Examining the impact of maternal experiences of domestic violence on the mental health of their adolescent children in India

Amritha Gourisankar; Preethi Ravi; Ameeta Kalokhe; Rachel Waford Hall; Nilakshi Vaidya; Eesha Sharma; Bharath Holla; Debasish Basu; Rose Dawn Bharath; Amit Chakrabarti; Sylvane Desrivieres; Matthew Hickman; Kamakshi Kartik; Krishnaveni Ghattu; Kumaran Kalyanaraman; Murali Krishna; Rebecca Kuriyan; Pratima Murthy; Dimitri Papadopoulos Orfanos; Meera Purushottam; Sunita Simon Kurpad; Rajkumar Lenin Singh; Roshan Lourembam Singh; Bhagyalakshmi Nanjayya Subodh; Mireille B. Toledano; Vivek Benegal; Gunter Schumann; Kartik Kalyanram; the cVEDA Consortium

doi:10.1371/journal.pone.0304936

Peer Review History

Original SubmissionMay 31, 2024
31 May 2024 Author Response https://doi.org/10.1371/journal.pone.0304936.r001
16 Oct 2024 Decision Letter - Hariom Kumar Solanki, Editor PONE-D-24-20231Examining the impact of maternal experiences of domestic violence on adolescent mental health disorders in IndiaPLOS ONE Dear Dr. Gourisankar, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please submit your revised manuscript by Nov 30 2024 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org . When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols . Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols . We look forward to receiving your revised manuscript. Kind regards, Hariom Kumar Solanki, M.D. Academic Editor PLOS ONE Journal Requirements: When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. Thank you for uploading your study's underlying data set. Unfortunately, the repository you have noted in your Data Availability statement does not qualify as an acceptable data repository according to PLOS's standards. At this time, please upload the minimal data set necessary to replicate your study's findings to a stable, public repository (such as figshare or Dryad) and provide us with the relevant URLs, DOIs, or accession numbers that may be used to access these data. For a list of recommended repositories and additional information on PLOS standards for data deposition, please see https://journals.plos.org/plosone/s/recommended-repositories . 3. One of the noted authors is a group or consortium “cVEDA Consortium”. In addition to naming the author group, please list the individual authors and affiliations within this group in the acknowledgments section of your manuscript. Please also indicate clearly a lead author for this group along with a contact email address. 4. Please include your full ethics statement in the ‘Methods’ section of your manuscript file. In your statement, please include the full name of the IRB or ethics committee who approved or waived your study, as well as whether or not you obtained informed written or verbal consent. If consent was waived for your study, please include this information in your statement as well. Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes Reviewer #4: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: I Don't Know Reviewer #3: I Don't Know Reviewer #4: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes Reviewer #4: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: No Reviewer #3: Yes Reviewer #4: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: This article is very well written and on a very important topic. Every section of the article is detailed beautifully. However, one suggestion from my side would be, with respect to the way forward would be, that if you could add something that the beneficiary side could implement in their lives to mitigate this problem. You have already explained clearly what the policy makers must do. But some initiatives need to be taken at the beneficiary level as well, in spite of the fact that they are the victims in their entirety. If those could be detailed, I would be really grateful. Reviewer #2: Dear author, DV is an important public health concern, but I hope there is room for improvement in your write up. Here are a few suggestions. kindly define the roles of so many authors for secondary data analysis. Title: title does not clearly state that you are examining the mental health of children of mothers. From the title it looks like it could be adolescent mothers themselves as child marriage is a possibility in south Asian sub-continent. kindly clearly write mothers and "their" adolescent children or any appropriate term to clarify. background: you talk about gap in knowledge, but you did not state what gap. kindly provide details of the gap in knowledge regarding association of DV on mothers and mental health issues in relevant children. Relevant literature about local studies should be mentioned. If no Indian studies available then this should be stated and studies from other any countries in the region with similar culture should be mentioned. Exclusion criteria: exclusion is done among the included sample. Not consenting is not an exclusion as they were never included. methods: sampling technique for your secondary analysis is missing. You have mentioned about the sampling technique of original data collection was convenience, but what is the sampling you employed? Did you include all children in cVEDA study aged 12-17 years or randomly selected some of them. Please clarify. in data collection section it is not clear if the data was collected by the researchers in past or you are referring to some information by the surveyors. Kindly explain clearly how data was collected and how you accessed it. What was the purpose of data collection and if there is any duplicity of findings. Sample size calculation is missing results: table 1 about descriptives is not clear. It is a bit haphazard. It needs to be restructured. You are talking about the details of children or their mothers? kindly clearly state descriptive statistics of children. “Past-year physical and sexual abuse, but not psychological abuse nor any DV, were significantly associated with anxiety disorders in the paired children (see Table 3). associations were found between adolescent depressive disorders and past-year physical, psychological, sexual abuse, and any maternal DV experience, and between adolescent common mental disorders and past-year maternal physical and sexual abuse and any DV.” Kindly, rephrase to more legible language. Each association should be clearly and specifically written in a scientific language. Table 3 needs to be better formatted properly. Discussion: should be further strengthened through relevant literature. details about informed consent should be further explained. Reviewer #3: Dear Author, it is a great effort writing this manuscript. To make it more appealing, I would suggest to reduce the number of tables and re-design table1 specifically. table is very long and row-wise there is not much information. Reviewer #4: Comments: 1. Section: Methods; Sub-section: Instrument- please operationalize adverse child events 2. Section: Result: Any data from nuclear family? 3. Section: limitation: is there any recall bias when respondents were asked to response against the variable in violence scale (e.g. not in past year but previously in my married life) ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean? ). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy . Reviewer #1: Yes: Dr Yash Alok Reviewer #2: No Reviewer #3: No Reviewer #4: No ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/ . PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org . Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0304936.r002
Revision 1
28 Nov 2024 Author Response Dear reviewers and PLOS One editorial team, We are grateful for your comments and for this opportunity to improve upon our submission. We have included how we have addressed each comment related to the journal’s requirements and reviewers’ comments below. When addressing reviewers’ comments, we have included the original comment and included our responses as bulleted points under each. Journal Requirements: Regarding PLOS One’s style requirements: the file naming was edited to be in lower case. Sentence style and the affiliation list was reviewed to ensure consistency with PLOS rules. Regarding our study’s underlying data set: the cVEDA dataset is maintained on a secure website, available on request, per the protocol outlined on the cVEDA project website: https://cveda-project.org/access-to-the-c-veda-dataset/. The cVEDA study was run by a third party, requiring approvals for us to access the data needed for our study. Regarding the “cVEDA Consortium” author group: A corresponding author and email address was added. The location of the consortium group full list was added to the affiliations page. The consortium group full list was named in the Acknowledgments section, along with their affiliations. Regarding the full ethics statement: The full ethics declaration from the published study protocol has been included in the Methods section, including the name of the original study ethics committee, IRB committee for the secondary data analysis, and consent process. Regarding our reference list: we have added 3 references (48, 49, 50 on the reference list) as we bolstered our discussion. We have otherwise reviewed our reference list to ensure that it is complete and correct. Reviewers’ comments: In response to Reviewer #2 answering “No” to the question “Is the manuscript presented in an intelligible fashion and written in standard English?”, we have reviewed the manuscript for typographical and grammatical errors. Reviewer #1: This article is very well written and on a very important topic. Every section of the article is detailed beautifully. However, one suggestion from my side would be, with respect to the way forward would be, that if you could add something that the beneficiary side could implement in their lives to mitigate this problem. You have already explained clearly what the policy makers must do. But some initiatives need to be taken at the beneficiary level as well, in spite of the fact that they are the victims in their entirety. If those could be detailed, I would be really grateful. We appreciate Reviewer #1’s feedback, but are uncertain what is meant by “beneficiary.” We have included information in the Conclusion regarding how findings from this study may be useful in designing interventions for domestic violence in community-based settings including schools and hospitals, which will require a conducive policy environment. Our results will not likely contribute directly to behavior change related to domestic violence (DV), but can be referenced in future efforts targeted at primary prevention. Reviewer #2: kindly define the roles of so many authors for secondary data analysis. We have specifically identified which authors were involved in secondary data analysis (AG, PR). Title: title does not clearly state that you are examining the mental health of children of mothers. From the title it looks like it could be adolescent mothers themselves as child marriage is a possibility in south Asian sub-continent. kindly clearly write mothers and "their" adolescent children or any appropriate term to clarify. We have changed the title of the manuscript to Examining the impact of maternal experiences of domestic violence on the mental health of their adolescent children in India to ensure readers understand that the children involved in the study corresponded to the mothers whose experiences of DV were assessed. background: you talk about gap in knowledge, but you did not state what gap. kindly provide details of the gap in knowledge regarding association of DV on mothers and mental health issues in relevant children. Relevant literature about local studies should be mentioned. If no Indian studies available then this should be stated and studies from other any countries in the region with similar culture should be mentioned. We specify that the existing gaps in knowledge are related to the impact of maternal experiences of DV on mental health outcomes among their adolescent children, including common mental disorders, externalizing disorders, and suicidality, in the Indian context. We have referenced studies done in India, in addition to studies done in other parts of the world (e.g., Bangladesh, Tanzania, United States) that are related to our research question. We have changed the language in the first paragraph of the introduction to clarify the gap we are seeking to address, in addition to what relevant literature exists. Exclusion criteria: exclusion is done among the included sample. Not consenting is not an exclusion as they were never included. We have removed “refusal of consent” as part of the exclusion criteria. Individuals who did not provide consent were not included in the sample, and therefore, could not be subsequently excluded as Reviewer #2 mentions. methods: sampling technique for your secondary analysis is missing. You have mentioned about the sampling technique of original data collection was convenience, but what is the sampling you employed? Did you include all children in cVEDA study aged 12-17 years or randomly selected some of them. Please clarify. In response to this comment, we have clarified that all children aged 12-17 in the original cVEDA study were included in our sample for secondary data analysis. in data collection section it is not clear if the data was collected by the researchers in past or you are referring to some information by the surveyors. Kindly explain clearly how data was collected and how you accessed it. What was the purpose of data collection and if there is any duplicity of findings. We have clarified that survey data was collected as part of the original cVEDA study and subsequently used for secondary analysis in our study, after we gained the appropriate approvals from the Executive Committee of the original study. Sample size calculation is missing We described our sample size in the Results section (2,784 mother-child pairs), in addition to including it in Table 1. For the purposes of clarity, we have also added this information to the Methods section, based on comments from Reviewer #2. results: table 1 about descriptives is not clear. It is a bit haphazard. It needs to be restructured. You are talking about the details of children or their mothers? kindly clearly state descriptive statistics of children. We are unable to consolidate Table 1 further in order to include all the necessary demographic information; however, we have specified in the caption that the participants are the adolescent children participants. “Past-year physical and sexual abuse, but not psychological abuse nor any DV, were significantly associated with anxiety disorders in the paired children (see Table 3). associations were found between adolescent depressive disorders and past-year physical, psychological, sexual abuse, and any maternal DV experience, and between adolescent common mental disorders and past-year maternal physical and sexual abuse and any DV.” Kindly, rephrase to more legible language. Each association should be clearly and specifically written in a scientific language. We have changed the wording of the sentence above summarizing the results included in Table 3 to be more clear and consistent. Table 3 needs to be better formatted properly. Table 3 has been reformatted to be more aesthetically consistent and neat. Discussion: should be further strengthened through relevant literature. The discussion has been bolstered with inclusion of additional key literature findings that contextualize our results and discussion (including references 48, 49, and 50). details about informed consent should be further explained. Additional details regarding the informed consent process (including obtaining informed consent from parents/guardians and assent from children) have been included in the Ethics Declaration section. Reviewer #3: Dear Author, it is a great effort writing this manuscript. To make it more appealing, I would suggest to reduce the number of tables and re-design table1 specifically. table is very long and row-wise there is not much information. We appreciate Reviewer #3’s comment regarding Table 1, however, we are unable to consolidate Table 1 further in order to include all the necessary demographic information. We have specified in the caption that the participants are the adolescent children. Reviewer #4: 1. Section: Methods; Sub-section: Instrument- please operationalize adverse child events With regards to “operationalizing adverse child events,” we have described adverse childhood events (ACEs) in the context of the Adverse Childhood Experiences — International Questionnaire (ACE-IQ) tool, which was used to measure the types and experiences of abuse experienced by children in their households and/or communities. We also included examples of specific ACEs encompassed by this scale. 2. Section: Result: Any data from nuclear family? In terms of data from the “nuclear family,” we specify that the dataset included in this analysis includes information from mother-child pairs only. Data was not collected from other members of the family; this also falls outside of the scope of examining the impact of maternal experiences of DV on the mental health outcomes of their corresponding adolescent children. 3. Section: limitation: is there any recall bias when respondents were asked to response against the variable in violence scale (e.g. not in past year but previously in my married life) We appreciate Reviewer #4’s comments about potential recall bias when asking about mothers’ past experiences of abuse. We have addressed this in the Limitations section. Additional revisions: While reviewing the manuscript, we have also clarified why and how control-related variables were not included in our analysis. Despite being an important component of the Indian Family Violence and Control Scale, control-related variables were difficult for us to operationalize in this context (i.e., we are unable to assess how children perceive control-related behaviors in the household in a standardized fashion), which we address in the discussion. Thank you so much for your time and careful consideration in reviewing our work. We appreciate your insight which has enabled us to improve this manuscript, and your affirmations regarding the importance of this work. Regards, Amritha Gourisankar, Preethi Ravi, et al. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0304936.r003
5 Mar 2025 Decision Letter - Hariom Kumar Solanki, Editor Examining the impact of maternal experiences of domestic violence on the mental health of their adolescent children in India PONE-D-24-20231R1 Dear Dr. Gourisankar, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at Editorial Manager® and clicking the ‘Update My Information' link at the top of the page. If you have any questions relating to publication charges, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Hariom Kumar Solanki, M.D. Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #4: All comments have been addressed Reviewer #5: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #4: Yes Reviewer #5: Partly ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #4: N/A Reviewer #5: No ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #4: Yes Reviewer #5: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #4: Yes Reviewer #5: No ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #4: The authors addressed all the issues raised in previous revision. They also put their clarifications against other comments made by other reviewers. Reviewer #5: (No Response) ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean? ). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy . Reviewer #4: No Reviewer #5: Yes: Mohammad Ashraful Amin ******** https://doi.org/10.1371/journal.pone.0304936.r004
Formally Accepted
Acceptance Letter - Hariom Kumar Solanki, Editor PONE-D-24-20231R1 PLOS ONE Dear Dr. Gourisankar, I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now being handed over to our production team. At this stage, our production department will prepare your paper for publication. This includes ensuring the following: * All references, tables, and figures are properly cited * All relevant supporting information is included in the manuscript submission, * There are no issues that prevent the paper from being properly typeset You will receive further instructions from the production team, including instructions on how to review your proof when it is ready. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few days to review your paper and let you know the next and final steps. Lastly, if your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. If we can help with anything else, please email us at customercare@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Hariom Kumar Solanki Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0304936.r005

Open letter on the publication of peer review reports

PLOS recognizes the benefits of transparency in the peer review process. Therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. Reviewers remain anonymous, unless they choose to reveal their names.

We encourage other journals to join us in this initiative. We hope that our action inspires the community, including researchers, research funders, and research institutions, to recognize the benefits of published peer review reports for all parts of the research system.

Learn more at ASAPbio .