Growth patterns of medical interviewing skills during a 6-year undergraduate curriculum are assessed by studying 563 medical students taken from five year-groups, interviewing simulated patients. In a cross-sectional, quasi-experimental design their skills are rated by means of the Maastricht History-taking and Advice Checklist (MAAS), an observation instrument which measures five categories of interviewing skills pertaining to initial medical consultations. The findings suggest that the skills for 'history-taking', 'presenting solutions' and 'structuring of the interview' are effectively learned. These learning effects result from a continuous small group teaching program with expert and peer review of videotaped encounters with simulated patients. The teaching effects of this program seem less for the skills pertinent to the phase of 'exploring the reasons for encounter' and to the 'basic interviewing skills', because the students' growing medical knowledge and the increasing ability to solve medical problems exert a counteracting influence on the acquisition of these easily deteriorating skills. The results might be helpful to curriculum planners in order to make their programs for medical interviewing skills more effective.

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Agoraphobia is related to demographic characteristics and social roles. To unravel behavioral aspects from demographic characteristics, daily life situations were registered with the Experience Sampling Method for 65 panic patients with and without agoraphobia. Surprisingly, panic patients with and without agoraphobia did not differ as hypothesized in reported frequencies of visits to public places. Panic subjects with agoraphobia did, however, spend significantly more time at home and with their families than did panic patients without agoraphobia and normal controls. When adjusted for demographic variables such as sex, marital status, family life, and employment, no significant differences between panic patients with and without agoraphobia emerged on the avoidance variables of remaining at home or being with a family member. The lack of discrimination of the diagnosis on these crucial behavioral variables highlights the influence of demographic characteristics and social roles on agoraphobia in daily life. Such findings challenge current diagnostic conceptualizations that rely on retrospective reports by patients of the avoidance of public places. Moreover, reliance on retrospective reports obscured the important role of significant others for understanding etiology and course.

Etats, syndromes et classes polythétiques: l'opérationalisation de l'analyse de classifications croisées dans la recherche dans les sciences du comportement. Par une analyse détaillée de la notion de classification et de la nomenclature de certains problèmes du comportement, les auteurs affinent les concepts de syndrome, de classe, de modèle et de type idéal, tout en précisant les relations étroites entre eux. La méthode de classifications croisées fournit un moyen d'opérationalisation de ces considérations. L'échantillonage d'expériences (ES), qui introduit des variables d'état mental et d'environnement immédiat, fournit un nouvel instrument de recherche. Ensemble ces développements constituent la méthodologie de recherche actuellement employée dans deux programmes importants de recherche sur le comportement: un sur l'anxiété, l'autre sur l'utilisation des drogues. La combinaison de ces deux techniques met en lumière des aspects nouveaux de la relation entre syndromes, analyse et modèles.