Review Reports

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Please find my comments attached.

Comments for author File: Comments.pdf

Author Response

1. what should be the primary active component ( skills,or mindset) of the recommended training programs L22-24

Thank you for this observation. Our results suggest that the central active component of the intervention should be the enhancement of perceived self-efficacy (mindset), while coping strategies represent the behavioral mechanisms through which this construct is strengthened. We have clarified this point in the manuscript to specify that training programs should be primarily self-efficacy-focused rather than purely skills-based.

2. gender imbalance (87% women), how might this affect the generalizability L16

Thank you for this important observation. We agree that the strong gender imbalance in the sample may affect the external validity of the findings. We have expanded the limitations section to clarify that previous literature reports gender differences in coping strategies, perceived self-efficacy and vulnerability to emotional distress, and therefore the predictive relationships observed in this study may not operate in the same way in predominantly male professional populations. This clarification has been added to the Discussion (Limitations section).

3. how did you check the assumptions of multicollinearity, particularly among the eight primary or four secondary coping factors L136-143

Thank you for this relevant methodological observation. We have clarified the statistical procedure in the Design and Procedure section. Prior to the regression analyses, multicollinearity among coping variables was examined using Variance Inflation Factor (VIF) and tolerance statistics. All predictors showed acceptable values (VIF < 5; tolerance > .20), indicating the absence of problematic multicollinearity.

4. What specific recruitment strategies were used to

Thank you for this observation. We have clarified the recruitment procedure in the Design and Procedure section. Participants were recruited through Early Childhood Care centers and professional networks by contacting coordinators and professional associations via email. The questionnaire link was distributed through institutional mailing lists and internal communication channels, and participation was voluntary and anonymous. This information has now been added to the manuscript.

5. focus are on anxiety and depression, why was the DASS-21's Stress subscale included in the study.

Thank you for this observation. We have clarified the rationale in the Introduction. Stress was included because anxiety, depression and stress are conceptualized as components of a broader psychological distress continuum. In occupational contexts, chronic stress is considered a precursor and maintenance factor for anxiety and depressive symptoms. Therefore, the DASS-21 stress subscale was used to capture the activation component of emotional distress and to provide a more comprehensive understanding of professionals’ mental health.

6. How was data from the single open-ended question analyzed and integrated with the quantitative scale results, or was it omitted? This needs clarification.

Thank you for pointing this out. The open-ended question included in the Coping Strategies Inventory was not analyzed, as the study focused exclusively on standardized quantitative measures. We have clarified this in the Measures section to avoid confusion.

7. The p-value is reported as p < .00, should this be formatted as p < .001 for clarity. L87-88

Thank your for the comment. We have checked and corrected this point.

8. The text mentions "Cognitive Reappraisal" but the table header uses "Cognitive reassessment"; should the terminology be standardized throughout. L190

Thank your for the comment. We have checked and corrected this point.

 

9. You report the adjusted R² for the Stress model. It should be reported for the Depression and Anxiety models in the table or text. L 187-88

Thank you for your suggestion. We have included an extra paragraph to clarify this in the text

10. L 227-229- Could you specify how training in cognitive reappraisal and problem-solving should be practically delivered.

Thank you for this valuable suggestion. We have expanded the Discussion section to explicitly describe how training in cognitive reappraisal and problem-solving could be practically delivered, including examples of intervention formats, core components, and applied strategies relevant to early childhood care professionals.

11. recommended component of the proposed training programs. L232

Thank you for the clarification. In response, we have revised the Discussion section to explicitly specify the recommended core components of the proposed training programs. These components are now clearly outlined and distinguished from the delivery format, in order to improve the practical applicability of the findings.

12. sample limits generalizability, should the title or abstract more explicitly state the focus is primarily on female AIT?

 

Thank you for this comment. We agree that the predominance of female participants limits the generalizability of the findings. To address this, we have explicitly acknowledged this issue in the Abstract, clarifying that the results primarily reflect the experiences of women working in early childhood care, while retaining the original title

13. For your proposed longitudinal design, what would be the key outcome variables and practical intervals for measurement

Thank you for this comment. We have revised the Future Research section to further clarify the proposed longitudinal design, explicitly noting that intervention-based longitudinal studies could include an additional post-intervention assessment to examine short-term effects, followed by longer-term follow-up measurements

Reviewer 2 Report

Comments and Suggestions for Authors

Thank you for the opportunity to review this paper. I found the results interesting but found for close to half of the paper I was very puzzled and unclear about who the participants of the study were. 

I have attached a PDF of the paper so that you can see where I finally realised what this research was about - to indicate how important it is for you to add in a very clear and explicit description of the participant context that they were working in at the beginning of the paper in order to clearly set the scene and explain the context.

I think some literature to focus on the context here would be early intervention professionals as they often work across some of the professions outlined in Table 1. 

I think making some significant changes to the introduction will really support the reader to understand the context and be clear about the participant cohort.

Otherwise, I have included all other related queries in the PDF.

I wish you well in reorganising the paper.

Comments for author File: Comments.pdf

Author Response

Thank you for your thorough work and your constructive suggestions on our manuscript. Below, we address each issue raised by you, considering all the comments. As you will see in the following section, we have been able to comply with all your comments and our response is detailed separately for each of your remarks. In the revised manuscript, you will find the modified text in blue. We believe that the modifications we made based upon your suggestions have improved the manuscript.

1. I suggest you use alternative terms here than are used in the title and abstract in order to facilitate more searchability for your paper.

Thank you for addressing this. We have revised the keywords to improve the visibility and searchability of the manuscript. It seems now: “Early intervention professionals; occupational mental health; emotion regulation; per-ceived self-efficacy; psychological distress”.

2. Introduction, line 33.

Thank you very much for the suggestion. We have restructured the sentence to improve clarity. It now reads as follows: “Although mental disorder affects approximately one in eight people worldwide, most commonly depression or anxiety, less than 2% of state budgets are allocated to mental health, according to estimates from the Pan American Health Organization [2]”

3. Introduction, line 53-54.

We appreciate the comments. The paragraph has been revised to offer a more comprehensive contextualization of the issue, and now reads as follows: “In this context, Early Childhood Care (ECC) Centers take on special relevance in Spain, involving multidisciplinary teams who work with children aged 0-6 years with developmental disorders or at risk of developing them, and with their families [9-11]”

4. Introduction, page 2, paragraph 2

Thank you for your valuable observation. We have included a key reference to substantiate the limited availability of scientific evidence in the field of Early Childhood Care. This study conducted a systematic review examining the mental health of Early Childhood Care professionals in relation to resilience and risk factors, and reported the absence of studies addressing this specific research focus. This information has been added on page 2, lines 82-87: “Notably, research conducted by Gómez-Herrera [14] indicates that there are currently no scientific studies specifically addressing the mental health and resilience of Early Childhood Care professionals. Consequently, the following discussion draws on re-search conducted with healthcare professionals, as this represents the closest available evidence to inform understanding in the ECC context”.

Reference:

Gómez-Herrera, S; Robles-Bello, M.A.: Sánchez-Teruel, D. Mental Health Exploration and Variables Associated with Young Health Professionals in Early Childhood Care Centers: A Systematic Review. Healthcare 2025, 13, 2354

 

5. Introduction, page 2, paragraph 3

This point is addressed in detail in the previous response.

 

6. Introduction, page 2, line 98. I wonder about using the terminology early childhood healthcare professionals to make this clearer.

Indeed, thanks. We have modified the sentence and it now reads: “Therefore, the present study aims to determine whether coping strategies and self-efficacy are related to psychological distress in early childhood healthcare professionals”.

 

7. Discussion, line 223. Healthcare

Thank you for your observation. The sentence now reads as follows: “This could mean that in certain contexts, such as early childhood healthcare, expressing emotions without using re-evaluation techniques or social support is not adaptive”

Reviewer 3 Report

Comments and Suggestions for Authors

Dear authors,

Thank you for the opportunity to review the results of your study.
This study examines the relationship between coping strategies and self-efficacy with anxiety, depression, and stress in early childhood intervention specialists. It was conducted on a representative sample of 125 specialists using validated questionnaires. The statistical methods used were appropriate. The results are clearly described, with the necessary tables included.
However, a number of recommendations for improving the manuscript should be noted:
1. The introduction should more convincingly explain the limitations of scientific knowledge on this topic. Which aspects have been well-studied in this sample, and which have not. Currently, evidence is provided indicating that the topic is sufficiently well-studied; I would like to see a clearer understanding of the research's novelty.
2. The introduction should include the purpose and hypotheses of the study.
3. The description of statistical methods should be expanded, including the method used for the regression analysis (forward stepwise, backward stepwise, or other) and the reason for using this particular method. Specify why the Pearson test was used rather than the Spearman test for correlations (if not all data are normally distributed).
4. In the description of the results, why were the adjacent characteristics of coping strategies and self-efficacy not included in a single regression model? Why weren't separate models constructed? And why were all parameters included in the model rather than a stepwise method chosen to incorporate the most significant influences?
5. The discussion of the results should be supplemented with information on the hypotheses being tested.
6. The study limitations should more clearly indicate the sample limitation (predominantly women), and this imbalance should also be justified in the description of the sample.
7. The discussion of the results should also be strengthened specifically in relation to the specificity of early childhood intervention specialists, rather than helping professions in general.
8. A conclusion section with brief conclusions on the study is missing.
Therefore, the article requires revision.
Best wishes, reviewer

Author Response

Apologies, we hadn't seen this section. We have now included the conclusion in the article. Best regards.

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

1. provide references for -In healthcare professionals, chronic work-related 66
   stress frequently acts as a precursor and maintaining factor for anxiety and depressive 67
   symptoms.
2. needs to write-the Spanish adaptation ranged from 0.72 -0.94. [L157]
3. Provide references for L272-298.

Author Response

Thank you for your suggestion, we have already added two references for this line.
needs to write-the Spanish adaptation ranged from 0.72 -0.94. [L157]
Thank you for your comment, we have already corrected it.
Provide references for L272-298.
Thank you for your suggestion, we have added two references for this paragraph.

Reviewer 2 Report

Comments and Suggestions for Authors

Thank you for promptly working on the suggested adjustments and changes requested by myself and other reviewers. This appears to be a much stronger paper. I wish you well in finalising it and publishing the paper.

Author Response

Thank you very much for helping to improve the article. Best wishes.