Factors Associated with Anxiety, Depression, and Stress Levels in High School Students

Round 1

Reviewer 1 Report

Overall this read well and presents on an important topic.

Line 26: Instead of writing “reduced the risk of depression.” instead have “is associated with a reduced risk of depression.” You even state on line 343 “does not allow for causal relationships.”

Line 72: replace “regularly” with “regular.”

Line 83: consider rewriting the first aim as “to investigate the relation between the levels of anxiety, depression, and stress with physical activity level …”

Line 105: replace “accept” with “accepted.”

Line 110: replace "Were” with “Anxiety, depression, and stress were …”

Line 156: replace "d of Cohen” with “Cohen’s d”

Line 189: “in favour of” is ambiguous; it sounds good. Instead say that “females scored higher on …” or similar.

Line 197: “concerning” might better be replaced with “relating”?

Line 208: Refer to the comments made for Line 83.

Lines 211 – 215. Consider making two sentences.

Line 219: Again, the expression “in favour of females” is ambiguous.

Line 220: see comment for Line 219.

Lines 225 – 229. Consider making two sentences.

Line 330: Instead of saying “their emotional health protected” refer to a “protective factor” like in Line 351.

Lines 254 – 258: Consider rewriting.

Line 293. “male” should be plural (“males”)

Line 294. “female” should be plural (“females”)

Line 300: “students be linked” should possibly be “students can be linked.”

Lines 329 – 323. Consider making two sentences.

Line 365: Instead of “There is an association between depression with physical activity level and academic” write “Depression is associated with physical activity level.”

Lines 367 – 370: State if the correlation is positive or negative.

 

 

 

Adequate. See above comments.

Author Response

In attached

Author Response File: Author Response.pdf

Reviewer 2 Report

The article corresponds to the special theme of the journal. The title of the article is appropriate to the content of the article.  The article has a strong emphasis on the importance of this type of research. In particular, in the introduction there are statistical data on depression specifically in Chile, and one of the inclusion criteria is that these are children from Chile, which makes this study particularly interesting. In general, the article "Factors Associated with Anxiety, Depression, and Stress Levels in High School Students", written by a group of authors, has been positively evaluated for publication. Firstly, the article is logically structured and contains all the expected components (limitations and future directions are listed). The methods used are in accordance with the standards and meet the stated ethical standards. The author's results are convincing and tabular data have been provided according to the objectives.

There are a few minor issues:

1. Did the authors take into account the use of medication that might have an effect on the emotional state of the students? 

2. and relevant psychological and emotional pathologies and diagnoses?

Author Response

In attached

Author Response File: Author Response.pdf

Reviewer 3 Report

This study investigated the relationship between anxiety, depression, stress levels, physical activity, and academic performance among high school students. The researchers assessed 443 students from the Maule region, Chile. They used the Depression, Anxiety, and Stress questionnaire (DASS-21) and the International Physical Activity Questionnaire (IPAQ) to gather data. Academic performance was evaluated based on language, mathematics, and overall grade point average. The findings revealed that engaging in vigorous physical activity and performing well in mathematics reduced the risk of depression. There was a notable negative correlation between physical activity and anxiety, depression, as well as stress levels. Similarly, mathematics performance was inversely correlated with depression. Additionally, significant gender differences were observed, with females showing higher levels of anxiety, depression, stress, and better grade point averages. In conclusion, the study suggests that active physical engagement and strong performance in mathematics can serve as protective factors against depression.

 

The study is interesting but there are several considerations to do:

 

- Correlational Nature: The study is cross-sectional and correlational in design, which means that causal relationships cannot be established. While the study identifies associations between variables, it cannot determine whether one variable causes changes in another.

- While several results are statistically significant, it's noticeable that the correlation coefficients (r values) are generally quite low. These low correlation coefficients indicate that the strength of the linear relationships between the variables is limited. In other words, the changes in one variable explain only a small portion of the variance in the other variable.

- Self-Report Bias: The data collected relies on self-report measures for anxiety, depression, stress, physical activity, and academic performance. Self-report measures are subject to bias and inaccuracies due to participants' subjective interpretations and social desirability effects.

- Gender Bias: The study reports significant gender differences in anxiety, depression, stress, physical activity levels, and academic performance. However, it does not deeply explore the underlying factors contributing to these differences, such as societal expectations, gender roles, or cultural influences.

- Limitation in Instrumentation: The Depression, Anxiety, and Stress questionnaire (DASS-21) and the International Physical Activity Questionnaire (IPAQ) are self-report tools that rely on participants' subjective recall. Objective measures of physical activity and clinical diagnoses of anxiety and depression could enhance the validity of the findings.

- Educational Context: The study focuses on academic performance within specific subjects (mathematics and language) and overall grade point average. It does not consider other factors that might influence academic performance, such as teaching quality, study habits, or individual learning differences.

- Potential Biases: The study mentions the protective role of physical activity against depression without exploring potential reverse causation (i.e., whether individuals with lower depression are more likely to engage in physical activity).

 

In conclusion, while the study contributes valuable insights into the relationships between anxiety, depression, stress, physical activity, and academic performance in high school students, its correlational design, sample characteristics, and limitations in variables considered emphasize the need for cautious interpretation and the potential for more comprehensive research in the field.

only needs some minor revision

Author Response

In attached

Author Response File: Author Response.pdf

Round 2

Reviewer 3 Report

seems ok