectional design. A theoretical scale midpoint is a mathematical property of the response scale rather than a validated clinical or normative threshold; scores above this midpoint should therefore not be interpreted as evidence of clinically significant distress. Similarly, cross-sectional associations cannot establish causal mechanisms. In particular, the absence of an association between length of residence and symptom scores does not demonstrate persistence of distress over time, while the observed association between social isolation and acculturative stress does not establish that one operates through the other. Claims regarding the structural origins of distress and the need for differentiated psychological interventions should likewise be framed as hypotheses or potential implications rather than as conclusions directly demonstrated by the data.

Finally, the absence of prospective review by a formal institutional ethics committee, or of documented exemption from such review, requires further clarification, particularly given the inclusion of a potentially vulnerable population. The authors should provide a fuller account of the ethical oversight available in the relevant institutional context, and this issue should be considered by the editors in accordance with the journal's ethical policies.

Overall, the study has scientific value as an exploratory and descriptive investigation, but the current methodological limitations do not support some of the stronger clinical, causal, and longitudinal interpretations presented in the manuscript. I therefore recommend Resabmit for Review. The manuscript could become suitable for publication if the study is more explicitly framed as exploratory, the psychometric and sampling limitations are fully acknowledged, the statistical reporting is strengthened, the cluster findings are treated as provisional, and the causal, clinical, and longitudinal claims are substantially moderated.