Post-Traumatic Stress Disorder and Blast Exposure in Active-Duty Military Service Members

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Major Suggestions

It would have been nice to have seen some discussion on the limitations to the study, such as the selective nature of the referrals to the service ie an element of screening.

A conclusion on where in the clinical pathway this could be applied, both in terms of a timeline for the 'injured' and by whom it can be or should be administered and interpreted.

Advice on future research or application in a prospective study.

 

These are only embelishments on an otherwise excellent and much needed piece of work.

Minor

Type setting in line 51 needs correcting.

Lines 211 and 212 I assume should read. Blast exposed only, PTSD only, Blast Exposed AND PTSD, and Neither.

Author Response

Thank you for your comments.  We provide both your comments and our responses.

Here are our responses-

Major Suggestions

It would have been nice to have seen some discussion on the limitations to the study, such as the selective nature of the referrals to the service ie an element of screening.

• Thank you for this comment. This has been addressed in the manuscript (see lines 675-692).

A conclusion on where in the clinical pathway this could be applied, both in terms of a timeline for the 'injured' and by whom it can be or should be administered and interpreted.

• This has been addressed in the manuscript (see line 696 to 700). Additional comments should help address the issue but the way that the volunteer data was obtained it is impossible to be highly granular.

Advice on future research or application in a prospective study.

• This has been addressed in the manuscript (see lines 671-692)

These are only embellishments on an otherwise excellent and much-needed piece of work.

• Thank you. We also believe that much work needs to be completed in this area.

Minor

Type setting in line 51 needs correcting.

• This has been corrected in the manuscript.

Lines 211 and 212 I assume should read. Blast exposed only, PTSD only, Blast Exposed AND PTSD, and Neither.

• This has been corrected in the manuscript.

Again thank you for your comments!

Reviewer 2 Report

Comments and Suggestions for Authors

There are frequent grammatic and general writing issues that make the text hard to follow for the first couple of paragraphs. This issue resolves after the first few paragraphs. I won’t list every example, since the issues are very frequent, but here are a couple of examples:

-          “military personnel was less likely to report intrusive memories” – was should be were

-          “differences such as hypervigilance and compulsive behaviors are predominant in military trauma” – meaning unclear

 

Citations missing:

-          “… , those deployed in the war reported higher physiological reactivity …” citation?

-          Measure section of the methods is missing a reference for the TSI

 

“A meta-analysis conducted by Fulton et al. (2015) reported that 20%–26% of individuals are returning from these wars with PTSD.” – this figure differs from the one given in the first introduction paragraph

 

“54.26% of true-negative PTSD cases” – the authors need to make it clear that this is not better than chance. Why would this have occurred?

 

Minor typographical errors:

“(Roberts et al., 2022). ,The TSI” remove comma

“… 2009).Therefore, the TSI has been” – space missing

“self-report limitation Several…” full stop missing

“item response theoryAs Loevinger” full stop missing

“, hence was not a goal of the current study” full stop missing

Comments on the Quality of English Language

See above

Author Response

Thank for the comments. Below are your comments with our responses with points below yours.

There are frequent grammatic and general writing issues that make the text hard to follow for the first couple of paragraphs. This issue resolves after the first few paragraphs. I won’t list every example, since the issues are very frequent, but here are a couple of examples:

• Thank you for this comment. The writing has been substantially revised. Please see the changes throughout the manuscript. We had three native English speakers re-review the manuscript independently. Then, we ran it through Microsoft Editor and then through Grammarly. We trust that we have captured the necessary concerns.
•  
• “military personnel was less likely to report intrusive memories” – was should be were

• This has been corrected
  
  

 “differences such as hypervigilance and compulsive behaviors are predominant in military trauma” – meaning unclear

• This has been corrected.

Citations missing:

“… , those deployed in the war reported higher physiological reactivity …” citation?

• Citation was added.
• The measure section of the methods is missing a reference for the TSI which now has a citation. We worked extensively to match the citations with the references and vice versa. We believe we have captured all the existing problems.

“A meta-analysis conducted by Fulton et al. (2015) reported that 20%–26% of individuals are returning from these wars with PTSD.” – this figure differs from the one given in the first introduction paragraph

• Thank you for highlighting this discrepancy. This is specific to veterans returning from Iraq and Afghanistan. This is noted in line 262, and there is discussion regarding differences in those returning from Vietnam relative to those returning from Iraq and Afghanistan. This has been clarified in the opening paragraph (see lines 34-35) and in lines 274-283.

“54.26% of true-negative PTSD cases” – the authors need to make it clear that this is not better than chance. Why would this have occurred?

• Thank you for this comment. This has been clarified in the manuscript (see lines 648 to 672).

Minor typographical errors:

“(Roberts et al., 2022).  The TSI” remove comma

• This has been corrected.

“… 2009).Therefore, the TSI has been” – space missing

• This has been corrected.

“self-report limitation Several…” full stop missing

• This has been corrected.

“item response theory Loevinger” full stop missing

• This has been corrected.

“, hence was not a goal of the current study” full stop missing

• This has been corrected.

Again, thank you for the careful review.

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

Nil

Reviewer 2 Report

Comments and Suggestions for Authors

No further comments