Trend and predictive psychosocial factors of persistent depression/non-depression in Chinese adolescents: A three-year longitudinal study

Ming Liu; Fei Xie; Zongpei Dai; Qin Dai; Xin-li Chi

doi:10.1371/journal.pone.0308303

Peer Review History

Original SubmissionJune 11, 2024
3 Jul 2024 Decision Letter - Muddsar Hameed, Editor PONE-D-24-21487Trend and Predictive Psychosocial Factors of Persistent Depression/Non-depression in Chinese Adolescents: a Three-year Longitudinal StudyPLOS ONE Dear Dr. Dai, 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 Aug 17 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. 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In the online submission form, you indicated that all data generated or analyzed during this study are available from corresponding author (daiqin101@hotmail.com) through adequate request. All PLOS journals now require all data underlying the findings described in their manuscript to be freely available to other researchers, either 1. In a public repository, 2. Within the manuscript itself, or 3. Uploaded as supplementary information. This policy applies to all data except where public deposition would breach compliance with the protocol approved by your research ethics board. If your data cannot be made publicly available for ethical or legal reasons (e.g., public availability would compromise patient privacy), please explain your reasons on resubmission and your exemption request will be escalated for approval. 4. Your ethics statement should only appear in the Methods section of your manuscript. If your ethics statement is written in any section besides the Methods, please delete it from any other section. 5. 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 If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references.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 ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: 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: No ****** 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: 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: 1. The introduction emphasizes the significance of researching non-depressive symptoms; however, it might provide additional details regarding the special nature of this topic and its potential benefits for the field of adolescent mental health. 2. Rationale of the study should be included 3. The ecological system theory is mentioned as a framework, but there is little discussion on how this theory has been applied in previous research on adolescent depression. 4. A theoretical framework could have been drawn as a support/guidance 5. While the attrition rate of 15.7% is mentioned, there is no detailed analysis of the characteristics of participants who dropped out compared to those who remained. This could help understand if attrition biased the results. 6. Include a comparison of demographic and baseline characteristics between completers and dropouts to assess potential attrition bias. 7. The sample could have been drawn from schools of various socio-economical status to increase the generalizability of the results 8. Seasonal effect on the depression (winter depression) could have been mentioned as it can act as a confounding factor. 9. Elaborate on how ecological system theory informed the study design, variable selection, and the interpretation of findings. 10. Address how potential confounding variables were accounted for in the analysis, ensuring that the observed effects are not due to unmeasured factors 11. Clearly define each group with specific criteria and thresholds used for classification, ensuring that the reader can easily understand the distinctions such as mixed depression 12. Elaborate on the role of migrant status in the context of depressive symptoms, providing insights into why this might be a significant factor. Reviewer #2: sample size is justified for a study measuring prevalence and attrition is well-managed. the stats from UNICEF in the first line need to be given with complete reference with year and date so that rationale can be stronger. rationale for a longitudinal study is made logically however they need to keep in mind large sample size of previous studies. how is gender correlated with depression? Please rephrase in line 90 most factors that are protective of depression have been explained in lines 90-117 and seem without any confusion thus rationale for finding protective factors gets weak, try to mention what was missing or what are the methodological gaps in the literature that prompted you to study this how were you able to manage the demand characteristics due to self-report of data? procedure, and results are well written along with the statistical analysis. in discussion the hypothesis 1 results are not completely explained. reasoning needs to be added, are lower depression rates related to the presence of protective factors, what is common among the sample that's causing them to have lower depression rates? rephrase 321-322 rest of discussion is well written and reasoning is appropriate, limitation of self-report is acknowledged, due to which caution should be added in interpreting results. future directions are not mentioned which need to be added. ****** 6. 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Revision 1
18 Jul 2024 Author Response Dear Dr. Muddsar Hameed, Thank you for giving us an opportunity to revise the manuscript. Please find enclosed revised version of our manuscript entitled “Trend and Predictive Psychosocial Factors of Persistent Depression/Non-depression in Chinese Adolescents: a Three-year Longitudinal Study” for your consideration. Many thanks for your constructive and detailed comments on the manuscript, which substantially improves the paper. In this revision version, we have addressed all of comments made by the reviewers (see below). With these changes, we hope that the manuscript will be of more relevant to the readership of your journal. This manuscript is not in consideration elsewhere and the author reports no conflicts of interest. Moreover, the co-author has approved the revised version making significant contributions to the writing and conceptualization of the manuscript. If I can be of any further assistance, please do not hesitate to contact me at my email address (daiqin101@hotmail.com). Thank you for your consideration. Yours sincerely, Corresponding author Reviewer's comments to the Author: 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 Author’s responding: Thank you for your detailed suggestion and revised accordingly. This version meets PLOS ONE's style requirements. See manuscript for details. 2. Thank you for stating the following financial disclosure: "This research was funded by the National Social Science Foundation of China (16CSH049) and key project of natural science foundation of Chongqing (cstc2020jcyj-zdxmX0009)." Please state what role the funders took in the study. If the funders had no role, please state: ""The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."" If this statement is not correct you must amend it as needed. Please include this amended Role of Funder statement in your cover letter; we will change the online submission form on your behalf. Author’s responding: Thank you for your detailed suggestion and revised accordingly. See Declarations Funding for details: “This research was funded by the key project of natural science foundation of Chongqing (cstc2020jcyj-zdxmX0009), Humanities and Social Sciences of Ministry of Education Planning Foundation (Grant 23YJA190002), and Guangdong Philosophy and Social Science Planning 2023 Co-construction Project (Grant GD23XXL17). The funders had a role in study design, data collection and decision to publish, while they had no role in data analysis and preparation of the manuscript.” 3. In the online submission form, you indicated that all data generated or analyzed during this study are available from corresponding author (daiqin101@hotmail.com) through adequate request. All PLOS journals now require all data underlying the findings described in their manuscript to be freely available to other researchers, either 1. In a public repository, 2. Within the manuscript itself, or 3. Uploaded as supplementary information. This policy applies to all data except where public deposition would breach compliance with the protocol approved by your research ethics board. If your data cannot be made publicly available for ethical or legal reasons (e.g., public availability would compromise patient privacy), please explain your reasons on resubmission and your exemption request will be escalated for approval. Author’s responding: Thank you for your detailed suggestion and revised accordingly. We uploaded data as supplementary information. 4. Your ethics statement should only appear in the Methods section of your manuscript. If your ethics statement is written in any section besides the Methods, please delete it from any other section. Author’s responding: Thank you for your detailed suggestion and revised accordingly. We deleted ethics statement in Declarations and described it at Methods section. See 2.3 Procedure for details: “The study and data collection received approval from the surveyed schools and the Human Research Ethics Committee of Shenzhen University. All methods were performed in accordance with the relevant guidelines and regulations. All students were informed of the study purpose and their data would be analyzed and published with personal information kept in strict confidentiality. Before the data collection, the written informed consent of participants was obtained from both students and their parents……” 5. 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. Author’s responding: Thank you for your detailed suggestion and revised accordingly. Reference 36 was deleted, references 2, 17, 27, 35 were replaced, references 8, 11, 12, 30, 44 were added, and Chinese references were indicated. Moreover, the first six authors were listed (followed by et al.) as well as all available doi were added. See References for details. Reviewers' comments: 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: Author’s responding: Thank you for your valuable suggestions, which substantially improves the paper. 1. The introduction emphasizes the significance of researching non-depressive symptoms; however, it might provide additional details regarding the special nature of this topic and its potential benefits for the field of adolescent mental health. Author’s responding: Thank you for your valuable suggestion and revised accordingly. Details regarding the special nature of this topic and its potential benefits for adolescent mental health were added in Discussion. See the second paragraph of Introduction for details: “……Although experiencing same adversity, same people suffer from depression, while most do not suffer from depression but manifest certain resilience, which could be used to prevent and cure depression. Adolescents without depressive symptoms may possess different personal diathesis (such as resilience) [8] and demographic-social characteristics (e.g., higher socio-economical status) which protect them from depressed mood……” 2. Rationale of the study should be included The ecological system theory is mentioned as a framework, but there is little discussion on how this theory has been applied in previous research on adolescent depression. A theoretical framework could have been drawn as a support/guidance Elaborate on how ecological system theory informed the study design, variable selection, and the interpretation of findings. Author’s responding: Thank you for your inspiring suggestion and revised accordingly. The ecological system theory in adolescent depression and a theoretical framework were added in Introduction. And how ecological system theory informed the study design, variable selection, and the interpretation of findings, were further added in Introduction and Discussions. See the third and seventh paragraph of Introduction “Apart from the prevalence of adolescent depression, researchers also have been exploring risk and protective factors of adolescent depressive symptoms. Based on the ecological system theory [10], personal and environmental factors (family and school, et al.) contributed to mental health status together. Based on recent reviews, researchers have highlighted the integral role of ecological factors to the American National Institute of Mental Health Research Domain Criteria framework in predicting onset and maintenance of internalizing problems in youth [11]. Furthermore, the risk factors and protective factors of young people relating to the mental health outcomes of both direct and indirect exposure to climate change were reviewed through the lens of ecological system theory [12]. Thus, for adolescents, specifically, it could be hypothesized that individual, family, and school factors may predict the onset of their depression together (Fig 1). Considering the studies on adolescents without depressive symptoms are sparse, information about the factors contributing to non-depression in adolescents are even less, so we intended to explore psychosocial predictors (individual, family, and school factors) of persistent depression/non-depression in adolescents based on the theoretical framework of the ecological system theory [13], which is potentially important to figure out a way to better prevent adolescents from depression……Building upon the existing literatures about adolescent depression, although factors from individual, family, and school levels were indicated separately, however, most studies only focused on solely one domain of the ecological system, and most of them were cross-sectional design. Specifically, some variables under Chinese culture context (one-child policy, migrant population between provinces) [30] did not include in previous survey. Thus, their combined effect on longitudinal prediction of depression in Chinese adolescent remains unclear. Notably, predictors of adolescent non-depression from ecological system are unexplored.” and third and sixth paragraph of Discussions “Based on the ecological system theory, risk and protective factors of persistent non-depressive symptoms were examined from the individual, familial and school levels in our study. At the individual level……The results enrich the ecological system theory in adolescent depression and non-depression, i.e., individual, family and school protective and risk predictors contribute to adolescent depression and non-depression together. This knowledge helps to prevent depression and promote non-depression in youth” for details. 3. While the attrition rate of 15.7% is mentioned, there is no detailed analysis of the characteristics of participants who dropped out compared to those who remained. This could help understand if attrition biased the results. Include a comparison of demographic and baseline characteristics between completers and dropouts to assess potential attrition bias. Author’s responding: Thank you for your valuable suggestion and revised accordingly. A comparison of demographic and baseline characteristics between completer and dropouts were applied. See 2.1. Participants and Supplementary tables for details: “……Comparison between 243 dropouts and 1301 formal sample found no significant differences on demographic and baseline characteristics between them, which indicated that attrition did not bias the results ( S1 Table)……” S1 Table Comparison between dropouts and formal sample Drop-out (n = 243) Final sample (n = 1301) F/x2 Gender 2.438 Male 139 666 Female 104 621 Missing data 14 Siblings 3.074 One Child 79 499 Non-one child 164 799 Missing data 3 Migrant status 2.692 Migrant students 55 235 Local students 188 1060 Missing data 6 Positive Youth Development 0.509 Family intactness 1.444 Intactness 232 1222 Divorced parents 7 36 Non-Intactness 2 24 Others 2 8 Missing data 11 Per capita monthly income in family (RMB) 4.201 ＜1,000 3 27 1,000-1,999 21 81 2,000-2,999 25 135 3,000-3,999 41 169 4,000-4,999 24 121 5,000-5,999 33 127 ≥6,000 88 439 Missing data 8 202 Father’s Education Level 3.814 Middle school or lower 84 404 High school or college 101 451 Graduate 41 226 Above graduate 16 120 Minssing data 1 100 Mother’s Education Level 1.437 Middle school or lower 99 492 High school or college 90 427 Graduate 36 217 Above graduate 13 74 Missing data 5 91 4. The sample could have been drawn from schools of various socio-economical status to increase the generalizability of the results Author’s responding: Thank you for your valuable suggestion and revised accordingly. The socio-economical status of school were added in Methods and further discussed in Discussions. See 2.1. Participants: “……all of which belonged to medium socio-economical status……” and the third paragraph of Discussion for details: “……Moreover, all six schools belonged to medium socio-economical status. However, Table 1 suggested that students came from families with different socio-economical statuses, with approximate 40% per capita monthly income in family (RMB) ≥6,000 and approximate 10% < 2000, which could represent students from low, medium, and high socio-economical statuses of families. Future studies are encouraged to include school of various socio-economical statuses to guarantee broader generalization of the results……” 5. Seasonal effect on the depression (winter depression) could have been mentioned as it can act as a confounding factor. Author’s responding: Thank you for your important suggestion and revised accordingly. Seasonal effect on the depression was mentioned in the discussion. See the first paragraph of Discussion for details: “……Notably, seasonal affective disorder is a mood disorder that is characterized by depressive symptoms that occur at a specific time of year (typically fall or winter) with full remission at other times of year (typically spring or summer). The investigation time-points of this study were October to November during three successive years, which may be potentially influenced by the season change. Future study may choose other survey season to further verify the results.” 6. Address how potential confounding variables were accounted for in the analysis, ensuring that the observed effects are not due to unmeasured factors Author’s responding: Thank you for your important suggestion and revised accordingly. See the second paragraph of 2.4. Statistical analyses for details: “……In which, potential confounding variable were controlled at level 1 (baseline age, gender, whether have siblings, migrant status) and level 2 (baseline father’s and mother’s educational level, family intactness or not, monthly household income)……” 7. Clearly define each group with specific criteria and thresholds used for classification, ensuring that the reader can easily understand the distinctions such as mixed depression Author’s responding: Thank you for your important suggestion and revised accordingly. See 2.4. Statistical analyses for details: “According to the three-wave CES-D scores in our study, three groups were identified[30]: 1) Persistent depression symptom, in which adolescents were constantly classified as reporting symptoms (CES-D ≥16) from Wave 1 to 3; 2) Persistent non-depression, in which adolescents report no depression symptoms (CES-D <16) continuously from T1 to T3; 3) Mixed depression symptom, in which adolescents were classified as reporting symptoms (CES-D ≥16) once (i.e., mixed depression across 12 months) or no more than twice (i.e., mixed depression across 24 months) from Wave 1 to 3”. 8. Elaborate on the role of migrant status in the context of depressive symptoms, providing insights into why this might be a significant factor. Author’s responding: Thank you for your detailed suggestion and revised accordingly. See the third paragraph of Discussion for details: “……At the individual level, local student was expected to reduce persistent depression and increase persistent non-depression, since those local students may be more familiar and adaptive with local life and local people which might be a capital whe https://doi.org/10.1371/journal.pone.0308303.r002
22 Jul 2024 Decision Letter - Muddsar Hameed, Editor Trend and Predictive Psychosocial Factors of Persistent Depression/Non-depression in Chinese Adolescents: a Three-year Longitudinal Study PONE-D-24-21487R1 Dear Dr. Qin Dai , 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, Muddsar Hameed Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0308303.r003
Formally Accepted
21 Aug 2024 Acceptance Letter - Muddsar Hameed, Editor PONE-D-24-21487R1 PLOS ONE Dear Dr. Dai, 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 If revisions are needed, the production department will contact you directly to resolve them. If no revisions are needed, you will receive an email when the publication date has been set. At this time, we do not offer pre-publication proofs to authors during production of the accepted work. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few weeks 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. Muddsar Hameed Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0308303.r004

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