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Article
Peer-Review Record

Nomophobia and Its Association with Depression, Anxiety and Stress (DASS Scale), among Young Adults in Greece

Eur. J. Investig. Health Psychol. Educ. 2023, 13(12), 2765-2778; https://doi.org/10.3390/ejihpe13120191
by Charalambos Gnardellis 1,*, Elissavet Vagka 2, Areti Lagiou 2 and Venetia Notara 2
Reviewer 1: Anonymous
Reviewer 2:
Reviewer 4: Anonymous
Eur. J. Investig. Health Psychol. Educ. 2023, 13(12), 2765-2778; https://doi.org/10.3390/ejihpe13120191
Submission received: 6 October 2023 / Revised: 21 November 2023 / Accepted: 24 November 2023 / Published: 26 November 2023

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

I have thoroughly reviewed the paper titled "Nomophobia and Its Association with Depression, Anxiety, and Stress (DASS Scale) among Young Adults in Greece." The paper is written concisely and accurately. It is simple and easy to read. My section-wise comments are provided below:

Abstract: Well-structured.

Introduction: The authors have done a good job with the introduction. The problem is well presented, and there are good references included in this section.

Aim of the Study: The aim of the study is well defined.

Materials and Methods: The study is based on three good questionnaires, with a clear and sound methodology. The use of a good sample is also significant.

Results: The results are well presented. The tables are a bit confusing and extensive. If the authors can modify them to make them simpler to follow.

Discussion: Excellent work. The discussion covers the entire topic at an admirable level. The limitations of the study do not need a separate section; just leave them as the last paragraph in the discussion.

Conclusion: The first and third sentences are redundant. Stick to the stated objective and provide a clear conclusion based on it.

Author Response

Reviewer 1

Comments: I have thoroughly reviewed the paper titled "Nomophobia and Its Association with Depression, Anxiety, and Stress (DASS Scale) among Young Adults in Greece." The paper is written concisely and accurately. It is simple and easy to read. My section-wise comments are provided below:

 
Abstract: Well-structured.

Introduction: The authors have done a good job with the introduction. The problem is well presented, and there are good references included in this section.

Aim of the Study: The aim of the study is well defined.

Materials and Methods: The study is based on three good questionnaires, with a clear and sound methodology. The use of a good sample is also significant.

Reply: We thank the reviewer for the valuable comments.

Comments: Results: The results are well presented. The tables are a bit confusing and extensive. If the authors can modify them to make them simpler to follow.

Reply: The tables were created so as to present a large amount of data into a concise format. They might be extensive, but it was the most appropriate way to present the data in a single table instead of 2 or 3 different tables.

Comments: Discussion: Excellent work. The discussion covers the entire topic at an admirable level. The limitations of the study do not need a separate section; just leave them as the last paragraph in the discussion.

Reply: The change was made as requested.

Comments: Conclusion: The first and third sentences are redundant. Stick to the stated objective and provide a clear conclusion based on it.

Reply: The change was made as requested.

Reviewer 2 Report

Comments and Suggestions for Authors

Dear Authors,

Thank you for the opportunity to review the article entitled: 'Nomophobia and its association with depression, anxiety and stress (DASS Scale), among young adults in Greece'. The aim of this study was to analyse the associations of nomophobia and negative emotional states and relate them to, among other things, self-esteem among Greek respondents.

The strengths of the manuscript presented for review are the research sample (just under 1,500 people), the statistical analyses used and the literature cited.

The reviewer's job, on the other hand, is to help improve the article so that it meets the highest possible standards of the journal, therefore I will focus on its weaknesses:

 

General comments:

[1].  The sentence from lines 190 and 191 should be combined.

[2].  Statistical test designations should be in italics: "r", etc.

[3].  The title of Table 4 should be re-formatted according to the journal guidelines.

[4].  The analysis of the results lacks the use of a test for significance of differences (e.g. t-student) - the authors in the discussion, for example, compare the results obtained against the gender of the subjects.

 

Introduction:

[5].  Missing full stop at end of sentence from lines 33-35.

[6].  No research questions or hypotheses formulated.

 

Materials and Methods:

[7].  Section 2.1. 'Participants and procedure' should be split into two separate sections - the first '2.1. Procedure' (containing what is currently in section 2.1.) and the second '2.2. Participants', which will characterise the subjects in terms of sociodemographic variables.

[8].  In line 104, four parts of the survey are mentioned, while in lines 105-110, five parts are mentioned.

[9].  Were the Cronbach's α coefficients obtained in the current study for the individual scales counted? If so, please provide these values next to the individual scale descriptions.

 

Results:

[10].        Sociodemographic characteristics from lines 207-217 should only be presented in the 'Participants' section.

[11].        The analysis of the results should start by presenting the characteristics of the pattern of smartphone use among the respondents and the results of the different scales (NMP-Q, DASS-21, RSES), followed by correlation analysis and other statistical analyses.

Author Response

Reviewer 2

Comment: Dear Authors,

Thank you for the opportunity to review the article entitled: 'Nomophobia and its association with depression, anxiety and stress (DASS Scale), among young adults in Greece'. The aim of this study was to analyse the associations of nomophobia and negative emotional states and relate them to, among other things, self-esteem among Greek respondents. The strengths of the manuscript presented for review are the research sample (just under 1,500 people), the statistical analyses used and the literature cited.

Reply: We would like to thank the reviewer for the valuable comments so as to improve the presentation of our findings.

Comment: General: The sentence from lines 190 and 191 should be combined.

Reply: The change was made as requested (pls see pg 4 line 195 - 196).

Comment: General:  Statistical test designations should be in italics: "r", etc.

Reply: All the changes were made as requested.

Comment: General: The title of Table 4 should be re-formatted according to the journal guidelines

 Reply: The title of Table 4 is according to the journal guidelines.

Comment: General:  The analysis of the results lacks the use of a test for significance of differences (e.g. t-student) - the authors in the discussion, for example, compare the results obtained against the gender of the subjects.

Reply: All statistical tests used for testing differences are shown at tables’ footnotes and in the data analysis section. Especially for testing the differences between the two sexes regarding the components of DASS (depression, anxiety, stress) the χ2 test for linear trend was used (the test, also known as the Cochran-Armitage test for trend, is appropriate for testing association between a nominal variable with two levels and an ordinal variable). In Table 2 which does not state the test used for inferential evaluation of the correlation coefficients, a footnote has been added (that this is the t-test). In all other tables the relevant tests are mentioned.

Comment: Introduction: Missing full stop at end of sentence from lines 33-35.

Reply: The change was made as requested (pls see pg 1 line 35).

Comment: Introduction: No research questions or hypotheses formulated.

Reply: Hypotheses were added in the revised manuscript as requested (pls see introduction section pg 2 lines 82-87).

Comment: Materials and Methods: Section 2.1. 'Participants and procedure' should be split into two separate sections - the first '2.1. Procedure' (containing what is currently in section 2.1.) and the second '2.2. Participants', which will characterise the subjects in terms of sociodemographic variables.

Reply: The change was made as requested (pls see pg 3 lines 103-110).

Comment: Materials and Methods: In line 104, four parts of the survey are mentioned, while in lines 105-110, five parts are mentioned.

Reply: The change was made as requested (pls see pg 3 line 112).

Comment: Materials and Methods: Were the Cronbach's α coefficients obtained in the current study for the individual scales counted? If so, please provide these values next to the individual scale descriptions.

Reply: The individual scales have already validated in the Greek context and the Cronbach's α coefficients in the study are provided in section 2.3. Measures (lines 136 -138, 166 -170 & 182 -184).

Comment: Results: Sociodemographic characteristics from lines 207-217 should only be presented in the 'Participants' section.

Reply: According to the STROBE statement the participants’ characteristics derive from statistical analysis, such as descriptive statistics, are presented in the results section. General sociodemographic characteristics are presented in the “Participants section”

Comment: Results: The analysis of the results should start by presenting the characteristics of the pattern of smartphone use among the respondents and the results of the different scales (NMP-Q, DASS-21, RSES), followed by correlation analysis and other statistical analyses.

Reply: The results are presented according to the aim of the study. The main aim was to examine the association between nomophobia and negative emotional states, specifically depression, anxiety, stress, in relation to self-esteem and sociodemographic data, among young Greek adults. Therefore, the analyses followed a structured method to depict gradually the results, i.e. starting from sociodemographic characteristics and further exploring more specific pathways.

Reviewer 3 Report

Comments and Suggestions for Authors

I propose to indicate in the title and content of the article that this study is a pilot study.

There is too much difference between the respondents in terms of gender, which raises methodological doubts and affects the conclusions.

I propose to describe only a group of men.


1. The main question that the researchers asked themselves was the in intensity of nomophobia in the group of students and the search for relationships with anxiety, depression and stress. 2.The topic is socially important, especially among children and adolescenta. 4.The authors examined too small a group of women compared to men, hence I propose to investigate a group of women. Furthermore, I propose that only men's results be presented as results from pilot studies. 5.The conclusions cannot be considered valuable and representative for the studied group of students due to the extremely unequal size of the groups. 6.References are appropriate.

Comments on the Quality of English Language

I suggest that the content of the article be read by a native speaker.

Author Response

Reviewer 3

Comments: The main question that the researchers asked themselves was the in intensity of nomophobia in the group of students and the search for relationships with anxiety, depression and stress. The topic is socially important, especially among children and adolescenta. References are appropriate.

 Reply: We thank the reviewer for the valuable comments.

Comment: General: I propose to indicate in the title and content of the article that this study is a pilot study. There is too much difference between the respondents in terms of gender, which raises methodological doubts and affects the conclusions. I propose to describe only a group of men.

Reply: The article concerns a special study (and not the pilot one) of a wider series of articles that have already been published and refer to the emerging phenomenon of nomophobia in Greece (citations 26,27,29,38). The validity study for all of these articles, which is also, in a way, a pilot evaluation of the research data on nomophobia in Greece, is the citation 29 of the present paper. The interim papers (26,27,38) up to the present have been published with the same sample. So, this study, in fact, cannot be characterized as a pilot.

Comment: The authors examined too small a group of women compared to men, hence I propose to investigate a group of women. Furthermore, I propose that only men's results be presented as results from pilot studies.

Reply: Regarding the comment about the under-representation of women in our sample, as it can be seen at Table 1 the actual ratio of the two sexes in the study is apparent: 1009 women and 399 men. So, a matter of under-representation of women does not exist de facto. Furthermore, a sample of approximately 400 (399) individuals which is the size of the subset of men in our sample does not raise issues of under-representation of them either. A sample of 400 observations is more than sufficient for any parametric statistical analysis and for any required power of observed differences, according to sampling theory. Moreover, our study does not focus on the issue of gender differences but on the phenomenon of nomophobia in the general population of young adults in Greece. Therefore, the Type I error probabilities derived for the study's statistical analyses apply to the entire sample, which is extremely large for empirical research data, approximately 1400 cases (1408 to be exact).

Comment: The conclusions cannot be considered valuable and representative for the studied group of students due to the extremely unequal size of the groups.

Reply: the authors are aware of the limitations regarding the generalization of the results of our study, which, however, concern mainly its epidemiological organization (it is a cross-sectional study) and the causal interpretation of its results. We highlight all these limitations in detail in the discussion and conclusion of our article.

Comment: I suggest that the content of the article be read by a native speaker.

Reply: We thank the reviewer for the above comment. The manuscript was checked from an external independent consultant and the comments were incorporated in the revised manuscript. 

Reviewer 4 Report

Comments and Suggestions for Authors

Dear authors, congratulations on the work you have presented. It is very interesting and studies the specific case of the Greek population. I just have to comment on some aspects that could be improved.

- In the introduction or for the discussion you can echo studies such as https://lc.cx/JZLYi8; http://dx.doi.org/10.3390/ijerph17124336; https://doi.org/10.22122%2Fahj.v13i2.309, https://doi.org/10.1016/j.heliyon.2023.e15464 and https://doi.org/10.3390/ijerph17020580

- In the method you should refer to the software you have used for the statistical calculations.

- The tables need to be revised because the data appear shifted.

- The discussion can be improved with some of the bibliography that has been recommended in previous points.

- The conclusions are somewhat brief and should be completed by incorporating the theoretical implications of the study, as well as the practical ones.

Author Response

Reviewer 4

Comments: Dear authors, congratulations on the work you have presented. It is very interesting and studies the specific case of the Greek population. I just have to comment on some aspects that could be improved.

Reply: We thank the reviewer for your useful comments.

Comments: In the introduction or for the discussion you can echo studies such as https://lc.cx/JZLYi8;

http://dx.doi.org/10.3390/ijerph17124336;

https://doi.org/10.22122%2Fahj.v13i2.309,

https://doi.org/10.1016/j.heliyon.2023.e15464 and

https://doi.org/10.3390/ijerph17020580

 

Reply: Apart from the first reference which is written in Spanish, the rest references have been added in the revised manuscript as requested.

Comments: In the method you should refer to the software you have used for the statistical calculations.

Reply: The data analysis has been done using SPSS version 28 statistical software (IBM SPSS, Armonk, NY, USA) and you can see it in the sub-section 2.4. Data analysis and Statistical Methods (pls see pg 5 line 208-210).

Comments: The tables need to be revised because the data appear shifted.

Reply: The change was made as requested.

Comments: The discussion can be improved with some of the bibliography that has been recommended in previous points.

Reply: All recommended references have been added in the discussion section (pls see pg 8 lines 294 & 297; pg 9 lines 302 & 328 and also in the references section).

Comments: The conclusions are somewhat brief and should be completed by incorporating the theoretical implications of the study, as well as the practical ones.

Reply: The change was made as requested (pls see pg 10 line 393-404).

Round 2

Reviewer 2 Report

Comments and Suggestions for Authors

I appreciate the authors' efforts to improve the manuscript. However:

1)     The formatting of the text should be standardised.

2)     The DASS-21 scale does not have an total score. Hence, quoting Cronbach's α coefficient for it does not make sense.

3)     No listed 'limitations' section.

Author Response

Reviewer 2 – R2

Comment: I appreciate the authors' efforts to improve the manuscript.

Reply: We would like to thank the reviewer for the valuable comments so as to improve the presentation of our findings.

Comment: The formatting of the text should be standardised.

Reply: The text has been standarised in the revised manuscript, as proposed.

Comment: The DASS-21 scale does not have an total score. Hence, quoting Cronbach's α coefficient for it does not make sense.

Reply: The certain phrase of the DASS-21 scale total score was deleted in the revised manuscript, as proposed.

Comment: No listed 'limitations' section

Reply: The limitations section was listed in the revised manuscript, as requested.

Reviewer 3 Report

Comments and Suggestions for Authors

After reading the authors' responses and the corrections made to the article, I accept the article. I recommend it for printing.

Author Response

We would like to thank the reviewer for the valuable comments.

Reviewer 4 Report

Comments and Suggestions for Authors

Dear authors, thank you very much for your replies. The article has improved enough to be published.

Best regards

Author Response

We would like to thank the reviewer for the valuable comments.

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