Review: Neglecting Connection: Associations Between Parental Emotional Support and Youth Mental Health in Four Latin American Countries {under peer review}

 

Reviewer: Sumbal Gilani

Completed: 09-09-2026 07:39

 

Recommendation: Revisions Required

 

 

	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?	+

 

Comments for the authors:

 

Thank you for sharing such excellent body of work with the scholarly community. This manuscript very timely, represents an important association on which many prevention activities hinge in the humanitarian community. The topic is relevant, the ethical conduct is well-documented, and the disaggregation of findings by parent and by country is a meaningful contribution to a literature that has historically underexamined paternal roles.

This is a paper with real empirical value and a genuinely useful dataset behind it, let down by insufficient statistical rigor in places and some avoidable inconsistencies that suggest the manuscript wasn’t given a careful internal review need. My recommendation would be major revisions, not because the contribution is weak, but because the model specification, multiple-testing exposure, and internal inconsistencies are weakening the results.

 

Overall Assessment:

This is a paper with genuine empirical value, built on dataset that is difficult to assemble and rarely analyzed at this scale in the Latin American context. The discussion section demonstrates good scholarly judgment, situating country-specific findings within Family Systems Theory and familism literature without flattening them into an oversimplified cross-country narrative. That said, the manuscript reads as though it did not receive a sufficiently rigorous internal read before submission: a sample-size figure contradicts itself between the Methods and Table 1, a stated location for the Haiti data (supplementary material) does not match where it actually appears (the main text), and the statistical approach to the paper’s central outcome measure is applied without justification or diagnostic support. None of these are fatal to the paper’s contribution, but together they suggest the manuscript is not yet at the standard of precision the underlying dataset and research question deserve.

 

Abstract

Structurally sound and appropriately non-overclaiming relative to the body of the paper but reads as an enumeration of country-specific results rather than a synthesis. It should give the reader an organized insight to carry forward (e.g., communication difficulty is the most consistent cross-country risk marker; parent-specific effects vary by country) rather and compressed results table. For paper this data-dense, the abstract should do more interpretive work, not enumerate findings. Furthermore, the exposure and outcome measures should be names precisely (the abstract says, ‘several dimensions of parental support’, say what they are: relationship status, closeness, communication difficulty).

 

Methodology

This section carries the paper’s most substantive weaknesses:

•    Sample-size discrepancy: Columbia and El Salvador are both listed as n=2.433 in-text, but Table 1 reports Colombia at n=2,705 (consistent with the stated total N). Must be corrected.

•    Unjustified model choice: Psychological distress (a bounded 6-30 Likert-sum score) is modelled via Poisson regression with IRR reporting, a specification conventionally used for count/event data, without justification or fit diagnostics. Needs either justification or re-specification (linear or negative binomial).

•    No multiple-comparison correction: Dozens of models run across four countries, four outcomes, and multiple exposures, several with confidence intervals narrowly excluding 1.0. this should be corrected for (e.g., FDR) or explicitly flagged as a limitation with appropriate caution in interpretation.

•    The wealth-index PCA cofounder is named but not detailed (no loading/variable list), which falls below expected reporting standards for a variable used in every adjusted model.

 

Results

Reported with commendable restraint, description stays close to the models without editorializing. Presentation is dense to the point of impeding readability (eight tables, many rows); a summary forest plot as the primary figure, with full tables moved to supplementary material, would substantially improve communication cross-country patterns. The Haiti reporting inconsistency sits here as well: the Methods state Haiti’s data are in supplementary material, but Table 8 (Haiti) appears in the main text with no supplementary file referenced anywhere. This needs correction, and the more limited exposure/confounder set for Haiti warrants explicit discussion of how it affects comparability within the four-country framing.

 

Discussion

The strongest section of the manuscript. Country-specific interpretation (e.g., paternal closeness in Honduras, maternal relationship in Colombia) is handled with appropriate nuance and grounded in relevant theory and comparative literature. The main correction needed in register: occasional causal-sounding phrasing (“strengthening parental communication... may help reduce...”) should be tightened to consistently associational language, in keeping with the cross-sectional design already acknowledges in the limitations.

 

Conclusion

Adequate but largely restates the Discussion rather than offering a forward-looking closing argument. Given the paper’s implications for family-based intervention design, the conclusion should commit to something more specific than a general call for future research, e.g., what the mother-in-Colombia/father-in-Honduras asymmetry implies for how such interventions should be designed or targeted. For someone like myself, working in the humanitarian sector and designing parenting programs, this evidential recommendation would be very significant.

 

Reporting Standards: STROBE Compliance

This is a cross-sectional observational study, and as such should be evaluated against the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist. The manuscript does not reference STROBE compliance anywhere, and I recommend the authors complete and submit a STROBE checklist alongside their revision.

Assessed informally against STROBE, the manuscript performs well on reporting of study design, settings, participants, ethical approvals, and disclosures (funding, competing interests, data availability), all of which are clearly and appropriately documented. However, several STROBE items inadequately addressed; item 9 (Bias), item 10 (study size), item 12 (statistical methods), and item 21 (generalizability).