PONE-D-21-33144Psychopathic tendencies are selectively associated with reduced emotional awareness in the context of early adversityPLOS ONE

Dear Dr. Smith,

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.

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3. We noted in your submission details that a portion of your manuscript may have been presented or published elsewhere. [In a separate paper under review, we also use the data on emotional awareness and early adversity to answer a separate research question about how early adversity influences emotional awareness. We do not reproduce any of those analyses here and explicitly acknowledge this other paper in our manuscript. In this manuscript we instead examine how emotional awareness measures relate to psychopathy measures and empathy measures, and whether early adversity and negative affect moderate those relationships. The data on psychopathy, empathy, and negative affect has not been used in any previous study. A preprint of this other paper can be found here: https://psyarxiv.com/7nzqk/]  Please clarify whether this [conference proceeding or publication] was peer-reviewed and formally published. If this work was previously peer-reviewed and published, in the cover letter please provide the reason that this work does not constitute dual publication and should be included in the current manuscript.

4. We note that you have referenced (Patrick CJ. Operationalizing the triarchic conceptualization of psychopathy: Preliminary description of brief scales for assessment of boldness, meanness, and disinhibition. Unpublished test manual Tallahassee, FL,: Florida State University; 2010.which has currently not yet been accepted for publication. Please remove this from your References and amend this to state in the body of your manuscript: as detailed online in our guide for authors

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Additional Editor Comments:

Thank you for submitting your top work to PLoS One for consideration.

First, an apology: Obtaining reviewers has been challenging during the pandemic, and I appreciate your patience throughout the process. At this point, I have been able to garner a high-quality review from one expert in the field, who has had the opportunity to provide detailed feedback on your submission. This reviewer has noted numerous strengths of the paper, including its high potential for theoretical import, and its overall statistical clarity. That said, the reviewer has also noted several features of the manuscript that decreased their enthusiasm somewhat. Overall, they have recommended a Major Revision.

I too have had the opportunity to review the manuscript, and am in broad agreement with the reviewer regarding the relative strengths and weaknesses of the manuscript. I believe the reviewer comments to be both clear and well-regarded, and so will not repeat them here. I will however expand somewhat on their concern regarding the method used to separate primary versus secondary psychopathy in the study. Whereas the reviewer has requested that you provide additional justification for these methods, I would request that you go one (or two) steps further than this, and also consider (regardless of your ability to find historical support for the method) its appropriateness in the present context. I do understand the logic – in fact, as someone who has recently been working with the PD-scale from the IRI, I quite like the logic of relating it to primary/secondary psychopathy concepts. However, relating it to primary/secondary psychopathy, and *defining it as* primary/secondary psychopathy are not the same thing. Moreover, in the present context, which is a study that relies on the reporting of relationships between different self-report measures, I wonder if your use of the PD scale in this manner doesn’t add substantive bias into the study design. You are, after all, predicting that psychopathy will be related to reduced emotional awareness, and are then using a measure of personal distress – which is established as a substantive correlate of emotional awareness – to demonstrate that only a subset of your psychopathy group shows this reduced EA. It all fits, it all makes sense…but is it in fact a somewhat circular process, wherein the category being used to separate participant groups is related to the dependent measure being evaluated for differences between groups (see Kriegerskorte et al., 2008)?

In addition, while I agree with the reviewer that your description of Bayes Factors was clear and helpful, I am nonetheless left wondering if those BF analyses were necessary. Perhaps some additional language that does more than simply explain how to interpret the BFs, but also informs on how they help further interpretation beyond the reported r and t-statistics (assuming they do) would be helpful.

In total, I agree with the reviewer that a Major Revision is in order, and welcome you to submit your revised manuscript for reconsideration at PLoS One. I do want to stress, however, that issues regarding potential circularity would need to be rectified before publication were possible; so I urge you to consider this issue, and its potential downstream empirical and theoretical impacts, carefully.

Best,

Matthew Shane

Action Editor, PLoS One

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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

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: I Don't Know

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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

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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

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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 manuscript reports results from a study examining the relationship between psychopathic traits (as measured by TriPM) and emotional awareness (EA; as measured by LEAS), including examination of “primary” and “secondary” psychopathy in relation to EA. The authors report their findings of apparent EA deficits in psychopathy, particularly in a subgroup of participants with high TriPM scores who reported experiencing early adversity (as measured by CECA and CTQ). The questions about empathy, EA, and psychopathy addressed by the research are interesting and important to furthering understanding of the relationship between those variables. Additionally, the authors did a good job of describing the Bayes factor analysis statistical methodology, providing sufficient information for readers less familiar with the BF method to understand the reported results. It was helpful to have access to the supplementary information provided by the authors, and I commend the authors on their clear delineation between a priori and post-hoc analyses. Despite the many strengths of this manuscript, there are some areas that warrant revisions, particularly adding support for certain methodological decisions and improving some aspects of the interpretation of the study results. Should the authors revise the document to reflect the feedback below, the manuscript would likely be suitable for publication and constitute a valuable addition to the published literature in this area.

Major Concerns

(1) Questionable definitional/methodological choices for assessing constructs of interest

A. The chosen way of defining and measuring “primary” vs. “secondary” psychopathy needs additional explanation/empirical support. Have other studies delineated the two subtypes of psychopathy in this way? Please include citations that support the chosen way of defining and measuring these constructs (e.g., Explain why using the CECA, CTQ, PANAS, and IRI personal distress subscale to distinguish between psychopathic subtypes is a valid method.).

i. The use of the IRI personal distress subscale as a “convergent measure of primary vs. secondary psychopathy” (p. 9) was odd and requires additional explanation/justification. As the personal distress subscale of the IRI is one of the affective/emotional empathy subscales, the authors will need to add to their justification and explanation for the hypothesis that this affective empathy subscale would be associated with the “secondary” form of psychopathy.

B. In the analyses looking at psychopathy subtypes, the authors included high psychopathy/high early adversity, high psychopathy/low-early adversity, and low psychopathy groups.

i. The choice to use median splits on the various measures to create the subgroups for analyses needs to be explained and supported with citations, including an explanation on how this choice may have impacted the results.

ii. The choice to not compare high and low early adversity in the “low psychopathy” group must be explained, including any impact this choice may have had on the results and interpretations of the findings. Further, the authors should include results of analyses showing whether the high and low psychopathy groups differed with regard to levels of experienced early adversity.

(2) Interpretation of study results and explanation in the Discussion could be stronger

A. The authors used the TriPM as their psychopathy measure, and I would have liked to see more discussion of the subscale-level results, as it appears that the results would be in-line with the authors’ hypotheses about intact EA associated with “successful psychopaths” or those adept in manipulation. Specifically, findings that the negative relationship between LEAS Total Score and TriPM psychopathy was driven by the Meanness and Disinhibition subscales (and not Boldness; p. 13), suggests that individuals high in Boldness (but lower on the other two subscales), might have intact EA. The discussion would benefit from more explanation of the TriPM subscale findings, particularly as they relate the authors’ hypotheses about “primary” and “secondary” psychopathy.

i. Including the TriPM subscales in the conceptualization of “primary” vs. “secondary” psychopathy in the introduction could help tie this together.

ii. This could be brought up in the Discussion as well. For example, the authors stated, “The weaker association with EA in primary psychopathy could help account for these individuals’ prowess at displaying superficial charm, manipulating others, and attaining leadership roles, while the stronger association in secondary psychopathy is consistent with the high impulsivity and high criminality seen in this population.” The authors would be able to make a stronger statement if they mentioned the potential role of Boldness scores in this distinction. Table 2 (p. 18) shows that the two “high psychopathy” groups differed at the subscale level, so highlighting this would make the discussion of the findings stronger.

B. There are a few places where non-significant results (with p > .05) are still interpreted, for example being described as “marginal” effects (e.g., p. 16). This type of questionable practice takes away from the manuscript as a whole, and is unnecessary, so use of such interpretations of the results in the manuscript should be reconsidered.

C. The discussion of the findings for “primary” vs. “secondary” psychopathy (p. 20) was confusing. Specifically, the authors mention that LEAS scores for individuals in the high psychopathy/high early adversity group did not significantly differ from those in the high psychopathy/low early adversity group, but then go on to discuss how their results show support for a difference in EA between the two groups. A clearer explanation of these findings is warranted.

Minor Concerns

(1) In the very first sentence of the introduction (p. 3), it says “Psychopathy is a personality trait characterized by...”. First, it would be more accurate to refer to psychopathy as a “constellation of traits” rather than just a singular trait (though that may have been a typing error in the manuscript). The definition of psychopathy as being “characterized by antisocial tendencies, such as cruelty, manipulation, grandiosity, callousness, and lack of empathy” (p. 3) is a bit questionable, particularly since you used the TriPM, which has reduced emphasis on the “antisociality/criminality” component of psychopathy (unlike the PCL-R).

(2) The mention of and emphasis on “dark triad” traits in the introduction (e.g., p. 3) was surprising and a bit confusing, seeing as the abstract and title focus on psychopathy. It seems that the arguments made in the introduction to set up the rationale behind the authors’ own study could have been made through sticking with the psychopathy literature. If the inclusion of “dark triad” traits is essential to the study, adding more explanation of the different constructs and how the psychopathy literature may differ from the “dark triad” literature would be helpful.

(3) The authors appear to use an “emotional empathy” definition of “empathy” throughout the manuscript; however, the explanation of this definition is lacking. Specifically, on page 4, it says “Despite deficits in empathy (or “affective theory of mind”; i.e., emotion contagion in response to others’ emotions) ...”. The terms of “emotional contagion,” “affective theory of mind,” and “empathic concern” all seem to be used interchangeably in this manuscript; however, the constructs are not necessarily considered equivalent in the literature. I would suggest clarifying your definitions of empathy by clearly laying out your definitions of both “cognitive empathy” and “affective empathy,” as you use both in the manuscript and study design/results interpretation.

(4) The authors cite study time constraints and their a priori hypotheses (p. 9) as the reason for not including the two cognitive empathy subscales from the IRI (Perspective Taking, Fantasy); however, this choice seems to require more explanation. Specifically, the authors made efforts to include measures for convergent validity for the psychopathy subtyping, so it was odd that they would leave the 14 items from the two cognitive empathy subscales of the IRI out. It seems like it would have been helpful to include these subscales, and the justification for not including these items seemed insufficient, particularly because the authors highlight this as a study limitation (p. 21).

(5) There appears to be a typing error on page 19, in the “Low Empathy Analyses” section, where it mentions “IRI Empathic Accuracy scores,” and I believe it is supposed to say “IRI Empathic Concern scores.”

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PONE-D-21-33144R1Psychopathic tendencies are selectively associated with reduced emotional awareness in the context of early adversityPLOS ONE

Dear Dr. Smith,

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 Sep 28 2022 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,

Peter Karl Jonason

Academic Editor

PLOS ONE

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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 #1: (No Response)

Reviewer #2: (No Response)

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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 #1: Yes

Reviewer #2: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: I Don't Know

Reviewer #2: I Don't Know

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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 #1: Yes

Reviewer #2: Yes

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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 #1: Yes

Reviewer #2: Yes

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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 #1: This manuscript reports results from a study examining the relationship between psychopathic traits (as measured by TriPM) and emotional awareness (EA; as measured by LEAS), including examination of “primary” and “secondary” psychopathy profiles as they may relate to EA. The authors report their findings of apparent EA deficits in psychopathy, particularly in a subgroup of participants with high TriPM scores who reported experiencing early adversity (as measured by CECA and CTQ). The questions about empathy, EA, and psychopathy addressed by the research are interesting and important to furthering understanding of the relationship between those variables. The authors did a great job of addressing the concerns raised during the initial review through edits to the manuscript. Aside from some minor concerns, outlined below, I believe the manuscript is suitable for publication and will constitute a valuable addition to the published literature in this area.

Minor Concerns:

1) In the description of the various measures used (starting on page 7), I noticed that Cronbach’s alpha is included for the LEAS measure, but not for the other measures. The authors might consider adding Cronbach’s alpha values for the subscales of the TriPM, and the other measures, as possible and appropriate.

2) There appears to be a typing error on page 21, in the “Secondary analyses in low-empathy participants” section, where it mentions “IRI Empathic Accuracy scores,” and I believe it is supposed to say “IRI Empathic Concern scores.”

3) On page 22, in the Discussion section, the following sentence presented a bit of confusion: “In contrast, these two groups did not show significant differences in EA.”

(a) When reading this sentence, I interpreted the two groups to be the high-TPM/high-early adversity and high-TPM/low-early adversity based on the preceding sentence that mentions heterogenous psychopathic profiles in the sample. If this is a proper interpretation, the sentence expressing that there was no significant difference in EA between the groups is confusing given other statements that seem to suggest that the two groups did differ in EA, with the high-TPM/high-early adversity group having lower EA (lower LEAS scores) and the high-TPM/low-early adversity group not showing the same “impairment” in EA. For example, in the abstract, the final sentence reads: “This suggests that EA may be selectively associated with levels of secondary psychopathy, while those with high levels of primary psychopathy remain capable of high EA.” This sentence in the abstract seems at odds with the idea that there was no difference in EA between the groups being referenced in the above-mentioned sentence on page 22.

(b) It is possible my interpretation of this sentence or the results is incorrect, though I think some clarification would be helpful to avoid similar confusion in others who will read this.

4) On page 23 of the Discussion section, the following sentence is included: “The selective lack of relationship between LEAS and boldness could therefore be seen as further evidence supporting the idea that EA is not associated with a primary psychopathy profile.”

(a) The authors could clarify this sentence by specifying that “diminished EA” (or “impaired EA” or some other synonym) does not seem to be associated with a primary psychopathy profile.

(b) For example, the sentence could be worded like this: “The selective lack of relationship between LEAS and boldness could therefore be seen as further evidence supporting the idea that diminished EA is not associated with a primary psychopathy profile.”

5) Additionally, on page 23 of the Discussion section, the following is included and seemed a bit confusing: “However, it appears less consistent with work showing that individuals with primary psychopathy, but not secondary psychopathy, show emotion recognition deficits [15, 46] or with studies showing preserved “cognitive” theory of mind abilities for emotions of others [16-18].”

(a) The point of confusion is related to the second part of the above sentence. Specifically, it is unclear to me how the results of the present study are not consistent with studies showing preserved cognitive empathy/cognitive theory of mind in primary psychopathy.

(b) I would suggest removing this part of the sentence or clarifying how the results are inconsistent with those referenced previous study findings on cognitive empathy in primary psychopathy.

Reviewer #2: The authors address an interesting issue. The question of how adverse early experiences may contribute to adult psychopathology is an important one. The paper is generally well-written. However, along with these strengths, there are some weaknesses. For example, the sample is relatively small and the methodology is a somewhat roundabout way to address the question – using childhood adversity and lower empathy to signal secondary psychopathy rather than addressing the sub-facets of psychopathy directly. In what follows, page numbers refer to the clean document from the reviewing PDF. I do not object, in principle, to the authors analyzing data from the same participants who contributed to a different publication on a different hypothesis, but milking data from a sample of 177 participants into two papers does feel a bit exploitative especially when the three measures included in the previous publication were analyzed again here.

Just because there is an association whereby those with lower LEAS scores had higher TPM and lower IRI scores, does not suggest that those with lower TPM and higher IRI scores had HIGH LEAS scores per se – Associations indicate how relatively higher or lower scores covary but do not indicate whether scores are high relative to average scores, for example. So, the authors might think about rephrasing the last sentence of the abstract. It should also be clear throughout that the sample is not a clinical sample.

On p. 4, the authors contrast primary and secondary psychopathy by referring to insufficient arousal to emotional cues as being emblematic of primary psychopathy and referring to secondary psychopathy as stemming from early adversity. This is a contrast of inequivalences of sorts. The authors should focus on either early etiology or associations with emotion awareness rather than comparing apples to oranges.

We can’t know if secondary psychopaths are incarcerated at higher rates without knowing the prevalence of both types both in the general population and in prison populations. All we can know is whether a higher rate of tested prisoners are characterized as secondary rather than primary psychopaths. The authors still need to be more precise in their language. For example, on p. 5 (end of first paragraph), they mention the etiology of psychopathic traits. Do we know that adverse experiences contribute to the development of such tendencies, or do they just covary? Authors have to be careful when making causal assumptions based on correlations. It is possible that, if there is a genetic component, parents high in psychopathy are both more likely to abuse their children and pass on psychopathic traits, meaning that maltreatment itself is not an etiological factor. All of these ideas are interesting and important, but require a great deal of care in how they are described.

P. 5 at reference [44], less accurate compared to what? The authors should specify when making comparisons.

P. 5 – there should be citations following the statement that trait EA is widely recognized…

The hypothesis at the bottom of p. 5 (that there are different reasons to suspect both high or low emotional awareness in individuals with psychopathy and other dark traits) has been suggested by others (e.g., Vonk et al., 2013 with regard to narcissism, Esperger & Bereczkei, 2012; Nagler et al., 2014; Vonk et al., 2015). It might be helpful to frame in terms of the distinction between ability to read emotion states (cognitive empathy) and the capacity to feel for others (emotional or affective empathy). It is not clear to me whether EA is capturing the latter or a form of emotional intelligence and how this should relate to theory of mind and empathy more broadly. Because much of the prior literature is coached in terms of this distinction, it would help for these authors to clarify the relations among these various related constructs. For example, they mention using the subscales of the IRI as a convergent measure of empathy but is LEAS really a measure of empathy? I am not personally familiar with the LEAS. Suddenly, the PANAS is mentioned as a measure of affect in the Method section but it is unclear why each construct is included. It would help to see a formalization of the conceptual model proposed by the authors before the Method. The authors should also spend some time indicating how the construct of psychopathy is captured by the TPM compared to other measures that have been used in previous studies. Do the authors care about the overall TPM score or the subscales? Do the subscales represent primary and secondary psychopathy? If not, how do they fit into the conceptual model for the study? Near the bottom of p. 9, is psychopathy/low affective empathy meant to treat these two as synonymous? It is difficult to evaluate the statistical approach without greater clarity from the authors on the model.

In addition, the measures of childhood adversity appear to focus on a somewhat narrow range of experiences related to abuse rather than more broadly capturing things like poverty, exposure to dangerous environments, illness etc.

If the scoring for the LEAS came from a computer scoring method, where does the inter-rater reliability come from?

The authors should report reliability for all measures.

P. 9, why do the authors say “the empathic concern subscale acted as a convergent measure of low affective empathy in addition to the TPM”? The TPM doesn’t measure empathy???!!

I don’t find the rationale for the personal distress scale to be compelling as described on p. 9-10.

Confidence intervals should be reported for t-tests.

How was the sample size determined? Is the student sample even representative and valid for the questions posed? The authors address this issue in the discussion but it is a serious limitation of the research.

One of the most interesting findings is that “high psychopathy (and low empathy) did not prevent individuals from displaying high EA in general.” (p. 22). I think the paper could be more strongly framed as an investigation of whether the association between psychopathy and EA is moderated by early adversity and why this is the case. Although I can see why TPM scores are treated as the outcome, it seems it might make sense to run reverse regression models with TPM predicting LEAS, including adverse experiences as a moderator. I don’t agree with the authors’ focus on the distinction between primary and secondary psychopathy since these facets were not directly assessed.

The authors should report the correlations between measures rather than depicting this information graphically.

Were there any attention checks? How was the data screened/cleaned?

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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 #1: No

Reviewer #2: No

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Psychopathic tendencies are selectively associated with reduced emotional awareness in the context of early adversity

PONE-D-21-33144R2

Dear Dr. Smith,

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.

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Kind regards,

Peter Karl Jonason

Academic Editor

PLOS ONE

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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 #2: All comments have been addressed

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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 #2: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: Yes

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Reviewer #2: Yes

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Reviewer #2: Yes

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Reviewer #2: (No Response)

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Reviewer #2: No

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