Title: Adolescent girls’ explanations of high rates of low mood and anxiety in their population:
A co-produced qualitative study
Version: 0 Date: 14 Feb 2024
Reviewer's report:
Thank you for the opportunity to review this manuscript.  I found it to be a very well written and
to add some valuable insights to the existing literature on gender norms and girls’ mental health,
particularly in relation to academic pressure and the role of social media from the perspective
of girls themselves.
I have a few minor suggestions to add clarity to the description of the existing evidence base
and to strengthen the methodological contribution of the paper.
On. P3/4. It would be useful for the last paragraph to describe the kind (or quality) of the
emerging evidence that is being described. Are these cross-section surveys? Adequacy of
samples size? are they conducted in the UK? And what do you mean by ‘limited scope of
questioning’? - That measures are poorly developed? E.g. Evidence also suggests that girls may
experience greater anxiety around specific educational pressures…what kind of evidence? Think
it would be useful just to clarify this and it may strengthen the argument for this work?
At the end of p.4 from 107 are these limitations discussed related to the qualitative studies
referenced in the preceding paragraph or do they also relate to what I assume are quantitative
studies described earlier?
Re methodology
I like the reflection on co-production in the supplementary materials and suspect this could
be extended in to a fuller reflexive piece drawing on both researcher and young researcher
experiences of co-production.  I did wonder though if it would be useful to mention how young
women contributed to the design of the study actually in the paper around line 129 (e.g. through
initial FGDs).  It was also unclear to me how young people for the initial FGD were recruited and
the two young researchers selected.  This would be helpful to understand their representatives
perhaps but might also be useful for other researchers considering similar work.  Similarly, any
training and support provided to the young researchers and how much time the contributed to
the project might be worth mentioning.
Re recruitment of participants at line 158 ‘Interested participants expressed interest’.  Could you
add in how participants expressed an interest? Was this directly to the member of staff at the
interested organisation?  Did the organisation also gather the demographic information?
Under ethics could you provide details of how far in advance of the FGD written information
and the video were provided to participants?
Line 386-388. Do you have another quote to reflect this point?  The quote seems to say that
discrimination from others affects low mood and bad mental health rather than individuals may
respond differently to the same issues or anything about varying/specific support needs?
In the discussion, you mention quantitative and qualitative evidence suggesting that educational
pressure and gendered educational discourses may have specific ramifications for girls.  I
wondered if you could elaborate on this to explain what gendered educational discourses (related
to STEM expectation of girls’ higher attainment overall?) and what ramifications to illustrate
how your own data resonate with these.
It seemed that the impact of Covid was raised little in your data and only quite generally not as
a substantive theme.  I wonder if you have an way of accounting for this given it is a prominent
factor in the existing literature, as you note in the introduction, and the public narrative about
current ‘crisis’ in adolescent mental health and the pressure schools and other services are
under to address this?  Maybe was because the focus was on girls rather than adolescents more
generally?