Trauma Chronicity and the Long-Term Needs of Childhood Sexual Trauma Survivors
Round 1
Reviewer 1 Report
A very important topic and a thoughtful study with a well-distinguished structure of the specific sections.
Neither in the abstract nor in the description of methods does the year of the study appear. In the tables there is always an annotation National Sexual Health Survey, 1996. This means publication of results from 28 years ago. However, the reasons for publishing such historical data were explained in the introduction (part 1.4) and mentioned again.in the limitations section. Reaching back to old research and comparing it with new studies should be indicated as one of the goals and the year of data collection should be provided in the abstract.
My next main concern is the imprecise definition of the prevalence of childhood sexual trauma (CST).
I suggest:
- provide this information in the abstract
- not provide contradictory information; in line 150 there is 8.9% and further 8.1% (and 8.9% is the upper limit of CI) in line 195.
The lack of a clearly stated purpose of the paper is also objectionable. Subsection title 1.5 could be changed from summary to purpose of the study. The main areas of analysis should be better bulleted.
I also suggest dividing Table 2 into two, separately presenting duration by demographic characteristics. The section on the prevalence of CST would be better reported in the first columns after the sample characteristics. For duration, percentages in the columns do not seem to be the most appropriate (structure not prevalence?). Duration data are provided in the text, but from the tables one has to calculate them oneself.
Other minor comments, including editing:
- please explain the abbreviation AAO's also in the abstract
- line 128 is cooperation rate equal to response rate
- in Table 2, the row TOTAL and the subtitle gender could be added at the top
- the scope of the collected information seems to be very extensive as for a phone survey; is it possible to provide the average length of the interview
- Authors should improve the layout of tables according to MDPI rules (e.g., no vertical lines, headings inside tables in bold)
- the notation of references does not comply with the MDPI guidelines, titles of papers are in quotation marks, year of publication of articles is not bolded.
Author Response
Responses to reviewer 1's comments are described in red text following each comment below.
Neither in the abstract nor in the description of methods does the year of the study appear. In the tables there is always an annotation National Sexual Health Survey, 1996. This means publication of results from 28 years ago. However, the reasons for publishing such historical data were explained in the introduction (part 1.4) and mentioned again.in the limitations section. Reaching back to old research and comparing it with new studies should be indicated as one of the goals and the year of data collection should be provided in the abstract.
We have added the study year to the abstract (line 12) and Methods section (line 33). We also added a sentence to the Study Purpose section (1.5, previously labeled Summary; lines 128-130) regarding the comparison of NSHS estimates to more recent studies.
My next main concern is the imprecise definition of the prevalence of childhood sexual trauma (CST). I suggest:
- provide this information in the abstract.
We have added a sentence reporting the weighted CST prevalence estimate (8.1%) to the abstract (line 16).
- not provide contradictory information; in line 150 there is 8.9% and further 8.1% (and 8.9% is the upper limit of CI) in line 195.
We appreciate the reviewer’s attention to the discrepancy between the two reported estimates. The difference is due to applying design and post-stratification weights (see lines 190-191) to the estimate reported in the results section (line 203); the percentage reported in the methods section (line 157) is based on unweighted data. We have added a note in brackets to the estimate in the results section indicating that it’s based on weighted data (line 203).
The lack of a clearly stated purpose of the paper is also objectionable. Subsection title 1.5 could be changed from summary to purpose of the study.
We have revised the title of subsection 1.5 from Summary to Study Purpose (line 123).
I also suggest dividing Table 2 into two, separately presenting duration by demographic characteristics. The section on the prevalence of CST would be better reported in the first columns after the sample characteristics. For duration, percentages in the columns do not seem to be the most appropriate (structure not prevalence?). Duration data are provided in the text, but from the tables one has to calculate them oneself.
We appreciate this suggestion and we have split up Table 2 into two separate tables (now Tables 2 and 3). We have also revised the text accordingly to reflect the changes in table numbers. However, if the editor prefers to limit the number of tables we can revert this change to include the original Table 2.
Other minor comments, including editing:
- please explain the abbreviation AAO's also in the abstract
The AAO abbreviation is defined in the first line of the abstract (line 9 of the manuscript) as adverse adult outcomes.
- line 128 is cooperation rate equal to response rate
We thank the reviewer for this question. The cooperation rate we report is a version of the response rate that has been adjusted to account for partial interviews, non-contacts, and refusals. Detailed sample design information and calculations from the NSHS is publicly available along with the survey data from the University of California, San Francisco School of Medicine (reference 56; https://prevention.ucsf.edu/research-project/national-sexual-health-survey-nshs).
- in Table 2, the row TOTAL and the subtitle gender could be added at the top
We have added a row to Tables 2 & 3 (previously aggregated in Table 2) to label the gender data.
- the scope of the collected information seems to be very extensive as for a phone survey; is it possible to provide the average length of the interview
The average interview time in the NSHS was approximately 1 hour. We have added a note in the methods section (line 134) with this information.
- Authors should improve the layout of tables according to MDPI rules (e.g., no vertical lines, headings inside tables in bold)
We appreciate the reviewer’s attention to these formatting errors and have revised the table format according to MDPI guidelines.
- the notation of references does not comply with the MDPI guidelines, titles of papers are in quotation marks, year of publication of articles is not bolded.
We have revised the references to align with MDPI guidelines (ACS style).
Reviewer 2 Report
Thank you for producing this well-written and extremely important piece of work. I have a few minor editorial comments for you to consider (see attached file).
Comments for author File: 
Comments.pdf
Author Response
Responses to reviewer 2's comments are described in red text following each comment below.
Abstract (line 20): Longer and more chronic? Delete longer and say those with more chronic
We have deleted longer from this sentence (line 21).
Abstract (line 24): I suggest either deleting this sentence or embedding it in the previous sentence. In the previous sentence, you might list out the reasons why assessing chronicity is important.
Both in response to the Reviewer 2’s suggestion and to accommodate additions to the abstract suggested by Reviewer 1, we have deleted this sentence from the abstract.
Discussion (lines 351-352): Awkward, reword
We appreciate the reviewer’s suggestion and have made revisions to improve the readability of this sentence (lines 382-383).
References: Be consistent in capitalizing words in titles of articles. Sometimes you capitalize (e.g., 19, 21, 22), other times you do not
We have revised the references to be consistent with MDPI style and in terms of title capitalization.
References (#5): Edit – journal listed twice
We thank the reviewer for catching this error and have corrected this reference.
References (#25): Replace 11 with "
We have corrected this reference to include only the relevant information.
