PONE-D-23-25826Relationship between social cognition and emotional markers and acoustic-verbal hallucination in youth with post-traumatic stress disorder: protocol for a prospective, 2-year, longitudinal case-control studyPLOS ONE

Dear Dr. Dumas,

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 Dec 22 2023 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,

Tord Ivarsson, MD, PhD

Academic Editor

PLOS ONE

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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 

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2. "In your Data Availability statement, you have not specified where the minimal data set underlying the results described in your manuscript can be found. PLOS defines a study's minimal data set as the underlying data used to reach the conclusions drawn in the manuscript and any additional data required to replicate the reported study findings in their entirety. All PLOS journals require that the minimal data set be made fully available. For more information about our data policy, please see http://journals.plos.org/plosone/s/data-availability.

"Upon re-submitting your revised manuscript, please upload your study’s minimal underlying data set as either Supporting Information files or to a stable, public repository and include the relevant URLs, DOIs, or accession numbers within your revised cover letter. For a list of acceptable repositories, please see http://journals.plos.org/plosone/s/data-availability#loc-recommended-repositories. Any potentially identifying patient information must be fully anonymized.

Important: If there are ethical or legal restrictions to sharing your data publicly, please explain these restrictions in detail. Please see our guidelines for more information on what we consider unacceptable restrictions to publicly sharing data: http://journals.plos.org/plosone/s/data-availability#loc-unacceptable-data-access-restrictions. Note that it is not acceptable for the authors to be the sole named individuals responsible for ensuring data access.

We will update your Data Availability statement to reflect the information you provide in your cover letter.

3. We note that the original protocol that you have uploaded as a Supporting Information file contains an institutional logo. As this logo is likely copyrighted, we ask that you please remove it from this file and upload an updated version upon resubmission.

Additional Editor Comments:

Dear Dr Dumas,

PLOS aplogizes for the long time this article has been under review, which largely is due to difficulties to get reviews.

I recommend you to make a "major revision" as our two reviewers had some serious concerns regarding the protocol.

However, as the protocol also has some very clear strengths, I ask you to consider carefully the points made by the reviewers and then revise your submission thoroughly.

If you consider that some points raised by the reviewers go too far, or not correct, your rebuttal of each point must be very clear and cogent.

First, the issue of ethics raised by needs to be sorted out, as proper permission is central to publication.

Second, the power issues is important too, because the collection of data that are bound to become indecisive with regard to the research question is problematic as well. Twenty cases in each group are quite few, and as a longitidinal design is fraught with attrition, power issues can not be taken lightly. Furthermore, if you have solid grounds for believing that 20 cases in each group will be enough, this pre-supposes a power analysis, in which case it needs to be included in the re-submission.

Third, the analysis plan was criticized. You state that you will use two years observation time, and as the research question implicates change across time, this must be clarified in the analysis plan.

As academic editor I agree with the reviewers independently through my own reading, and I hope that you will be able to revise and re-submit.

Kind regards,

Tord Ivarsson

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions?

The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field.

Reviewer #1: Yes

Reviewer #2: Partly

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2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses?

The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory.

Reviewer #1: No

Reviewer #2: Partly

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3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable?

Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible.

Reviewer #1: No

Reviewer #2: Yes

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4. Have the authors described where all data underlying the findings will be made available when the study is complete?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. 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: No

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 and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics.

You may also provide optional suggestions and comments to authors that they might find helpful in planning their study.

(Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: This protocol refers to an interesting and important topic, namely the trajectory of hallucination and psychosis development in adolescents with PTSD. The authors aim to make use of a prospective design to eliminate issues that are currently present in the literature, namely the exclusive use of cross-sectional data. If completed, this study would contribute significantly to elucidating the relationship between PTSD, auditory hallucinations and psychosis development.

While relevant and interesting in scope, the study protocol presents with a number of issues that I think are necessary to address:

1. Ethics approval/Trial registration: The proposed study is based on a pilot study which was registered under clinicaltrials.gov (https://clinicaltrials.gov/study/NCT02567500#publications). However, the ethic amendment for the study protocol is related to another study investigating the effects of exposure to the attack in Nice on July 14th, 2016 (Program 14-7 Study https://clinicaltrials.gov/study/NCT03356028). Since the two studies (proposed (“Physalis”) and Program 14-7) are very different in terms of recruitment (14-7 is already recruited, specifically from people exposed to the attacks) it is not clear to me how these two studies are related. I would suggest the authors make clear in the manuscript; in what way the proposed study is an extension of the original study and why the pilot “Physalis” study had their own clinical trial entry, but this current extension has not.

In addition, the clinical trial reference to the program 14-7 study is not helpful, insofar as the recruitment strategy is very different from the proposed study. Furthermore, the amendment and attached study protocol mention the distinction between mass and individual trauma which does not occur in the current manuscript. If they proposed study does not recruit from the Program 14-7 sample at all, this should be made clear and in this case I do no think the current study can be considered an extension of the Program 14-7 study.

2. Study instruments: One of the main variables of interest in this study is the presence of auditory-verbal hallucinations. The authors briefly mention that the instrument was published previously (in a French study, so not accessible to international readers) but give no more detail. The authors should describe this instrument here in detail as well, especially since the outcome variables of this instrument (presence yes/no or a continuous outcome?) is important for the statistical analysis.

3. Sample size calculation: The authors mention that it is impossible to make a quantified hypothesis for the sample analysis, but then go on to provide some information on an analysis anyway. The analysis is missing the effect size that was considered for the calculation. The authors should either state clearly that they have not done a sample size analysis or perform sufficient detail to replicate this analysis (see also the Work of Daniel Lakens regarding sample size justification https://psyarxiv.com/9d3yf/). Additionally, the authors mention the small sample size in their limitations section, however the study is still running. Why not recruit more patients if that’s the main limitation?

4. Data analysis: The data analysis plan is currently incomplete. The authors should mention the specific variables (MINI-KID; NEPSY, etc.) used in each analysis and give more analysis regarding the time point of each analysis. As of now the plan ready as if conducted in a cross-sectional study and it is not clear how the prospective design is considered in the analysis plan. Please include specific analyses regarding the time frame, and mention which analysis is done at which time point (T0, T1, etc.). Additionally, the main analysis seems to be a correlational analysis, however it is not clear to me that all involved variables continuous (especially since the AVH variable is not clearly described in the instruments sections). I suspect a between-group analysis (AVH+ vs. AVH-) would be more appropriate. A correlational analysis also seems not best suited for the relationship between patients’ diagnosis (categorical I assume) and AVH (again, probably a categorical variable). Here as well, the authors state that correlational analysis is used because of the small sample size, but since this is a study protocol, they can just plan to include more participants if that’s what needed for an appropriate analysis. Overall, this section is most concerning and needs the most comprehensive rewrite.

5. Hypothesis: In the discussion section the authors discuss a very interesting theory regarding the co-development of AVH and PTSD symptoms (“dys-sensory perception”), however as far as I can tell they plan no tests or analyses to investigate this model. I suggest the authors deduce specific predictions from this model that can be tested with their collected data.

Minor concerns:

1. Figure quality: The attached figures are not of sufficient quality for publication.

2. Hypotheses: The hypotheses in the introduction should be stated more clearly and in statistical terms.

3. Data availability: The authors should add a data availability statement to the method section, detailing where their data will be made available.

Reviewer #2: For the sample size calculation, the information that was used to derive the sample size is to be provided e.g. reference of the previous study is to be cited, and whether the sample size calculation in the previous study was performed.

The statistical software, its version, publisher name and the accepted level of significance is to be stated.

The language version for all the tools/inventories/questionnaires including validation information (where applicable) is to be stated.

The sentence ‘A bivariate descriptive analysis will look for a significant difference between the case and control groups by the Student's test for the comparison of quantitative variables (or the non-parametric test of Wilcoxon if the validity conditions are not validated), and the chi² test (or Fisher's exact test in the case where the validity conditions are not validated) ‘ requires revision.

For Fisher’s exact test, 1 or 2 -tailed test is to be stated. Chi2 test to be written as chi-square test.

The statement ‘Pearson's correlation method was used to measure the association between two variables in a small population sample.’ requires revision. Pearson's correlation can be used in small population samples to measure the association between two continuous variables but it is crucial to consider the nature of the data.

Typo 'Bonferonni' (Bonferroni)

The statement ‘Since these are two primary outcomes, correcting the alpha risk by the Bonferonni method is necessary, with alpha = 2.5% for each marker’ could be revised to ‘Since there are two primary outcomes, correcting the alpha risk by the Bonferroni method is necessary, with an adjusted alpha of 2.5% for each marker to control the overall familywise error rate.’

Some references did not conform to the journal format.

The authors have stated that the limitation of the study is due to the low sample size. This is a good and interesting study and since it is a prospective case-control study, it is a waste not to make an attempt to get more subjects in order to derive more meaningful data/results. Studying the relationship between social cognition and emotional markers and acoustic verbal hallucination in youth with post-traumatic stress disorder requires a good number of subjects. Also, there are many variables that could possibly be involved/interplay, where confounding, mediating, and moderating effects could present in the study and require more meaningful statistical analysis. The authors could make an attempt to increase the sample size by recruiting subjects from other sites. Also, the attrition rates could be more than what the authors have anticipated.

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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: Yes: Dr. Lukas A. Basedow

Reviewer #2: No

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PONE-D-23-25826R1Relationship between social cognition and emotional markers and acoustic-verbal hallucination in youth with post-traumatic stress disorder: protocol for a prospective, 2-year, longitudinal case-control studyPLOS ONE

Dear Dr. Dumas,

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 Mar 21 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,

Dirceu Henrique Paulo Mabunda, M.D.

Academic Editor

PLOS ONE

Journal Requirements:

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.

Additional Editor Comments:

Please address the issues raised by reviewers.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions?

The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field.

Reviewer #1: Yes

Reviewer #2: Partly

Reviewer #3: Yes

**********

2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses?

The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory.

Reviewer #1: No

Reviewer #2: Partly

Reviewer #3: Yes

**********

3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable?

Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

**********

4. Have the authors described where all data underlying the findings will be made available when the study is complete?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. 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

**********

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

Reviewer #3: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics.

You may also provide optional suggestions and comments to authors that they might find helpful in planning their study.

(Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: I thank the authors for providing a revision and responding politely and extensively to all my comments. The majority of concerns has been adressed. However, there still remain two central issues that I believe should be adressed:

1) Sample size calculation: The authors state that they were unable to calculate a required sample size. Nonetheless they need to include a sample size, so there is a clear criterion for when recruiting should be stopped. Indeed, the authors write that the "number of inclusions neccessary was reached on February 8, 2023". If no sample size is defined, this does not make sense. Apparently recruitment has stopped already, but as of now it is unclear why recruiting stopped if no sample size is determined. Since the authors specified their hypothesis I believe the appropriate way of calculcating a sample size would be to determine an effect size of interest (how large does the effect in question need to be to be considered relevant?) and then calculating the required number of participants to detect this effect. So, if the authors are able to implement this and adapt their recruiting strategy to the results I would think this is the best action to take. However, I suspect that circumstances might prevent further recruitung (e.g. lack of funding or recruitment possibilities). In that case, the authors should still calculate the required sample size and then state why they are unable to collect this sample transparently (which is something that happens all the time and thus should not be seen as a failure on the authors side but rather an accident of circumstances).

2) Data Analysis: The section on data analysis, while updated, is still not sufficiently detailled to allow for replication or meaningful outcomes. I think the issue starts with the hypothesis: "The hypothesis of our study is the social cognitions and emotional markers are cognitive biases associated, or even correlated, with the presence of AVH in children and adolescents with PTSD." First of, I don't understand the distinction between association and correlation drawn here. This should be clarified. Second, the "presence of AVH" is a categorical variable in this study, thus the correct analysis to test the hypothesis would a between-subject test (such as t-test) with "social cognitions" and "emotional markers" as outcomes. The hypothesis should state this clearly, e.g.: "The hypothesis of our study is that social cognitions and emotional markers are more/less strongly expressed in a AVH group than in a similar group without AVH". Ideally, this hypothesis already includeds the specific names of the variables from the specific measures applied. If the hypothesis is clearly formulated the section on data analysis can be written more clearly as well.

From my understanding of the collected data the second paragraph in the data analysis section ("A bivariate descriptive analysis will look for a significant difference between the AVH+ and AVH- groups. Continuous variables will be compared using the Student's test (or the non-parametric Wilcoxon test if the variables do not follow a normal distribution), and categorical variables with the chi-square test (or the non-parametric bilateral Fisher's exact test if the variables do not follow a normal distribution.)") seems a sufficient explanation of the testing procedure. The only neccessary addition would be a clear written out mention of all variables. For example: "Continuous variables tested with Student's test are: BAVQ-R, DES IV, etc.; Categorical variables assessed with the Wilcoxon test are: NEPSY II Theory of Mind, NEPSY II Emotion recognitoon, etc.". This should be a direct reflection of the hypothesis stated at the end of the introduction. As the authors state there are only two primary outcomes, I recommend only these two should be listed here. And if exploratory analyses are to be conducted they should be mentioned separately in a section on "exploratory analses".

This also applies to the section on secondary outcomes. To my understanding this would be a repetition of the first analysis, two years later? This should also be mentioned in the hypothesis so it is obvious what variables are tested specifically.

Minor points:

1) There is no need to repeated the procedure from the figures in detail in the "Procedure" section. Apparently that was a misunderstanding from my first review, for which I apologize.

2) The authors replied that they only assess AVH status via a question by the study evaluator. However, in the section "Assessment of group allocation" they still mention a "self-report questionnaire". Please explain what measure is used here.

3) Since the clinical trial registry belongs to the 14-7 programm this should be removed.

Reviewer #2: The authors have put in great effort to address the comments.

Spearman correlation is suitable for comparison of ordinal data or nonparametric (skewed) data. For comparison of two nominal data, Cramer’s V could be used.

Reviewer #3: I have had the opportunity to review the work "Relationship between social cognition and emotional markers and acoustic-verbal

hallucination in youth with post-traumatic stress disorder: protocol for a prospective, 2-

year, longitudinal case-control study", the modifications made by the authors have notably improved the previous version and have satisfactorily answered the questions and recommendations of the reviewers. I believe that the article could be ready for publication but, nevertheless, I I would like to make some recommendations in case you consider that it can be improved even further. Regarding the calculation of the effect size, in the event that there is no data from other research on the same characteristics, in addition to pointing this out as a limitation, other research could be used with similar populations (even though different variables have been measured). This is only a suggestion, due to the relevance that reporting the effect size may have. As for the statistical analyses, if the authors plan to obtain a small number of participants, the correlational analyzes they may not be the most appropriate and the authors should point out this as a limitation and suggest alternatives adjusted to the expected reality of the data. In this sense, I suggest that they add comparisons between groups of general linear models such as ANOVA, as an alternative.

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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: Yes: Lukas Basedow

Reviewer #2: No

Reviewer #3: Yes: Juan A. Moriana

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[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.

Relationship between social cognition and emotional markers and acoustic-verbal hallucination in youth with post-traumatic stress disorder: protocol for a prospective, 2-year, longitudinal case-control study

PONE-D-23-25826R2

Dear Dr Louis-Emilie Dumas

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,

Dirceu Henrique Paulo Mabunda, M.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions?

The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field.

Reviewer #3: Yes

Reviewer #4: Yes

**********

2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses?

The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory.

Reviewer #3: Yes

Reviewer #4: Yes

**********

3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable?

Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible.

Reviewer #3: No

Reviewer #4: Yes

**********

4. Have the authors described where all data underlying the findings will be made available when the study is complete?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. 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 #3: Yes

Reviewer #4: 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 #3: Yes

Reviewer #4: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics.

You may also provide optional suggestions and comments to authors that they might find helpful in planning their study.

(Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #3: I believe that the authors have made the suggested changes and now it meets the requirements for publication.

Reviewer #4: I was able to read the study "Relationship between

social cognition and emotional markers and acoustic-verbal hallucination in youth with

post-traumatic stress disorder: protocol for a prospective, 2-year, longitudinal casecontrol

study"relatively late in the review process. The work by Dumas et al. provides interesting insights into the relationship of social cognition to AVH. Upon reading it became apparent that the authors have provided great care to work in the reviewer's comments. Thus we feel that this manuscript is ready for publication. However, I have two small recommendations:

1. I would advise to go over the manuscript one final time to improve wording and sentence structure - especially in the abstract.

2. I agree with the authors point of view that it is challenging to calculate needed sample sizes for power calculations if no precedents exist, however I would recommend providing a reference for the cited work that was used to do the actual sample size calculations in order to make the calculation replicable.

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Reviewer #3: No

Reviewer #4: No

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