Autorreporte de Ansiedad en Niños y Adolescentes Chilenos no Consultantes: Análisis de sus Dimensiones / Anxiety self-report on non-consulting chilean children and adolescents: dimensional analysis

Los trastornos ansiosos en la población chilena infantojuvenil son de alta prevalencia y frecuentemente subdiagnosticados. Han existido variados intentos para crear instrumentos que ayuden a su tamizaje, dentro de estos el SCARED es uno de los más utilizados. Para la población hispanoamericana se adaptó este autoreporte de niños y adolescente (AANA) con características psicométricas adecuadas. El objetivo del presente trabajo es analizar la capacidad para discriminar entre Trastorno ansioso y sus distintas dimensiones (pánico/somático, ansiedad de separación, ansiedad generalizada, fobia social y fobia escolar) del AANA en población infantojuvenil chilena no consultante. Los resultados obtenidos mostraron que el instrumento estudiado es capaz de determinar un único constructo (ansiedad) y que los distintos ítems logran determinar las 5 dimensiones encontradas en el estudio original. De acuerdo a los resultados es posible concluir que el AANA es un instrumento adecuado para pesquisar trastornos ansiosos en la población infantojuvenil chilena estudiada. Palabras Claves: Trastornos ansiosos, ansiedad, infantojuvenil, AANA, Análisis factorial exploratorio.

Anxiety disorders in chilean children and adolescents are highly prevalent and often underdiagnosed. Various attempts have been made to design tools which contribute in the screening of these conditions, among these the SCARED is one of the most popular ones. An adaptation of this instrument has been developed for hispanic population, the AANA (anxiety self-report for children and adolescents), which has proven adequate psychometric characteristics. The aim of this article is to analyzethe AANA's discriminant capacity for anxiety disorders and its various dimensions (panic / somatic, separation anxiety, generalized anxiety, social phobia and school phobia) in Chilean non consulting children and adolescents. Our results showed that this instrument was able to determine a single construct (anxiety) and its items succeeded in identifying the 5 dimensions found in the original study. According to these results, we can conclude that the AANA is a suitable instrument for anxiety disorders screening in the chilean child and adolescent population studied. Key words: Anxiety disorders, self-reporting, SCARED, exploratory factor analisys,children and adolescents.

Intrathoracic impedance vs daily weight monitoring for predicting worsening heart failure events: results of the Fluid Accumulation Status Trial (FAST).

The relative sensitivity and unexplained detection rate of changes in intrathoracic impedance has not been compared with standard heart failure (HF) monitoring using daily weight changes. The Fluid Accumulation Status Trial (FAST) prospectively followed 156 HF patients with implanted cardioverter-defibrillator or cardiac resynchronization therapy defibrillator devices modified to record daily changes in intrathoracic impedance in a blinded fashion for 537±312 days. Daily impedance changes were used to calculate a fluid index that could be compared with a prespecified threshold. True positives were defined as adjudicated episodes of worsening HF occurring within 30 days of a fluid index above threshold or an acute weight gain. Unexplained detections were defined as threshold crossings or acute weight gains not associated with worsening HF. Impedance measurements were performed on >99% of follow-up days, compared with only 76% of days for weight measurements. Sixty-five HF events occurred during follow-up (0.32/patient-year). Forty HF events were detected by impedance but not weight, whereas 5 were detected by weight but not impedance. Sensitivity was greater (76% vs 23%; P<.0001) and unexplained detection rate was lower (1.9 vs 4.3/patient-year; P<.0001) for intrathoracic impedance monitoring at the threshold of 60Ω days compared with acute weight increases of 3 lbs in 1 day or 5 lbs in 3 days and also over a wide range of fluid index and weight thresholds. The sensitivity and unexplained detection rate of intrathoracic impedance monitoring was superior to that seen for acute weight changes. Intrathoracic impedance monitoring represents a useful adjunctive clinical tool for managing HF in patients with implanted devices.

Evaluación de validez de escala de ansiedad para niños y adolescentes en población chilena / Psychometric characteristic of the anxiety scale for children and adolescents in chilean population

Se realizó un estudio transversal- explicativo de las propiedades psicométricas y la validación estructural de estandarizar la Escala de Ansiedad en niños y adolescentes (SCARED) traducida y posteriormente validada en México, en población infanto-juvenil entre 8 y 15 años de edad (AAA). Se aplicó la escala a 128 niños escolarizados de ambos sexos entre los 7 y 17 años, consultantes a un centro privado de salud mental en Santiago, Chile. El plan de análisis consideró la evaluación de la consistencia interna (alfa de Cronbach), la capacidad discriminativa de cada ítem y la validez de constructo, usando el análisis factorial a partir de los componentes principales con rotación Varimax. Se determinó la adecuación del modelo factorial mediante el índice de Kaiser-Meyer-Olkin (KMO). Se consideró, además, que la distribución de frecuencia para las opciones de respuesta de cada ítem de la escala fuera homogénea.La escala queda finalmente conformada por 38 ítems, los cuales cumplen todos con el criterio de discriminación y homogeneidad. La consistencia interna de la escala obtenida fue 0.88. Con el análisis se formaron 6 factores que agrupan características clínicas. Conclusión: la escala de ansiedad AAA es un instrumento útil por ser breve y de fácil aplicación, permitiendo identificar síntomas de ansiedad en la muestra infanto-juvenil estudiada.

We perfomed a cross-sectional analytical study of psychometric characteristics and structural validation of the anxiety scale for children and adolescents (SCARED) translated and validated in Mexico, on a population of children and adolescents aged between eight to fifteen years old (AAA) .The scale was applied on 128 students, males and females, aged seven to seventeen years old, attending to a private center of mental care in Santiago, Chile. The plan of analysis considered to assess the internal consistency (Cronbach alpha), discriminative capacity of each item and the validation of construct using factorial analysis based on principal components with varimax rotation We evaluated the factorial model by means of Kaiser-Meyer-Olkin index (KMO). We also considered the homogeneity, frequency distribution of the answers of each item. The final scale was made up of 38 items that satisfied the discriminative and homogeneity criteria. Internal consistency for the total scale was high (Cronbach’s á = 0.88).The factorial analysis found 6 factors that explain 79.9 per cent of the total variability. Each factor is related to one specific clinical characteristic Coclusions: The anxiety scale for children and adolescents (AAA) would be a good instrument for measuring and identifying clinical characteristics of anxiety in children and adolescents.