Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

I would like to thank the editors and authors for the opportunity to review the article

“Descriptive Study on State and Trait Anxiety Levels in University Students and Their Potential Influencing Factors”

Please find attached the text with suggestions for improvement. The manuscript requires moderate revisions.

Kind regards

Comments for author File: Comments.pdf

Author Response

REVISOR 1

Comments and Suggestions for Authors

I would like to thank the editors and authors for the opportunity to review the article

“Descriptive Study on State and Trait Anxiety Levels in University Students and Their Potential Influencing Factors”

Please find attached the text with suggestions for improvement. The manuscript requires moderate revisions.

Kind regards

peer-review-49345024.v1.pdf

Reviewer

I would like to thank the editors and authors for the opportunity to review the article

"Descriptive Study on State and Trait Anxiety Levels in University Students and Their Potential lnfluencing Factors"

I will offer my suggestions for improvement:

AUTHORS' RESPONSE: We would like to sincerely thank Reviewer 1 for the time and effort dedicated to reviewing our manuscript and for the constructive suggestions provided. We greatly appreciate the valuable feedback, which has been very helpful in improving the quality and clarity of our work

Title/abstract

The title and abstract include the necessary information. The study design, specifically descriptive -cross-sectional, is clearly indicated, either directly in the title or abstract. The abstract gives an informative summary related to these sections (background, methods, results, and conclusions) in a single paragraph, without being separated by headings.

AUTHORS' RESPONSE: We would like to thank Reviewer 1 for the positive assessment of the title and abstract. We truly appreciate these encouraging comments, which strengthen our confidence in the clarity and presentation of the manuscript.

lntroduction

The article addresses the background and rationale for the investigation, providing an explanation of the scientific context. The specific objectives are also clearly stated, including any prespecified hypotheses. 1 recommend expanding on the following points or adding additional literature to further strengthen the argument:

Regarding the statement in lines 70-71, "Balancing al/ these aspects can become a complex task far students who lack the necessary tools," it would be of interest to examine whether there is an additional literature that further analyzes these tooIs and explores in greater depth the reasons why such students experience greater difficulties.

AUTHORS' RESPONSE: We greatly appreciate your suggestions and have carefully taken them into account. In response, we have incorporated additional literature that analyzes these tools and further explores the reasons why some students experience greater difficulties. The changes can be seen in lines 73–80 of the manuscript.

In lines 67-68, the statement regarding "Far this reason, promoting early detection, raising mental health awareness, and providing access to preventive strategies is crucial. Such strategies should address associated risk factors, including the development of adaptive stress management ski/Is and the strengthening of support networks. 11 could be elaborated further by discussing the impact such strategies may have on students' attendance and academic performance. This point could be further supported by relevant literature, and adding references that substantiate this conclusion would strengthen the argument.

AUTHORS' RESPONSE: Thank you very much for your helpful comments regarding lines 67–68. We appreciate your suggestion to further elaborate on the impact of early detection, mental health awareness, and access to preventive strategies on students’ attendance and academic performance. In response, we have expanded this discussion and included relevant literature to support these points. The changes can be seen in lines 103–113 of the manuscript.

In lines 92-93, it is noted that "In this context, the State-Trait Anxiety lnventory (STA)}, developed by Spielberger et al. (16), is one of the most widely used toolsfor assessing anxiety'” lt may be beneficia! to precede this statement with a paragraph that highlights the significance of anxiety in students' academic life and links this issue to the previous discussion on early detection and preventive strategies. This would provide a clearer and more coherent rationale for the subsequent introduction of the STAI.

AUTHORS' RESPONSE: Thank you very much for your helpful suggestion regarding lines 92–93. We agree that providing a brief paragraph highlighting the significance of anxiety in students’ academic life and linking it to the previous discussion on early detection and preventive strategies enhances the clarity and coherence of the manuscript. We have incorporated this introduction, which provides a smoother rationale for the subsequent mention of the STAI. The changes can be seen in lines 114–121 of the manuscript.

Materials and Methods

In the methods section, the descriptive statistics provided in the sample table (1) and in lines 166-172, would be more appropriately mentioned in the results section, as they pertain to the findings and not the methodological setup.

AUTHORS' RESPONSE: Thank you for your valuable comment regarding the placement of the descriptive statistics. We have moved Table 1 to the Results section as suggested (line 323). However, we still believe it is relevant to provide a brief, more general description of the sample in the Methods section to give readers context regarding the study participants.

In the Materials and Methods, it is preferable to focus on the key elements of the study design, such as the sample description, which is already mentioned in text. The design of the study should be clearly described, including the setting, which should cover the locations, relevant dates, periods of recruitment, and data collection. Additionally, it is important to discuss the expected response rote of the sample and provide information on how many of those who were sent emails ultimately responded. This would give further context to the sample's representativeness and the response rate, which are crucial far understanding the study's scope. This will enhance the clarity and understanding of the methodological framework. lf this infarmation is unable to be provided, it would be appropriate to mention it as a limitation of the study.

AUTHORS' RESPONSE: Thank you for your constructive comments regarding the Materials and Methods section. We have added the missing information on the study design. The changes can be seen in lines 197–201 of the manuscript.

In the methods section, the authors should clearly describe the statistical methodology used, including the application of Levene's test, Kolmogorov-Smirnov test, any parametric tests, regressions and Cronbach's alpha (as mentioned in lines 222-234 of the results section). These methods should be explained in detail, outlining the purpose of each test and the criteria used far interpretation, to ensure clarity and reproducibility of the analysis. Additionally, it would be helpful far the authors to mention which statistical software was used to perfarm the analyses.

AUTHORS' RESPONSE: Thank you for your valuable suggestion regarding the description of the statistical methodology. In response, we have added a new subsection in the Materials and Methods section, titled “3.5 Data Analysis,” where we detail the statistical procedures used. The purpose of each test and the criteria for interpretation are also provided. Additionally, the statistical software used for the analyses is mentioned. You can find these additions in lines 262–319 of the manuscript.

In the Assessment lnstruments section, it is important to mention the use of Cronbach's alpha to assess the interna! consistency of the seales used in the study.

AUTHORS' RESPONSE: Thank you for your comment regarding the Assessment Instruments section. We have added information about the use of Cronbach’s alpha to assess the internal consistency of the scales employed in the study in lines 232-233 of the manuscript.

Results

As mentioned earlier, the descriptions of the statistical methodology, including the application of Levene's test, Kolmogorov-Smirnov test, parametric tests, and Cronbach's alpha (lines 222-234), should be clearly stated in the Methods section. Additionally, it would be helpful far the authors to mention which statistical software was used to perfarm the analyses. This would further enhance the transparency and reproducibility of the study.

AUTHORS' RESPONSE: Thank you for your comment. As previously mentioned, the description of the statistical methodology has been addressed by adding the new subsection “3.5 Data Analysis” in the Methods section. Additionally, the statistical software used for the analyses is specified at the beginning of this subsection, specifically in line 265 of the manuscript.

lt would be helpful far the authors far hypothesis 1 to clarify the use of the term "percentile seores" in this section. Given that M and SD are reported (M = 70.97, SD = 28.4 and M = 73.70, SD = 25.08), these appear to be mean seores rather than actual percentile ranks. lf the intention is to refer to percentiles, it would be important to explain how these were calculated (e.g., by comparison with normative data) and to indicate the corresponding percentile values. This clarification would improve the precision and interpretability of the results.

AUTHORS' RESPONSE: Thank you for your observation. We agree that the use of the term “percentile scores” was not sufficiently clear. We appreciate your feedback, and in response, we have added a paragraph in lines 273–280 clarifying that percentiles were used and explaining how they were obtained.

a) Since far hypothesis 2, 3 and 4, the comparisons were made between distinct groups (e.g., gender, faculties) it would add clarity to specify that an independent samples t-test was used.

AUTHORS' RESPONSE: Thank you for your comment. We have clarified that an independent samples t-test was used for the comparisons in hypotheses 2, 3, and 4. The corresponding updates can be seen in lines 347, 352, 369–370, and 384 of the manuscript.

10.b) far the regression analysis, briefly noting the type of regression (e.g., simple or multiple linear regression) and including a table with key statistics (e.g., ANOVA table, coefficients table, R² and adjusted R²) would make the results section more transparent, and if it is not possible to include them in the text, they could be provided as supplementary material.

AUTHORS' RESPONSE: Thank you for your helpful suggestion regarding the regression analyses. In response, we have added Tables 2, 3, 4, 6, and 7, as recommended, corresponding to lines 357, 376, 391, 414, and 430 of the manuscript. Additionally, we realized that the regression analysis for the last hypothesis, although conducted as part of the study, had not been described in the manuscript. This analysis has now been included and is detailed in lines 423–429.

10.c) make clear which confaunders were adjusted far and the rationale far their inclusion (e.g., age) and lf no such adjustments were made or reported, this could be acknowledged as a limitation of the study.

AUTHORS' RESPONSE: Thank you for your comment. These adjustments were not previously considered in the analysis, and we have now acknowledged this as a limitation of the study. This has been added in lines 559–563 of the manuscript.

Dicussion/ limitations/conclusions

While the findings are presented and discussed with the existing bibliography, they should also be supported by references from sources accessible in English to ensure wider accessibility and verification.

AUTHORS' RESPONSE Thank you for your suggestion. We have added new references from sources accessible in English to support the discussion and ensure wider accessibility and verification (references 40 and 41).

Sorne points could be further explored. In the Discussion section, you mention that state and trait anxiety levels were "measured using percentile seores," (lines 332-333), but in the results section you report mean seores and standard deviations. lfyou did calculate percentiles to compare with normative benchmarks, please make the results and discussion sections more consistent.

AUTHORS' RESPONSE: Thank you for your comment. We believe that, with the inclusion of the paragraph explaining the calculation and use of percentiles in the study (lines 273–280), there is consistency between the Results and Discussion sections regarding the reporting of state and trait anxiety levels.

Regarding lines 362-364 "Traditional gender stereotypes-where women externalize emotions and men suppress them-may be eroding in more egalitarian, mental health conscious environments, this statement could benefit from further elaboration. In particular, it would be helpful to explain in more detail how it relates specifically to anxiety in the university context, supported by relevant literature to substantiate the connection.

AUTHORS' RESPONSE: Thank you for your suggestion. We have added a paragraph developing the ideas proposed in your comment. These additions can be seen in lines 483–494 of the manuscript.

References

I would suggest reviewing and enriching the bibliography to include relevant and accessible sources that can support and clarify this research. There is sorne difficulty in reviewing certain parts of the bibliography due to references being in Spanish, which limits accessibility. For example, in rows 30-31, reference 3 (Beck, A.T.; Clark, O.A. Ansiedad: Una Condición Común Pero Multifacética; 2012; ISBN 9788433025371} is not easily accessible. A similar issue appears in rows 40-41 for reference 6 (Sánchez Hernández, N.A.; Morales Ramírez, D.; Hernández Martínez, V.Hugo. Estrés, Ansiedad y Depresión En Adultos Jóvenes y Su Relación Con Estado Nutricional. Archivos en Medicina Familiar 2023, 25, 221-226). Comparable difficulties are also observed when following the discussion and conclusion session such as in lines 453-455, for references 49-50, as sorne supporting literature is not readily available in English.

lt would be beneficia! to update the bibliography with additional references that are indexed also in databases such as PubMed, Scopus or Web of Science (Clarivate) and/or are available in English, to ensure broader accessibility and verification.

AUTHORS' RESPONSE: Thank you for your valuable suggestion. We have added new references throughout the manuscript, which are indicated in red in the bibliography. Additionally, for selected references : 3,6,49 (now 57) and 50 (now 58), we have included links to facilitate the access.

The manuscript requires moderate revisions. Thank you.

Kind regards.

Reviewer 2 Report

Comments and Suggestions for Authors

This is a review of the manuscript, “Descriptive Study on State and Trait Anxiety Levels in University Students and Their Potential Influencing Factors.” I complete research with mental wellbeing in graduate students; therefore, this study is of particular interest to me.

Collectively, the manuscript is well-written with strong scholarly support. There are few suggestions in moving this paper forward. Please see below.

Consider using subheads throughout the paper. Only first-level headers are currently used. The paper is well written, but these will greatly assist the read as they work through the paper and move between the sections.

Consider including a theoretical or conceptual framework in the introduction. The background on anxiety is thorough and clear; however, relating these psychological components to framework that focuses on university students will add to the scholarly value of the study.

Be careful in using quotation marks as emphasis; italics is preferable to quotes if the statement is not actually quoting another source. Review the results section where the hypotheses are restated and the disciplines are listed.

Author Response

REVISOR 2

Comments and Suggestions for Authors

Collectively, the manuscript is well-written with strong scholarly support. There are few suggestions in moving this paper forward. Please see below.

AUTHORS' RESPONSE: We sincerely thank Reviewer 2 for the careful review of our manuscript and for the encouraging remarks regarding the relevance and quality of our work. We are grateful for the constructive feedback, which has been very valuable in further improving the manuscript.

AUTHORS' RESPONSE: We sincerely thank you for this valuable suggestion. Following your recommendation, we have created subheadings throughout the theoretical framework section, which we believe will significantly improve the clarity and ease of navigation for readers.

Introduction
Theoretical framework

2.1 Vulnerability of University Students

2.2 Prevalence of Anxiety in University

2.3 Preventive Strategies and Protective Factors

2.4 Assessment of Anxiety: State vs. Trait Anxiety

2.5 Objectives

2.6 Hypotheses

AUTHORS' RESPONSE Thank you for your insightful suggestion. We believe this is an excellent proposal, and in response, we have divided the initial part of the manuscript into an Introduction and a Theoretical Framework, incorporating the relevant aspects of our study (lines 73-80 and 103-121).

AUTHORS' RESPONSE: Thank you very much for your feedback. We have taken your advice into consideration and have removed those quotation marks that were excessive, particularly in the Results section. We appreciate your suggestion and agree that italics provide a clearer emphasis when the statements are not direct quotes from other sources.

Review Reports

REVISOR 1

Reviewer

Title/abstract

lntroduction

Materials and Methods

Results

Dicussion/ limitations/conclusions

References

REVISOR 2