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Implicit and Self-Attributed Dependency

Needs in Dependent and Histrionic
Personality Disorders
Robert F. Bornstein
Published online: 10 Jun 2010.

To cite this article: Robert F. Bornstein (1998) Implicit and Self-Attributed Dependency Needs in
Dependent and Histrionic Personality Disorders, Journal of Personality Assessment, 71:1, 1-14

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 JOURNAL OF PERSONALITY ASSESSMENT,71(1),1-14
Copyright O 1998, Lawrence Erlbaum Associates, Inc.

Implicit and Self-Attributed

Dependency Needs in Dependent and
Histrionic Personality Disorders
Robert F. Bornstein
Department of Psychology
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Gettysburg College

Theorists speculatethat dependent personality disorder (DPD) and histrionic person-

ality disorder (HPD) are both associated with high levels of implicit (i.e., uncon-
scious) dependency needs but speculatethat only DPD is associated with high levels
of self-attributed (i.e., conscious) dependency needs. To test this hypothesis, 444 un-
dergraduates (236 women and 208 men) completed the Personality DiagnosticQues-
tionnaire-Revised (PDQ-R), along with widely used measures of implicit depend-
ency needs (the Rorschach Oral Dependency Scale; ROD), and self-attributed
dependency needs (the Interpersonal Dependency Inventory; IDI). Correlational
analyses and comparisons of ID1 and ROD scores in participants scoring above and
below the PDQ-R DPD and HPD thresholds supported theorists' speculations re-
gardingimplicit and self-attributeddependency needs in DPD and HPD. Implications
of these results are discussed, and suggestions for future studies are offered.

For many years, dependency-related needs and motives have been thought to play a
prominent role in two forms of personality pathology: dependent personality disor-
der (DPD) and histrionic personality disorder (HPD). On the surface, however,
DPD and HPD are not at all alike. Individuals with HPD and DPD show very differ-
ent behaviors in interpersonal relationships. Whereas the essential feature of DFD
is "a pervasive and excessive need to be taken care of that leads to submissive and
clinging behavior and fears of separation" (American Psychiatric Association
[APA], 1994, p. 665), the essential feature of HPD is "pervasive and excessive
emotionality and attention-seeking behavior" (APA, 1994, p. 655). Not surpris-
ingly, DPD is grouped in the "anxious" Diagnostic and Statistical Manual of Men-
tal Disorders (4th ed. [DSM-IVI; APA, 1994) personality disorder (PD) clustex,
whereas HPD is grouped in the "dramatic7' cluster.
Theoreticians and researchers generally agree that although DPD and HPD are
both linked with high levels of underlying dependency needs, DPD- and
 2 BORNSTEIN

HPD-diagnosed persons differ with respect to the degree of insight they have in
this domain (Kantor, 1992; Millon, 1996).Typically, the individual with DPD has
at least some awareness of the ways that underlying dependency needs affect his or
her behavior, whereas the person with HPD has little insight in this area. As the
DSM-N noted,

without being aware of it, [persons with HPD] often act out arole ... in their relation-
ships with others. They may seek to control theirpartner through emotional manipula-
tion or seductivenesson one level, whereas displaying a marked dependency on them
at another level. (APA, 1994, p. 656)

Consistent with the assertions of the DSM-ZV, a number of researchers have ar-
gued that DPD is associated with high levels of "self-attributed" (i.e., conscious)
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dependency needs, as well as high levels of "implicit" (i.e., unconscious) depend-

ency needs (Bornstein, 1993; Overholser, 1996;Pincus & Gurtman, 1995). In con-
trast, HPD appears to be associated with high levels of implicit dependency needs
but low levels of self-attributeddependency needs (Horowitz, 1991;Millon, 1996;
Pfohl, 1991).1
Although many clinicians believe that both DPD and HPD are associated with
high levels of implicit and self-attributeddependency strivings, whereas only DPD
is associated with high levels of self-attributed dependency needs, this hypothesis
has never been tested directly. The purpose of this investigation was to examine
implicit and self-attributed dependency needs in individuals who report high lev-
els of DPD and HPD symptoms. The Personality Diagnostic Questionnaire-Re-
vised (PDQ-R; Hyler et al., 1988) was used in this study to assess personality
pathology. Hirschfeld et al.'s (1977) Interpersonal Dependency Inventory (IDI)
served as a measure of self-attributeddependency needs, whereas Masling, Rabie,
and Blondheim's (1967) Rorschach Oral Dependency (ROD) scale served as a
measure of implicit dependency strivings.
It was hypothesized that relative to participants with other forms of personality
pathology, or no personality pathology, DPD participants would show high levels
of implicit and self-attributed dependency needs (i.e., elevated ID1 and ROD
scores). It is further hypothesized that relative to control participants, HPD partici-
pants would show high levels of implicit-but not self-attributed-dependency
needs (i.e., elevated ROD scores only).

'Borderline personality disorder (BPD) has also been linked by some theorists (e.g.,
Kemberg, 1984) with unacknowledged dependency needs. BPD, however, shows only modest
comorbidity with dependent personality disorder @omstein, in press). Moreover,
self-conceptlegoboundary problems are more central than underlying dependency needs to the
etiology and dynamics of BPD (American Psychiatric Association, 1994; Millon, 1996), and
high levels of dependency in BPD patients may be a consequence of these other difficulties.
 IMPLICIT AND SELF-ATTRIBUTED DEPENDENCY NEEDS 3

One subsidiary hypothesis was also tested: Consistent with previous studies in
this area, it was expected that women would obtain significantly higher scores tlhan
men on the ID1 but that men and women would obtain camparable scores on the
ROD scale.

METHOD

Participants

Participants in the dependency prescreening sessions were 491 students (260

women and 231 men) enrolled in General Psychology classes at Gettysburg Col-
lege. Participants were predominantly White and ranged in age from 18 to 22 years
(M= 19.37, SD = 0.89). Four hundred fifty-four students (242 women and 212 men)
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took part in follow-up sessions in which PDQ-R scores were obtained. Participants
received course credit for taking part in the prescreening and $3 for taking part in
the follow-up session.

Measures
Self-altributed dependency needs. The measure of self-attributed de-
pendency needs in this study was Hirschfeld et a l . ' ~(1977) IDI. The ID1 is one of the
most widely used self-report measures of dependency (Bornstein, 1994; Overholrser,
1996). It is a 48-item questionnaire consisting of a series of dependency-related
self-statements,each of which is rated on a 4-point scale ranging from 1 (disagree) to
4 (agree). Ilirschfeld et al.' s (1977) factor analysis of ID1items revealed that these 48
items form three subscales: (a) Emotional Reliance on Others (EX; 18 items), (b)
Lack of Social Self-confidence (LS; 16items), and (c) Assertion of Autonomy (PLA;
14 items), Typical items from the three ID1 subscales include "the idea of losing a
close friend is terrifying to me" (ER), "when I have a decision to make I always ask
for advice" (LS), and "what people think of me doesn't affect how I feel" (AA). ID1
whole-scale scores were calculated by summing each participant's scores on the ER
and LS scales and subtracting from this total the participant's score on the AA scale.
Bornstein (1994) provides a detailed review of evidence by assessing the construct
validity of the ID1 as a measure of self-attributed dependency neecls.

Implicit dependency needs. The measure of implicit dependency needs in

this investigation was Masling et al.'s (1967) ROD scale The ROD scale is the
most widely used projective measure of dependency, having been employed in
more than 50 published studies during the past 25 years (Bornstein, 1996).
ROD scores are derived from Rorschach protocols that rnay be administered in-
dividually or in groups. In the group administration of the ROD scale, participants
are shown slides of standard Rorschach inkblots projected onto a screen. Partici-
 4 BORNSTEIN

pants are asked to provide three written responses each to Cards I, 11,111, VIII, and
X and two responses to each of the remaining five cards. One point is assigned for
each oral-dependent Rorschach response; ROD scores typically range from 0 to 8
(Masling, 1986). Masling's (1986) ROD scoring manual included the following
categories: (a) foods and drinks, (b) food sources, (c) food objects, (d) food provid-
ers, (e) passive food receivers, (f) begging and praying, (g) food organs, (h) oral in-
struments, (i) nurturers and protectors, (j) gifts and gift givers, (k) good-luck
symbols, (1) oral activity, (m) passivity and helplessness, (n) pregnancy and repro-
ductive anatomy, (0) "baby talk" responses, and (p) negations of oral-dependent
percepts (e.g., "not pregnant," "man with no mouth"). Bornstein (1996) provided a
review of studies examining the construct validity of the ROD scale as a measure
of implicit dependency needs.
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Personality disorders. Personality disorders were assessed via the PDQ-R

(Hyler et al., 1988).The PDQ-R is a 163-item self-report measure that assesses the
11 Axis I1 PDs (and two putative PDs) included in the DSM-III-R. All PDQ-R
items are in truelfalse format; several items include follow-up checklists wherein
participants note specific behaviors associated with a particular PD screeningitem.
The PDQ-R also includes two validity scales: (a) the Too Good (TG) scale and (b)
the Suspect Questionnaire (SQ) scale. The PDQ-R yields a raw score for each PD
dimension and provides a series of threshold scores that enable the researcher to
make a presencelabsence classification for each PD category.
Studies examining the convergent and discriminant validity of the PDQ-R in
inpatient, outpatient, and nonclinical samples have generally produced encour-
aging results. For example, Hyler, Skodol, Kellman, Oldham, and Rosnick
(1990) found that PDQ-R diagnoses showed good concordance with other ques-
tionnaire- and interview-derived PD diagnoses. The discriminant validity of the
PDQ-R is supported by findings that indicate that PDQ-R subscale scores are
mare strongly correlated with theoretically related personality trait scores than
with those that should be unrelated (or only weakly related) to the PD dimension
in question (Hunt & Andrews, 1992). Other investigations have shown that
PDQ-R scores show adequate retest reliability in variotls participant groups
(Hyl~ret al., 1990). Hyler et al. (1988, 1990) provided detailed i n f h a t i o n re-
garding the construct validity of the PDQ-R as a measure of PD
symptamatology. Johnson and Bornstein (1992) provided information regarding
the utility of the PDQ-R in nonclinical sample^.^

ZAlthoughthe Personality Diagnostic Questionnaire-Revised was originally designed to

assess the 13 personality disorders (PDs) listed in the Diagnostic and Statistical Manual of
Mental Disorders (DSM-111-R; including passiveaggressive, self-defeating, and sadistic
PDQ, i t includes all 10 PD categories included in the DSM-N. Because data involving the
former DSM-III-R PD dimensions may be useful to other researchers, these data are in-
cluded in Tables 1 and 2.
 IMPLICIT AND SELF-ATTRIBUTED D13BENDENCY NEEDS 5

Procedure

When participants arrived at the laboratory, they were told they were taking p~ in
a study of personality and self-perception. Groups of 10 to 12participants were ad-
ministered the ID1 (Hirschfeld et al., 1977) and the ROD scale (Masling et al.,
1967), with order of measures counterbalanced across participants.
Approximately 2 months after completing the dependency measures, partici-
pants were contacted by phone and asked to take part in a follow-up session in
which PDQ-R scores were obtained. An individual appointment was then set up
for each participant. Four hundred fifty-four participants (242 women and 212
men) completed both the initial and follow-up testings (is., 92% of the original
prescreened sample). A 2-month interval was used so that all Time 1 test protocols
could be collected and scored and ROD scale reliability indexes determined before
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the Time 2 testing sessions took place (a total of 42 Time 1 testing sessions were
required to collect ID1 and ROD scale data).
After all PDQ-Rs were collected, participants who a~btaineda score gre,ater
than 0 on the TG or SQ scales were dropped from the study (Hyler et al., 19188;
Hyler et al., 1990). This resulted in 10participants being excluded (6 who obtained
scores of greater than 0 on the TG scale and 4 who obtained scores of greater than 0
on the SQ scale). Thus, the final sample consisted of 444 participants (236 wornen
and 208 men).
All 444 ROD protocols were scored for oral-dependent content by the experi-
menter, who was blind to information regarding individual participants. Reliabil-
ity in ROD scale scoring was determined by having a second rater, also blind to
information regarding individual participants, rescore a sample of 40 protocols
containing a total of 1,000 responses. The two raters agreed regarding the scoring
of 962 responses (96%). A Pearson correlation coefficient calculated between the
two sets of scores was .95. These reliability coefficients are comparable to those
reported in recent studies involving the ROD scale (e.g..,Bornstein, Bowers, &
Bonner, 1996; Bornstein, Rossner, Hill, & Stepanian, 1994).

RESULTS

Gender Differences in IDI, ROD, and PDQ-R Scores

As expected, significant gender differenceswere obtained on the ID1but not on the

ROD scale. The mean ID1 score for women was 53.27 (SD = 7.71), whereas the
mean ID1 score for men was 46.62 (SD = 5.99), t(442) = 10.08,p < .001. The mean
ROD score for women was 3.15 (SD = 1.03), whereas the mean ROD score for men
was 3.21 (SD = 1.07), t(442) = 0.67, ns. Consistent with ]previous studies in this
area, ID1and ROD scores showed modest positive intercorrelations: The IDI-ROD
 correlation for women was .34 (p < .005), whereas the IDI-ROD correlation for
men was .27 (p < .01).
Table 1 summarizes the PDQ-R subscale scores obtained by men and women
in this sample. Significant gender differences were obtained on 8 of 13 PDQ-R
subscales (6 of 10 subscales associated with PDs included in the DSM-N).
Women obtained higher scores than men on the Schizotypal, Histrionic, Depend-
ent, and Obsessive-Compulsivescales; men obtained higher scores than women
on the Schizoid, Passive-Aggressive, Antisocial, and Sadistic scales. Table 1 also
shows the number (and percentage) of participants who obtained scores over the
PDQ-R threshold for each PD dimension. (PDQ-R threshold scores were the
same as those used in previous investigations involving clinical and nonclinical
participants; Hyler et al., 1990.)
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Correlations of ID1and ROD Scores With PDQ-R Scores

Table 2 summarizes the correlations between dependency scores and PDQ-R

subscale scores in women and men. Because of the large number of correlation co-
efficients calculated, a Bonferroni correction was used, and significance levels
were set at p = .005 throughout. As Table 2 shows, ID1 scores showed significant
positive correlations with PDQ-R dependent scores in women (r = .57) and men (r
= S1). As hypothesized, ID1 scores were unrelated to PDQ-R histrionic scores in
participants of either gender (r = .I0 for women and r = .07 for men). In addition to
these hypothesized relations, there was an unanticipated positive correlation be-
tween ID1 scores and self-defeatingPD scores in women and an unanticipatedneg-
ative correlation between ID1 scores and sadistic PD scores in men.
Like ID1 scores, ROD scores showed significant positive correlations with
PDQ-R dependent scores in women (r = 30) and men (r = .35). Unlike ID1 scores,
ROD scores also showed significant positive correlations with PDQ-R histrionic
scores in participants of both genders (r = .29 in women and r = .24 in men).

Relations of Gender and PD Status to ID1 and ROD Scores

Additional information regarding the relations of implicit and self-attributed de-

pendency needs to DPD and HPD was obtained by examining the ID1 and ROD
scores of participants who scored above the dependentPD and histrionic PD thresh-
olds on the PDQ-R. As Table 1 shows, 28 participants (17 women and 11 men)
scored above the dependent threshold, whereas 24 participants (14 women and 10
men) scored above the histrionic threshold. These participants comprised the DPD
and HPD groups.
Comparisongroups of Other PD and No PD participants were constructed using
a two-step process. First, after DPD and HPD participants were removed from the
pool, all participants who scoredabove at least one other PD threshold were placed in
 TABLE 1
PDQ-R Mean Scores With Standard Deviations and Number of
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Participants Over Threshold

Score Participants Over Threshold

Women Men Women Men

PDQ-R Scale M SD M SD t n % n %

Schizoid
Schizotypal
Paranoid
Borderline
Narcissistic
Histrionic
Dependent
Obsessive-compulsive
Passive-aggressive
Avoidant
Self-defeating
Antisocial
Sadistic
- -

Note. N = 444 (236 women and 208 men). PDQ-R = Personality Diagnostic Questionnaire-Revised (Hyler et al., 1988). Only participants who
obtained ascore of 0 on the PDQ-R TGand SQ scales were included in this analysis. Standard deviationsand percentages are in parentheses.Two-tailed t
tests were used to assess gender differences on PDQ-R subscale scores (df = 442 throughout).
*p < .05. **p < .W1.
 TABLE 2
Correlations of Interpersonal Dependency Inventory (IDI) and
Rorschach Oral Dependency (ROD) Scale Scores With PDQ-R Scores

Correlation

IDI ROD

PDQ-R Scale Women Men Women Men

Schizoid
Schizotypal
Paranoid
Borderline
Narcissistic
Histrionic
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Dependent
Obsessive-compulsive
Passive-aggressive
Avoidant
Self-defeating
Antisocial
Sadistic

Note. N = 444 (236 women and 208 men). PDQ-R = Personality Diagnostic Questionnaire-Revised
(Hyler et al., 1988). Only participants who obtained a score of 0 on the PDQ-R TG and SQ scales were
included in this analysis (df = 442 throughout).
*p < .005.**p < ,001.

the Other PD group (N= 77; 47 women and 30men). Next, 77 No PD participants (47
women and 30 men) were selected at random from the remaining pool of 3 15women
and men who did not score above the threshold on any PDQ-R scale.3
Table 3 summarizes the ID1 scores obtained by participants in the DPD, HPD,
Other PD, and No PD groups. A 2 x 4 between-subjects analysis of variance
(ANOVA) revealed a main effect of gender on ID1 scores, F(1, 198) = 36.98, p <
.001: Women obtained significantly higher ID1 scores than men regardless of PD
group membership. There was also a main effect of PD group on ID1 scores, F(3,
198) = 6 . 0 9 , ~< .001. The Gender x PD Group interaction was nonsignificant, F(3,
198) = 1.25, ns.

3Thenumber of participants in the No personality disorder (PD) group was limited to 77 to minimize
heteroscedasticityproblemsthat often result from analysesof variance involvingmarkedly differentcell
Ns. Reanalyses of these data with all 315 available participants included in the No PD group produced
virtually identical results. Highly similar results were also produced when data were reanalyzed with
passive-aggressive, self-defeating,and sadistic PD participants excluded from the Other PD group and
dropped from the analysis.
 IMPLICIT AND SELF-ATTRIBUTEDDIEPENDENCY NEEDS 9

TABLE 3
Relations of Gender and Group Membership to ID1 Scores
7

Group

DPD HPD Other PD No PD

-
Gender M SD M SD M SD M SD
Women 59.31a 9.17 53.760 4.88 51.08b 7.02 53.08b 5.73
Men 52.30" 4.76 42.560 7.26 42.92b 4.17 44.27b 5.64

Note. N of DPD group = 28 (17 women, 11 men); N of HPD group =: 24 (14 women, 10men); Nof
Other PD group = 77 (47 women, 30 men); N of No PD group = 77 (47 women, 30 men). ID1 =
Interpersonal Dependency Inventory (Hirschfeld et al., 1977); DPD = dependent personality disorder;
HPD =histrionicpersonalitydisorder. Means with differentsuperscriptsdiffered significantly(p c .05)
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in one-way analyses of variance conducted separately for women and men.

TABLE 4
Relations of Gender and Group Membership to FlQD Scores
Group

DPD HPD Other PD No PD

7

Gender M SD M SD M SD M SD
-
Women 4.00" 1.29 3.92a 1.93 2.65b 1.29 2.41b 1.82
Men 4.10a 2.28 3.8ga 1.76 2.5ab 1.00 2.30b 1.41

Note. Group Ns are described in Table 3. ROD =Rorschach Oral Dependency Scale (Masling 1% al.,
1967);DPD = dependentpersonality disorder; HPD =histrionicpersonality disorder; PD = personality
disorder. Means with different superscriptsdiffer significantly(p < .05).

Follow-up one-way ANOVAs confirmed that ID1 scores differed as a function

ofPDgroupinwomen, F(3,121)=4.48,p<.01, andmen, F(3,7'7)=5..59,p<.01.
Tukey tests indicated that in both cases ID1 scores of participants in the DPD group
were significantly higher than ID1 scores of participants in the HPD, Other PD, and
No PD groups ( p < .05).The ID1 scores of participants in the HPD, Other PD, and
No PD groups did not differ from each other.
Table 4 shows the ROD scores obtained by participants in the DPD, HPD,
Other PD, and No PD groups. A 2 x 4 between-subjects ANOVA revealed a main
effect of group membership on ROD scores, F(3,198)= 7 . 0 8 ,<~.001. There was
no main effect of gender on ROD scores, F(l, 198) = 0.14, ns. The Gender x PD
Group interaction was also nonsignificant, F(3, 198) = 0.90, ns.
Follow-up one-way ANOVAs (collapsing across gender) confirmed that ROD
scores differed as a function of PD group, F(3,202)= 6.48,p < .001. A Tukey test
 10 BORNSTEIN

further indicated that ROD scores of participants in the DPD and HPD groups were
significantly higher than ROD scores of participants in the Other PD and No PD
groups (p < .05). ROD scores of participants in the DPD and HPD groups did not
differ from each other. Similarly, ROD scores of participants in the Other PD and
No PD groups did not differ.

DISCUSSION

This study provides the first empirical evidence that DPD and HPD are both associ-
ated with high levels of implicit dependency needs, whereas only DPD is associated
with high levels of self-attributed dependency needs. These results are consistent
with the hypotheses of Millon (1996), Horowitz (1991), and others. These results
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also support the assertionsof the DSM-ZV(APA, 1994)regarding differencesin the

underlying and expressed dependency strivings of DPD and HPD patients.
This investigation did not explore factors that account for the differential re-
lations of implicit and self-attributed dependency needs to DPD and HPD, so
one can only speculate regarding this issue. It may be that these results reflect
different defenses used by DPD and HPD individuals to cope with underlying
dependency strivings. Although studies show that DPD persons have consider-
able insight into the ways that underlying dependency needs motivate and direct
their behavior (Bornstein, 1992, 1993), two defenses-rationalization and de-
nial-nonetheless play a prominent role in this disorder. First, DPD persons tend
to deny interpersonal difficulties and conflicts, to maintain the facade that im-
portant relationships are never at risk (Birtchnell, 1988; Bornstein, 1995b). Sec-
ond, DPD persons often rationalize neglecting or abusive behavior exhibited by
nurturers and caregivers because acknowledging neglect or abuse requires disen-
gaging from the abuser and functioning autonomously (Murphy, Meyer, &
O'Leary, 1994; Sperling & Berman, 1991). Both of these defensive strategies
serve to mask interpersonal conflict but still allow underlying dependency needs
to reach conscious awareness.
In contrast to individuals with DPD, persons with HPD appear to use a combi-
nation of displacement, denial, and repression to keep underlying dependency
needs outside of awareness. Thus, whereas the DPD individual actively seeks inti-
macy with a significant other, the HPD person displaces his or her needs for sup-
port and reassurance from a valued other to the world at large, behaving in such a
way as to call attention to himself or herself and to ensure that others are focusing
on his or her needs (Bornstein, 1998). Moreover, the HPD person typically denies
any overt dependency-related needs or motivations, thereby maintaining a facade
of independence (Berman & McCann, 1995). Repression is used by the HPD indi-
vidual to cope with unpleasant affect and anxiety-producingemotional responses
(e.g., feelings of neediness and vulnerability; Horowitz, 1991).
 IMPLICIT AND SELF-ATTRIBUTED DEPENDENCY NEEDS 11

These findings help explain the contrasting dependency-related behaviors ex-

hibited by DPD and HPD individuals in real-world situations and settings. DP.0 is
generally associated with an overtly dependent (i.e., passive.and submissive) cop-
ing style, whereas HPD is associated with an active, manipulative orientation that
functions in part to mask a pervasive underlying dependency. Millon (1996) cap-
tured this distinction well when he described the DQD person as preoccupied with
"a search for relationships in which one can lean on others for affection, security,
and leadership ... submittingto the wishes of others to maintain their affection" (p.
68). Millon went on to note that the HPD person's "sociable and capricious behav-
iors give the appearance of considerable independence of others, but beneath this
guise lies a fear of autonomy and an intense need for signs of social approval and
attention" (p. 68). The suggestibility and somatizing tendencies of the HPD person
may also represent subtle, indirect manifestationsof unacknowledged dependency
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needs (Bornstein, 1995a; Bornstein, Krukonis, Manning, Mastrosimone, &

Rossner, 1993).
The finding that Other PD and No PD participimts did not differ in
self-attributeddependency needs (Table 1) or implicit dependency needs (Table 2)
wwants discussion. Previous studies have shown that although certain PDs are as-
sociated with high levels of underlying and expressed dependency needs (e.g., bor-
derline, narcissistic), other PDs are actually associated with unusually low
dependency levels (e.g., schizoid, antisocial). Thus, when ID1 and ROD scale
scores are averaged across the eight DSM-ZV PD categories (excluding HPD and
DPD), overall levels of implicit and self-attributed dependency needs in
PD-diagnosed participants do not differ from overall levels of implicit and
self-attributed dependency needs in non-PD participants (see Bornstein, 1998, for
a detailed discussion of this issue).
Two subsidiary findings of this investigation also deserve mention. Consistent
with previous studies in this area, women obtained significantly higher ID1 scores
than men in this sample, but men and women obtained comparable ROD scores.
This pattern of gender differences has been obtained numerous times (Bornstein,
1995c) and appears to reflect many men's unwillingness to acknowledge depemd-
ent attitudes and behaviors. As Bornstein (1992) noted,
boys are generally discouraged from expressing openly dependent feelings and
needs, yet girls have historically been encouraged to exhibit these feelings,because
passive, feminine behavior has traditionally been regarded as consonant with the fe-
male (i.e., feminine) sex role. Parents, teachers, older siblings,and other role mod-
els ... encourage children-either subtly or directly-to conform to traditional sex
role expectations [with respect to the overt expression of underlying dependency
needs]. (p. 8)
A second subsidiary finding from this investigation involves the base rates of
PD diagnoses obtained in this college student sample (5% and 6%, respectively,
 12 BORNSTEIN

for HPD and DPD). These base rates are consistent with those obtained by re-
searchers who use questionnaire and interview PD measures in nonclinical sam-
ples (e.g., Kass, Spitzer, & Williams, 1983; Maier, Lichtermann, Klingler, Heun,
& Hallmeyer, 1992;Zimmerman & Coryell, 1989).HPD base rates in these inves-
tigations are generally in the 2% to 8% range (Bornstein, in press; Maier et al.,
1992), whereas DPD base rates typically range from 2% to 11% (Bornstein, 1996;
Kass et al., 1983). These results are also consistent with previous findings indicat-
ing that PD base rates in nonclinical samples are somewhat lower than those found
in clinical (i.e., psychiatric inpatient or outpatient) populations (see Bornstein,
1993, 1996, for reviews).
Two limitations of this study warrant discussion in this context. First, PD
symptomatology in this investigation was assessed via questionnaire rather than
by structured clinical interview. Although studies confirm that questionnaire mea-
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sures such as the PDQ-R generally show good concurrent and predictive validity
(Hyler et al., 1988,1990), replication of these findings using an alternative method
for deriving PD diagnoses would strengthen these results.
In addition, these findings were obtained on a nonclinical sample. While this
might actually represent a potential strength (although stronger findings would be
expected to emerge when clinical participants with a broader range of PD symp-
toms are studied), it is clear that these results should now be extended to clinical
populations. If similar findings are obtained in psychiatric inpatients or outpa-
tients, this would support the robustness and generalizability of these results.

ACKNOWLEDGMENTS

Robert F. Bornstein now at Department of Psychology, Fordham University,

New York.
This research was supported by a grant from the Paul H. Rhodes Teaching and
Development Fund at Gettysburg College.

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Robert F. Bornstein
Department of Psychology
Fordham University
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Lincoln Center
113 West 60th Street
New York, NY 10023

Received October 10, 1997

Revised March 14,1998