The Role of Emotional Skills (Competence) and Coping Strategies in Adolescent Depression
Round 1
Reviewer 1 Report
GENERAL COMMENTS
The aim of this paper was to examine emotional competence and coping styles as predictors of depression among adolescents. Although this article addresses an interesting topic, many issues should be addressed before publication.
SPECIFIC COMMENTS
ABSTRACT
Please state the p-value for results, such as any significant difference ….
INTRODUCTION
The introduction needs minor revision and clarification. First, the aim of the study is not clear. Research manuscript should answer a specific research question, which is lacking in this study. Also, the way the authors build up their introduction does not lead to the research question. Although many of the necessary information regarding the background is already briefly written down, the authors should re-structure their introduction, explaining why their research is important. I would also suggest to add more literature on depression for adolescents especially during the post-COVID period.
METHODS
The methods section needs major revision.
1. Please provide ethical approval code as dealing with human participants and vulnerable population. What about parental consent?
2. Please include sample size calculation. I think the sample size is too small.
3. Is the questionnaires validated for the adolescents population in Croatia?
4. What statistical analysis used in this study? Not mention.
5. What is the demographic information of the participants?
RESULTS
The results section needs minor revision. The authors should add how they gathered all the information. Probably, including a research question would help the authors to structure their results.
DISCUSSION
In the discussion section, the authors should further discuss their findings and the implication of these findings. They should also discuss their findings in more depth. The authors also discuss many topics that are not related to the results. In addition, they describe many studies in great detail which is not necessary for the discussion.. The limitation is also not well thought. It is rather generic. Please revise.
Conclusion
I think the sample size is too small to make such a bold conclusion. Suggest to revise to softer statement.
Thank you.
Author Response
Dear colleague,
I have read your review report thoroughly. Thank you for your sharp insight and suggestions for improving our original manuscript.
Attached you can find all the alterations I made based on your comments, on behalf of all authors, with your responses interleaved. Hope I have done a good job of presenting our findings in a more cohesive, structural and vertical manner.
Looking forward to your final verdict and further feedback, if needed.
Sincerely,
Katarina
Author Response File: 
Author Response.pdf
Reviewer 2 Report
The authors present an interesting paper related to the exceptional situation experienced in relation to Covid. There are many investigations that have addressed the effects of this "abnormal" episode, and on all its effects on health and well-being in different strata of society.
The paper is well written and it is easy to read and follow its exposition. However, I would like to make a series of recommendations/suggestions.
-I am surprised that the abstract does not mention the COVID episode, since later in the introduction they do highlight that importance and it acts as a context for the research.
-Introduction and discussion are very disconnected. The introduction is too short, it should be more developed and perfectly connected with its objectives. In this case, when one arrives at the objective of the investigation and the expected "results", it is difficult to connect them with the previous introduction. For example, the discussion is organized based on two sections (4.1. Gender differences in depression, emotional competence, and coping styles references and 4.2. The relationship between depression, emotional competence, and coping styles references) The introduction should be more or less equally structured, and as I already mentioned, the introduction should have more development.
-Another issue is that both are quite disconnected. In section 4.1, only two of the references discussed in the introduction (15 and 16) appear, and in section 4.2 another two (9 and 14). That is to say, of 18 references that are handled in the introduction, only 4 appear in the discussion. As I already mentioned, not only should they be structurally similar, but there should also be a greater relationship between the two, the first presents the problem to be investigated, and the second the relationship of the data obtained with previous investigations, so the harmony between the two must be greater. They present the problem supported by one reference and discuss it with the support of different ones. On the other hand, it would be convenient to review the references since their level in the last 5 years is quite low: 7/50.
-As I mentioned before, the paper is well written, but there are some repetitions that should be corrected, such as the "even before" of lines 29-31 or the "a t-test" of line 154.
-I imagine that on an ethical level they have followed the legal protocols of Croatia, although since they are minors it would be convenient to make them very clear. And although it is obvious, also make it clear that the Helsinky declaration is followed, in this regard.
-In the ESCQ-45 and the DASS they provide the alpha of the test and the one obtained is this work, whereas with the Styles os Coping with Stress in Adolescent Scales, only the alpha of the present work.
-Methodologically, the work is very well planned, and the analyzes are adequate. But, it would be interesting to incorporate the typical statistical analysis section. In this case, it is also necessary to better explain the mediation analysis, what procedures and models have been used specifically, have they used the spss macro process, R?
It would be interesting to check the role of age, for example as a covariate, since it seems to me that between 14 and 17 years there may be some differences.
It would also be interesting to have a more precise description of the sample, with socio-demographic variables in use, rural-urban, socio-economic level, family unit or type of family, etc. which can be variables relevant to the case. As well as others related to healthy habits, practicing a sport, leisure activities, hours of social networks and the like, if you smoke or consume substances. Aspects that can interact with the interests of the investigation.
Author Response
Dear Sir or Madam,
I have made certain changes in our original manuscript in light of your review report, which I am sending attached.
I have taken into account your expert advice and made some necessary alterations in order to gain clarity, structure and uniformity, with your comments interleaved in the disclosed document. Hope I answered most of your concerns and eliminated some ambiguities regarding the aims and methods used.
I would like to thank you for recognising the potential of this research area and topic, it is deeply appreciated.
Best wishes,
Katarina
Author Response File: Author Response.pdf
Reviewer 3 Report
This manuscript discusses how emotional competence and coping strategies are related to depression in adolescents. The authors collected data from 142 high school students with questionnaires. Analyses were conducted to reveal the relationships, including hierarchical regression and mediation analysis.
In general, the manuscript was well-written and not difficult to follow. The authors introduced the related background that is related to the research. The data collection procedure looks reasonable. The findings were compared with previous findings in the Discussion Section.
Section 2 describes how the data is collected. However, I think the authors might also want to briefly introduce how the statistical analysis is conducted in this section.
The analysis looks reasonable in general. However, in the mediation analysis, the authors might want to discuss the possible impact of unmeasured confounders. Some subjects may be facing problems they cannot solve, and they tend to avoid them, but these problems are more likely to cause depression. The other subjects may be facing problems they can solve, and they can solve them with a problem-focused coping strategy. If this is true, then the difficulty of the detailed problems is an unmeasured confounder related to both the coping strategies and the depression outcome. Such a cofounder makes the causal analysis results unreliable.
The manuscript has shown that gender plays an essential role in the analysis. Therefore, I suggest the authors conduct a moderated mediation analysis, where gender is the moderator. The analysis might better reveal the role of gender in the causal model.
Minor:
In Line 154, the phrase "A t-test" is duplicated and should be removed.
Author Response
Dear Sir or Madam,
I am attaching our Reply to your review report with additional clarification and details on how and where we implemented your suggestions.
We are glad you find our paper well-written. You have helped us improve our original manuscript immensely and inspired us to plan the following research designs.
On behalf of all authors, kind regards.
Katarina
Author Response File: Author Response.pdf
Reviewer 4 Report
I congratulate the authors for this interesting study that provides important results in practice for addressing depression in adolescents.
However, in my opinion, the article requires some revisions/clarifications before being accepted for publication- please see below.
- Lines 29-31- ”According to the European Commission report, even before the pandemic, European adolescents' mental health started to deteriorate even before the COVID-19 pandemic”. This sentence should be reworded to avoid repetition.
- Lines 29-32- a bibliographical reference should be added
- Line 90- It is not clear what kind of ”school prevention programs” the authors are referring to.
- The distribution of participants by age should be mentioned
- Line 154- Please delete one of the two ”A t-test”.
- Line 215- Please delete the full stop after 2001
- Lines 315-316- ” The obtained results indicate that many adolescents in Croatia experience severe and extremely severe symptoms of depression, predominantly girls”. Given the limitations of the study due to the characteristics of the participant group, the results of the study cannot be generalized to allow conclusions regarding the entire Croatian adolescent population.
- Lines 320-321- ”We could theorize how increased digital activity and social isolation could affect vulnerable youth” - The mentioned aspects do not result from the conducted study, which calls into question the appropriateness of their inclusion in the conclusions of the study.
Author Response
Dear colleague,
Please find attached our reply to your review report and the changes we made based on your suggestions.
Thank you for your time and kind words on behalf of all the authors.
Sincerely,
Katarina
Author Response File: Author Response.pdf
Round 2
Reviewer 2 Report
The paper has improved substantially. Introduction and discussion are better connected, 6 references, although they could be better connected, as is the step from introduction to objectives.
Most of the issues raised have been handled satisfactorily. Although there are aspects that have been omitted.
It would be interesting, even at the covariate level, to analyze whether age has any kind of incidence, since at those ages the differences can be notable, with 14 you are still almost a child, and at 17, you are already a young adult, although always with nuances.... And in terms of limitations, better argue omitted aspects such as substance use, physical activity, social networks, etc., which can be clear explanatory factors.
Author Response
Answer: Dear sir/madam,
to answer your concerns about whether age has any incidence, I must address the age groups by frequency. We aimed at second-grade high school students just before they go through several school preventive programs. We are hopeful to be able to test them again in fourth grade and compare them with their peers who have not gone under a licenced prevention program. With that in mind, most of our pupils were 16 years old (more than 75% of the sample size). Therefore, any age-related analysis would be inappropriate and inaccurate - we couldn't even merge age groups for two-way ANOVA with interaction (gender x age).
Table 1. Frequency by age:
Age F %
14 2 1,4
15 20 14,1
16 108 76,1
17 12 8,5
When computing covariance, we tested all criteria variables for cross-product deviations and covariances in SPSS; but only found barely significant results for depression (r=0,17; c=1,086; p=0,045).
And in terms of limitations, plausible behaviour variables such as substance use, physical activity, and social networks are addressed in lines 397-408. Additional note – in the original manuscript, we were advised not to refer to digital activity since it was not measured in this research.
Hope this answers the remaining questions; thank you for your time and patience.
Sincerely,
Katarina
Reviewer 3 Report
I suggested considering gender as a moderator because I suspect that mediators might impact males and females differently.
My other concerns have been addressed.
Author Response
Dear sir/madam,
We have conducted several analyses regarding gender and only found some mean differences in depression and some emotional competencies.
For example, neither one of the partial correlations differed from regular bivariate Pearson when controlling for gender. They were all almost identical, except for emotional coping (r=0,288 vs r=0,302 when controlling for gender).
We also tested several Hayes models, including gender, such as model 1 (with general emotional competence as a predictor and depression as a criteria variable, and gender being a moderator), and the results were not significant, perhaps due to the fact there were no gender differences in emotional competencies (general or specific). We also tested model 3, where gender (W) tested for moderating effect of both problem and emotion-focused coping strategies, but none of the models was statistically significant. Since there is already one insignificant analysis (model 4 - mediation), we did not see the point in adding multiple ones. We do, however, plan to repeat measures on the same pupils since we know which school and grade they are attending, so we can do a mixed mediation analysis with gender as a moderator. Maybe even add a comparison with the same age group that did not participate in a school prevention program during the 4-year high school period to see any treatment effect.
I hope that answers your concerns, and thank you again for your time and patience.
Sincerely,
Katarina
