Conflicted Anger as a Central Dynamic in Depression in Adolescents—A Double Case Study

Round 1

Reviewer 1 Report

Authors adressed all my concerns. Paper is interesting and worth publishing in its present form.

Reviewer 2 Report

Dear researchers,
The incorporated changes seem appropriate to me and I accept the manuscript in its current form for publication.

This manuscript is a resubmission of an earlier submission. The following is a list of the peer review reports and author responses from that submission.

Round 1

Reviewer 1 Report

The main intention in this study was to illustrate a way to address parts of a case formulation by focusing a psychodynamic feature in two different therapies with a good outcome suffering from depression. The manuscript presents two representative patients from the FEST-IT with case formulations revealing conflicted anger. I advise its publication with some minor changes.

Introduction

This is an interesting topic of research, but it is necessary to expand the review of previous studies, and include more recent studies. In this manuscript, there are only 7 references from 2018 or later. There is no article from the year 2020 and only one from the year 2021. For example, it is important to update the reviews or meta-analysis about the efficacy and effectiveness of psychodynamic psychotherapy for children and young people.

The objectives of this study are not clear. No hypotheses are provided. It is necessary to describe more clearly the objectives of the study and indicate specific hypotheses in relation to the objectives.

I think it would be important to justify and argue more each of the variables and the relationship between them based on previous studies.

And also justify and argue the objective and the hypotheses in previous studies.

Materials and Methods

The research design is appropriate. The authors provide sufficient information about the sample and the instruments used to measure the variables included in this study. The method is adequately described. I suggest only some minor changes:

69 adolescents aged 16 - 18 years diagnosed with unipolar major depressive disorder (MDD) according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edi-tion (DSM-IV; American Psychiatric Association, 2000). Why is the DSM-5 not used?

Results

Results are clearly described, and tables and figure are adequately presented.

Discussion

The conclusions are supported by the results. However, it should be reformulated when there is a clearer definition of the objectives and hypotheses of this study.

Conclusions

It would be interesting to include a paragraph to explain its usefulness in practical applications.

Reviewer 2 Report

Comments to Authors

This study aimed at the issue of conflicted anger as a central dynamic  in adolescents depression. Though youths depression is one of the most remarkable area of scientific research and implementation of new therapeutic techniques and paradigms, I think that the presented therapeutic approach here is a bit "niche". Of course, it doesn't mean it is not effective.

I do not agree with the statement that adolescents cannot fully process emotions and think abstractly as adolescence is a period of transition from concrete reasoning into abstract one. It is the case especially in older adolescents who can think hypotheticallly, understand ambiguity, complex underpinnings of emotions etc. I also do not agree fully with statement that adolescents live "here" and "now". How Authors could explain future plans including career, personal life and important life goals of young people? Formation of individual viewpoint  is one of the most important developmental tasks of adolescence. 

Table 1 - what does the number 13.5 refer to? (I mean personality diagnostics measured with SIDP-IV?) What does it mean that someone obtained 13.5? Besides, below the table the notes refer to some other variables, as the numbers reported do not appear in Table 1. Maybe it is a descritpion of a different table?

3.2. - This section should be described better

3.4. - This section, in my opinion, is unnecessary

Results

Descriptions of both Patients are unnecessary, it is better to present, step by step, how the results were analyzed.