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Behavioral Sciences and the Law
Behav. Sci. Law 22: 345–356 (2004)
Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/bsl.585
Rorschach Oral Dependency in
Psychopaths, Sexual Homicide
Perpetrators, and Nonviolent
Pedophiles
Steven K. Huprich, Ph.D.,*
1
Carl B. Gacono,
Ph.D.,
2
Robert B. Schneider, M.S.
1
and Michael
R. Bridges, Ph.D.
3
Rorschach Oral Dependency scores (Masling, Rabie, &
Blondheim, 1967) were compared among nonsexually
offending psychopaths (NSOPs, n¼32), sexual homicide
perpetrators (SHPs, n¼38), and non-violent pedophiles
(NVPs, n¼39) as initially reported by Gacono, Meloy, and
Bridges (2000). The aggressive special scores of Gacono
and Meloy (1994; Gacono, unpublished doctoral disserta-
tion, 1998) were also scored and compared with ROD
scores. Consistent with theory and predictions, NVPs
were found to have significantly higher levels of oral de-
pendency scores than NSOPs or SHPs. Additionally, there
was a high degree of association between oral dependency
and aggression in the SHP and NSOP groups. These
Rorschach differences support the validity of the ROD as
an implicit measure of dependency and add to the under-
standing of the dynamics that fuel sexually deviant vio-
lence. Copyright #2004 John Wiley & Sons, Ltd.
The Rorschach Oral Dependency Scale (ROD; Masling et al., 1967) assesses
elements of interpersonal dependency. For example, Shilkret and Masling (1981)
found that ROD scores predict help-seeking behavior of participants in a research
project. ROD scores are also positively and significantly correlated with cooperation
and compliance with authority figures (Bornstein & Masling, 1985; Masling,
O’Neill, & Jayne, 1981), self-reported levels of insecure attachment (Duberstein
& Talbot, 1993), eating disorders (Bornstein & Greenberg, 1991), and behavioral
difficulties in terminating inpatient psychiatric treatment (Greenberg & Bornstein,
1989). Summarizing 28 years of research with the ROD, Bornstein (1996) con-
cluded that the ROD has construct validity and is a good measure of overt
dependent behavior.
Copyright #2004 John Wiley & Sons, Ltd.
*Correspondence to: Steven K. Huprich, Ph.D., Department of Psychology and Neuroscience, Baylor
University, P.O. Box 97334, Waco, TX 76798-7334, U.S.A. E-mail: Steven_Huprich@baylor.edu
1
Baylor University.
2
Clinical and Forensic Psychologist Austin, TX.
3
Temple University.
The ROD is scored from the content of Rorschach material that is administered
either in standard or group format (Bornstein, 1996). Each response is read and
inspected for oral dependency content. Content may fall into one of 16 categories:
food and drinks, food sources, food objects, food providers, passive food receivers,
begging and praying, food organs, oral instruments, nurturers, gifts and gift-givers,
good luck objects, oral activity, passivity and helplessness, pregnancy and repro-
ductive organs, ‘‘baby talk’’ responses, and negations of oral dependent percepts.
One point is assigned for each oral dependent response, and a percentage score is
obtained by taking the number of oral dependent responses divided by the total
number of responses provided. Although the ROD is not used to assign a diagnosis
of dependent personality disorder, it has been found to correlate highly with other
projective measures of dependency (Fowler, Hilsenroth, & Handler, 1996) and
moderately with self-report measures of dependency (Bornstein, 1996, 1999;
Bornstein, Rossner, Hill, & Stepanian, 1994; Hirschfeld et al., 1977). ROD studies
have demonstrated its robust psychometric properties (Bornstein, 1994, 1996,
1999) including adequate interrater reliability and test–retest consistency
(Bornstein, Hilsenroth, Padawer, & Fowler, 2000; Bornstein, Rossner, & Hill,
1994; Juni & Semel, 1982). Given the nature of the Rorschach’s ability to partially
bypass volitional controls (Meloy, 1992; Gacono & Meloy, 1994), the ROD is
ideally suited to assess interpersonal dependency in samples where self-presentation
bias may be a concern, such as in a forensic population (Bannatyne, Gacono, &
Greene, 1999; Gacono, Evans, & Viglione, 2002).
Although this measure has been used to assess non-pathological aspects of
dependency (Bornstein, Riggs, Hill, & Calabrese, 1996; Bornstein, 1998a,
1998b) and the relationship of dependency to Axis I disorders (Bornstein &
Greenberg, 1991; Greenberg & Bornstein, 1989; O’Neill & Bornstein, 1990,
1991), little research has been conducted with the ROD scale and Axis II disorders.
Blais, Hilsenroth, Fowler, and Conboy (1999) found that DSM-IV (APA, 1994)
dimensional ratings for borderline personality disorder significantly correlated with
ROD ratings (r¼0.43). Comparing inpatient and outpatient borderlines, psychotic
inpatients, and dependent, avoidant, narcissistic, and antisocial outpatients,
Bornstein et al. (2000) found that inpatient borderlines had the highest ROD scores
(mean ¼0.265), followed by dependent and avoidant outpatients (mean ¼0.204)
and narcissistic outpatients (mean ¼0.202). Antisocial outpatients (mean ¼0.117)
and borderline outpatients (mean ¼0.109) produced lower mean scores than the all
of these groups, including university-student nonclinical controls (mean ¼0.162).
In the present study, we selected a forensic population to study ROD scores.
Specifically, we compared the ROD scores of nonsexually offending psychopaths
(NSOPs), sexual homicide perpetrators (SHPs), and nonviolent pedophiles (NVPs)
who were incarcerated or in a forensic psychiatric hospital. Previously, Gacono,
Meloy, and Bridges (2000) had evaluated the Rorschachs of such individuals with
Comprehensive System variables (Exner, 1993) and found that psychopaths were
distinguished by their lack of interest and attachment to others (NSOPs, 100%,
T¼0; mean for human content ¼4.00; mean COP ¼0.56) compared with SHPs
and NVPs (SHPs, 39%, T51; mean for all human content ¼6.39; COP ¼1.37;
NVPs, 49%, T51; mean for all human content ¼8.05; COP ¼1.18). However,
they did not evaluate these protocols for ROD and the extended aggression scores
(Gacono, unpublished doctoral dissertation, 1998; Gacono & Meloy, 1994).
346 S. K. Huprich et al.
Copyright #2004 John Wiley & Sons, Ltd. Behav. Sci. Law 22: 345–356 (2004)
Although dependency and aggression were not directly assessed by Gacono et al.
(2000), their results suggested that psychopaths are the least likely of the three
groups to experience dependency needs.
We evaluated the aforementioned groups for four reasons. First, to our knowl-
edge, no published study has examined Rorschach Oral Dependency in pedophiles,
sexual homicide perpetrators, or psychopaths, despite the importance of this
construct to the theoretical underpinnings of each group. Second, we were inter-
ested in extending the growing body of research related to the ROD’s validity as a
measure of dependency. Third, these groups were ideal for examining the manner in
which dependency needs and aggression drive derivatives are expressed (Gacono &
Meloy, 1994; Gacono et al., 2000), given the links between interpersonal depen-
dency and aggression in violent sexual behavior. Based upon a confluence of
psychodynamic principles and previous research with these populations (Bridges,
Wilson, & Gacono, 1998; Gacono & Meloy, 1994; Gacono et al., 2000), we
predicted that that the sexual homicide perpetrators would have significantly higher
ROD scores than pedophiles, and that the lowest levels of oral dependency would be
found among psychopaths (SHPs >NVPs >NSOPs). Finally, we were interested in
the manner in which dependency and aggression might be associated in Rorschachs
of these groups. SHPs and NVPs are believed to experience deep conflicts over their
dependency needs and how to express them in the context of aggression they feel
toward themselves (NVPs; Bridges et al., 1998) and others (SHPs; Gacono, 1997b;
Gacono & Meloy, 1994; Meloy, 1992). In contrast, psychopaths have been found to
have little need or interest in interpersonal relationships, while also expecting
interpersonal relationships to be fraught with conflict and aggression (Gacono &
Meloy, 1994; Gacono et al., 2000). In the present study, it was believed that, given
the predominance of dependency and aggression in the real world behaviors of such
individuals, aggression and dependency would be found together in sequence in
participants’ Rorschach protocols. We predicted that this mixture would be most
frequently found in the sexual homicide perpetrators (high aggression toward
others, high interpersonal dependency), followed by the pedophiles (moderate
levels of aggression toward others, high interpersonal dependency) and non-sexually
offending psychopaths (high aggression toward others, low interpersonal depen-
dency). That is, SHPs >NVPs >NSOPs.
METHOD
Participants
Participants were comprised of three groups: NSOPs (n¼32), SHPs (n¼38), and
NVPs (n¼39). Rorschachs were administered by advanced doctoral level clinical
psychology interns or licensed clinical psychologists using Comprehensive
System guidelines (Exner, 1974, 1986, 1993). The inclusion criteria for each group
were as follows: (i) having a valid Rorschach protocol; (ii) for the NSOPs, a valid
PCL-R score (530; Hare, 1991); (iii) for the NVPs, a DSM-IV (American
Psychiatric Association, 1994) diagnosis of pedophilia; and (iv) for the SHPs,
having committed a sexual homicide. All other data, including demographic
information, were treated as dependent variables.
RODs of psychopaths 347
Copyright #2004 John Wiley & Sons, Ltd. Behav. Sci. Law 22: 345–356 (2004)
Psychopaths
All individuals in this group were free of mental retardation, psychosis, or neuro-
logical impairment, and were incarcerated in medium- to maximum-security
correctional or forensic facilities when tested. Psychopathic Rorschachs were
obtained from a larger male antisocial personality disorder Rorschach sample
(n¼105; see Gacono & Meloy, 1994). Forty-six of the 105 were psychopathic,
with PCL-R scores530 (Hare, 1991). Of the 46, 30 individuals, although violent,
had no history of sexual violence or any sex offense. Two cases (violent but not
sexually violent) were randomly chosen from the Gacono and Meloy (1994) female
psychopathic antisocial personality disorder sample (n¼24) and added to the male
psychopaths. These cases were added to match the number of females present in the
SHP group. All individuals in this sample were administered the Rorschach between
1984 and 1996.
Sexual Homicide Perpetrators
Sexual homicide perpetrators were chosen from valid cases among the Gacono–
Meloy (1994) sexual homicide sample. The sample was entirely male except for two
individuals. All 38 Rorschachs were administered between 1986 and 1997 to
individuals convicted of sexual homicide and incarcerated in various prisons and
forensic hospitals in California, Florida, Illinois, Massachusetts, and the District of
Columbia. Evidence that a sexual homicide had been committed and the produc-
tion of a valid Rorschach protocol were the only inclusion criteria. Positive evidence
of a sexual homicide was verified by independent record reviews by Carl B. Gacono,
Ph.D., and J. Reid Meloy, Ph.D., and included an intentional killing and (i) physical
evidence of sexual assault; (ii) sexual activity in close proximity to the victim, such as
masturbation; or (iii) a legally admissible confession of sexual activity by the
perpetrator during the homicide. In order to accurately represent the heterogeneity
of this population, individuals were not excluded due to mental retardation, mental
illness, neurological impairment, or gender to accurately represent the probable
heterogeneity of this population. None, however, were mentally retarded (IQ <70)
or psychotic when tested and, although it was not formally assessed, organic
impairment was not suggested from record review or clinical interviewing. Two-
thirds of this sample met criteria for psychopathy, and most met criteria for
antisocial personality disorder. Two of the 38 subjects were female.
Nonviolent Pedophiles
Nonviolent pedophiles were obtained randomly by Michael R. Bridges, Ph.D., from
a larger sample that contained violent and nonviolent subjects (n¼60; see Bridges
et al., 1998). Rorschachs were administered between 1991 and 1996 to subjects
incarcerated in a correctional facility awaiting sex offender treatment. All individuals
were male and met the DSM-IV criteria (APA, 1994) for pedophilia, as determined
by agreement by two experienced clinicians (an advanced clinical psychology
graduate intern or licensed psychologist) from record review and interview. None
348 S. K. Huprich et al.
Copyright #2004 John Wiley & Sons, Ltd. Behav. Sci. Law 22: 345–356 (2004)
of the pedophiles were mentally retarded, psychotic, neurologically impaired, or
evidenced a history of interpersonal violence. While individual PCL-R scores were
not available for the 39 pedophiles, a review of their files indicated that no
individuals met the criteria for antisocial personality disorder, and none would be
psychopathic (i.e., PCL-R 530).
Procedure
All protocols were those evaluated initially by Gacono et al. (2000). In this study, the
protocols were scored for ROD content (Masling et al., 1967) and the aggressive
content scores of Gacono and Meloy (1994; Gacono, unpublished doctoral
dissertation), neither of which were scored or reported by Gacono et al. Scoring
for ROD content is described above. In the present study, all ROD content was
scored by the first author. All aggressive content scores are scored from content
within both the Free Association and Inquiry and include (i) Aggressive Content
(AgC), (ii) Aggressive Potential (AgPot), (iii) Aggressive Past (AgPast), or (iv)
Sadomasochistic Aggression (SM). Examples of each category are as follows: (i) ‘‘A
blood-hungry bat’’ (AgC); (ii) ‘‘A tiger about to attack a goat’’ (AgPot); (iii) ‘‘A
missionary killed by an African tribesman’’ (AgPast); and (iv) ‘‘A bat who has been
beaten and tortured’’ (examinee laughs; SM). These scores increase the examiner’s
ability to assess and code aggressive drive derivatives in psychopathic and non-
psychopathic antisocial personality disordered individuals, beyond that of Exner’s
Aggression score (Gacono, 1997a). Each response is evaluated for all of the
aforementioned categories. A given response may be scored for more than just
one of these categories, and the results of each category are reported for each
individual. In the present study, all aggressive content scores were scored by the
second author.
Once ROD and aggression special scores had been computed, ROD scores were
evaluated for the presence of aggressive content in the response immediately prior
to, co-occurring with, or immediately after an oral dependent score. The total
number of oral dependent–aggressive sequences for each individual was computed
and evaluated across groups. Such computations were an empirical way by which to
represent a sequential analysis of the pairing of aggression and dependency.
Sequential analysis has long been understood as a mechanism by which to evaluate
the processes with which an individual copes with, defends against, and recovers
from conflicting psychological impulses, needs, and states (Peebles-Kleiger, 2002;
Weiner, 2003). Given the nature of our clinical samples, we expected that stimuli
from a given Rorschach card would generate dependent or aggressive impulses, and
that the generation of such impulses would more than likely be associated with the
other impulse. Utilizing sequence analysis guidelines, we anticipated that the two
impulses would be in close proximity to each other in Rorschach responses. As
stated earlier, we predicted that this mixture would be most frequently found in the
sexual homicide perpetrators (high aggression toward others, high interpersonal
dependency), followed by the pedophiles (moderate levels of aggression toward
others, high interpersonal dependency) and non-sexually offending psychopaths
(high aggression toward others, low interpersonal dependency). That is, SHPs >
NVPs >NSOPs.
RODs of psychopaths 349
Copyright #2004 John Wiley & Sons, Ltd. Behav. Sci. Law 22: 345–356 (2004)
RESULTS
Demographics
Demographic data are presented by Gacono et al. (2000). However, it should be
noted that Gacono et al. reported that pedophiles were both significantly older and
better educated than psychopaths or sexual homicide perpetrators. Psychopaths and
sexual homicide perpetrators contained male and female subjects, while pedophiles
were all male.
Interrater agreement for the PCL-R scores and Rorschach variables are reported
by Gacono et al. (2000). Interrater agreement was also computed for ROD and
Aggression special scores. Twenty individuals’ protocols were randomly selected for
reliability analysis, which was conducted by the third author. The two raters agreed
on 97% of the ROD scores. Kappa was computed to be 0.72. The interrater
reliabilities for the Aggression special scores were also good. The two raters agreed
on 97% of the Aggression Content scores (kappa ¼0.97), 99% of the Aggression
Potential scores (kappa ¼0.99), 99% of the Aggression Past scores (kappa ¼0.99),
and 99% of the Sadomasochism scores (kappa ¼0.99).
Analyses
Means, standard deviations, and frequencies of the selected Rorschach variables are
presented in Tables 1 and 2 along with reports of effect sizes, as computed by the
methodology suggested by Rosnow, Rosenthal, and Rubin (2000). For the mea-
sures of oral dependency and oral dependency coupled with aggressive scores, the F
values reported are focused contrast Fvalues. It was hypothesized a priori that these
variables’ means would be ordered in the following direction: oral dependency,
SHPs >NVPs >NSOPs, and oral dependency–aggression, SHPs >NSOPs >
NVPs. There were significant main effects on one-way analyses of variance for the
mean number of ROD responses (F(1, 107) ¼5.14, p¼0.013, r¼0.19) and the
ROD score expressed as a percentage of R(F(1, 107) ¼4.00, p¼0.024, r¼0.18).
Tukey post hoc analyses indicated the following pattern of significant differences in
means: ROD mean (NVPs >NSOPs) and ROD score expressed as a percentage of
R(NVPs, SHPs >NSOPs). Significant main effects were also found for the mean
number of ROD responses that were asssociated with aggression special scores
(F(1, 107) ¼4.93, p¼0.015, r¼0.21) and ROD percentages that were associated
with aggression content special scores (F(1, 107) ¼7.09, p¼0.004, r¼0.25).
Tukey post hoc analyses were conducted and the following results were obtained:
mean number of RODs that included aggression special scores, SHPs >NVPs,
NSOPs, and ROD percentages that included aggression special scores,
SHPs >NVPs, NSOPs. These results are presented in Table 1.
The aforementioned variables were also analysed with non-parametric tests, as
these variables are low base rate variables that may violate the distribution assump-
tions implicit in parametric tests (i.e. ANOVA; see the work of Viglione (1995) for a
discussion of this issue). The following significant results were obtained: number of
RODs produced,
2
¼16.42, p<0.001, r¼0.24.
350 S. K. Huprich et al.
Copyright #2004 John Wiley & Sons, Ltd. Behav. Sci. Law 22: 345–356 (2004)
Table 1. Means, standard deviations, and frequencies for oral dependency and oral dependency–
aggression variables
Psychopaths Pedophiles Sexual hom. perp. pr
es
Variable (n¼32) (n¼39) (n¼38)
ROD number 3.48 (2.84)
b
8.31 (6.94)
a
6.32 (4.35) 0.013 0.19
(0) 6% 5% 5% <0.001*0.24
(1) 23% 0% 8%
(2) 16% 5% 5%
(3) 19% 13% 8%
(4 þ) 36% 72% 73%
ROD % 0.17 (.13)
b
0.26 (0.15)
a
0.25 (0.16)
a
0.024 0.18
ROD number sequentially paired or co-occurring with Aggression special scores
1.63 (1.88)
b
1.82 (1.52)
b
3.13 (3.73)
a
0.015 0.21
(0) 34% 23% 29% 0.116*
(1) 25% 23% 8%
(2) 16% 23% 26%
(3 þ) 25% 31% 37%
ROD % sequentially paired or co-occurring with Aggression special scores
0.08 (0.09)
b
0.06 (0.05)
b
0.14 (0.19)
a
0.004 0.25
ROD sequentially paired or co-occurring with Aggression special scores/Total ROD
0.42 0.26
b
0.47
a
0.045 0.24
r
es
is the computation of effect size as suggested by Rosnow et al. (2000). Superscripts indicate that means
differ significantly at p<0.05 on the Tukey post hoc test. *indicates the pvalue when frequencies were
evaluated with a
2
test.
Table 2. Means, standard deviations, and frequencies of aggression special scores
Psychopaths Pedophiles Sexual hom. perp. p
Variable (n¼32) (n¼39) (n¼38)
AgC 2.65 (1.92) 3.00 (2.08) 3.21 (2.41) 0.556
AgC % 0.137 (0.10) 0.116 (0.12) 0.128 (0.10) 0.679
(0) 6% 10% 5% 0.555
(1) 25% 5% 21%
(2) 29% 31% 24%
(3þ) 40% 54% 50%
AgPast 0.68 (1.05) 0.38 (0.67)
b
1.05 (1.49)
a
0.036
AgPast % 0.036 (0.06) 0.015 (0.03)
b
0.048 (0.06)
a
0.018
(0) 55% 72% 45% 0.042
(1) 35% 18% 32%
(2þ) 10% 10% 23%
AgPot 0.03 (0.18)
b
0.21 (0.47)
b
0.71 (1.14)
a
0.001
AgPot % 0.00 (0.01)
b
0.01 (0.02)
b
0.036 (0.07)
a
0.002
(0) 97% 82% 58% <0.001
(1) 3% 15% 26%
(2) 0% 3% 10%
(3) 0% 0% 6%
SM 0.19 (0.40) 0.03 (0.16)
b
0.45 (1.13)
a
0.037
SM % 0.011 (0.02) 0.00 (0.01)
b
0.01 (0.04)
a
0.030
(0) 81% 97% 76% 0.022
(1) 19% 3% 16%
(2þ)0% 0% 8%
RODs of psychopaths 351
Copyright #2004 John Wiley & Sons, Ltd. Behav. Sci. Law 22: 345–356 (2004)
All aggressive content scores were evaluated with an omnibus ANOVA. The
following significant effects were found: AgPast, F(2, 107) ¼3.43, p¼0.036; Ag-
Past as a percentage of R,F(2, 106) ¼4.18, p¼0.018; AgPot, F(2, 106) ¼8.38,
p¼0.001; AgPot as a percentage of R,F(2, 106) ¼6.42, p¼0.002; SM,
F(2, 106) ¼3.41, p¼0.037; and SM as a percentage of R,F(2, 106) ¼3.64,
p¼0.030. Tukey post hoc analyses were conducted, and the following results were
obtained: AgPast, SHPs >NVPs; AgPot, SHPs >NSOPs, NVPs; and SM,
SHPs >NVPs. A similar pattern of post hoc results was obtained when these analyses
were conducted on these variables while controlling for R. These results are
presented in Table 2. The aforementioned variables were also analysed with non-
parametric tests, as these variables are low base rate variables that may violate the
distribution assumptions implicit in parametric tests (i.e. ANOVA; see the work of
Viglione (1995) for a discussion of this issue). Furthermore, we were interested in
assessing the difference in frequencies among the three groups. The following
results were obtained: AgPast,
2
¼6.35, p¼0.042; AgPot,
2
¼16.22, p<0.001;
and SM,
2
¼7.63, p¼0.022.
To further explore the relationship between dependency and aggression in this
sample, Pearson correlations were computed between ROD scores and each of the
Gacono–Meloy (1994) aggression scores. The percentage of RODs produced
during Free Association was significantly and positively correlated with AgPot as
a percentage of R(r¼0.23, p¼0.02, two tailed) and SM as a percentage of R
(r¼0.19, p¼0.05, two tailed). The percentage of RODs produced in the entire
protocol was significantly and positively correlated with AgPot as a percentage of R
(r¼0.26, p<0.01) and SM as a percentage of R(r¼0.22, p¼0.02).
DISCUSSION
The results of our findings add to the growing body of literature supporting the
utility of the ROD in understanding dependency and aggression. Two of our groups
were sexually deviant (SHPs, NVPs), and two had histories of aggression (NSOPs,
SHPs). Consistent with the idea that dependency or interpersonal strivings fuel their
behavior, ROD scores were elevated in our sexually deviant groups (SHPs, NVPs).
The frequent pairing of dependency and aggression in SHPs (almost 50% of ROD
scores were accompanied by aggression) offers a Rorschach marker that differenti-
ates the real world behaviors of the SHP (sexually violent) and NVP (sexually
nonviolent). These findings will be discussed in greater detail.
Psychopaths appear to lack interpersonal relatedness. Given the low frequency of
ROD scores, the absence of Texture responses in their records, and the low
frequency of COP (Gacono et al., 2000), psychopaths have very little ‘‘need’’ for
others, except related to narcissistic enhancement (elevated reflections; Gacono
et al., 2000). Additionally, dependency, when infrequently expressed, was often
associated with aggression, a finding consistent with the high frequencies of
Kwawer’s (1980) violent symbiosis responses previously reported in psychopaths
(Gacono & Meloy, 1994). It appears that whatever levels of dependency remain in
the psychopath act as an irritant rather than a source of affectional relatedness (see
Gacono & Meloy, 1991, for a discussion of negated and spoiled T responses).
352 S. K. Huprich et al.
Copyright #2004 John Wiley & Sons, Ltd. Behav. Sci. Law 22: 345–356 (2004)
In contrast, pedophiles seem to have greater interest in interpersonal relatedness,
as they had the highest levels of oral dependency. As noted previously, pedophiles
tend to feel damaged and experience low self-esteem and dysphoria (Bridges et al.,
1998; Gacono et al., 2000). Their acting out may be triggered by such feelings and
fueled by the dependency identified by the ROD. Consistent with their history of
‘‘nonviolence,’’ our findings suggest that pedophiles’ dependency needs are the least
associated with aggressive impulses of the three groups.
Sexual homicide perpetrators were found to have relatively high levels of oral
dependency, which was consistent with their relatively high levels of Texture and
Food responses (Gacono et al., 2000). Yet, much of their dependency was
associated with aggressive content. Furthermore, SHPs had the highest levels of
the aggressive special scores of Gacono and Meloy (1994) on three of the four
categories (AgPast, AgPot, and SM), suggesting that they are highly preoccupied
with aggressive impulses, including the dangerous mix of sadomasochistic ideation.
Gacono et al. (2000) found that SHPs have high levels of dysphoria, interpersonal
yearning, cognitive distortion, and obsession, coupled with an inability to disengage
from the environment (low Lambdas). Thus, when complex ideation coupled with
sexual arousal meets a certain threshold, sexual homicide perpetrators act from their
internal fusion of sexual, dependent, and aggressive impulses collectively. Consis-
tent with the use of projective identification, SHPs project their oral needs into their
victims and then react with rage, disgust, and violence in attempt to eradicate these
needs (see Gacono & Meloy, 1988). This group’s high levels of thought disturbance
(X %¼26; X þ%¼0.47; WSUM6 ¼23.00; see Gacono et al., 2000) provides a
template for the cognitive and perceptual distortions that allow such behavior.
These findings are best reflected in one SHP’s Rorschach response, ‘‘a lonely bird of
prey out looking for a relationship.’’
The present findings have important implications in understanding and assessing
these groups of patients. First, our results demonstrate the utility of projective
assessment in detecting implicit needs and motives that may not otherwise be
acknowledged (McClelland, Koestner, & Weinberger, 1989). Bannatyne et al.
(1999) and Gacono et al. (2002) state that the Rorschach is especially helpful in
assessing forensic patients who tend to misrepresent themselves in traditional self-
report measures. Since dependency is often unacknowledged by SHPs, NVPs, and
NSOPs, and because dependent and aggressive impulses are often associated within
these individuals, it appears that the ROD is a meaningful tool by which to further
elucidate the psychopathology of these individuals beyond traditional self-report
measures.
Second, effects obtained in this study provide meaningful information about
individuals incarcerated for sexual and/or aggressive deviance. Although the present
effect sizes are generally considered to be small (Cohen, 1988), the practical and
clinical significance of these findings is notable. ‘‘Practical significance’’ indicates
not only the magnitude of the difference between group means, but also its meaning
for the question being asked (Kirk, 1996). ‘‘Clinical significance’’ refers to the
phenomenon of whether the method applied to a reference group has any positive or
real effect (Kazdin, 1999). From the perspective of practical significance, the
present study set out to determine whether there is a detectable difference in levels
of Rorschach oral dependency among the three groups. As this study may have been
the first of its kind, the findings suggest that, indeed, there is a detectable difference
RODs of psychopaths 353
Copyright #2004 John Wiley & Sons, Ltd. Behav. Sci. Law 22: 345–356 (2004)
in the levels of interpersonal dependency in these groups. From the perspective of
clinical significance, the present findings demonstrate that incarcerated individuals
with criminal histories can be meaningfully differentiated by their levels of depen-
dency and aggression. Such differences may affect the way that inmates interact with
each other, with forensic officials, and with mental health professionals who are
faced with the task of evaluating them. Thus, despite the positive correlations that
exist between oral dependency and aggressive potential and sadomasochistic con-
tent for the entire sample, analyses of group differences indicate that SHPs and
NSOPs are much more likely to associate dependency and aggressive impulses,
while NVPs are not.
In an exploratory set of analyses, aggressive content scores (Gacono & Meloy,
1994) were evaluated. Since no research has been conducted on this scoring system
with these groups, it was uncertain what differences might exist. All three groups
had aggressive content (AgC), past aggression (AgPast), and potential aggression
(AgPot) mean scores higher than has been reported in nonclinical samples (Gacono
& Meloy, 1994). Among the groups, SHPs had significantly higher means of
AgPast, AgPot, and SM than NVPs and significantly higher AgPot means than
NSOPs. Consistent with Gacono et al. (2002), it appears that SHPs are preoccupied
with aggression and its expression against others.
The present findings are limited in that they may only apply to NSOPs, NVPs,
and SHPs who are incarcerated. It may be that, when such individuals are not within
the restrictive environment of a prison, their levels of dependency and aggression
would differ. Likewise, it is uncertain whether the association of dependency and
aggression would be found in individuals who commit lesser crimes, or who have
other serious psychopathology (e.g., schizophrenia a severe personality disorders).
Nonetheless, given the similarities among members of each group with respect to
their crime, cognitive functioning, and state of incarceration, the present findings
meaningfully demonstrate how implicit assessment of dependency and aggression
allows clinicians and researchers to better understand the intrapsychic dynamics
that fuel their deviant behavior. Thus, the Rorschach Oral Dependency scale
continues to remain a meaningful tool for clinicians to better understand personality
dynamics and corresponding behavioral disorders.
ACKNOWLEDGEMENT
Special thanks are extended to Ariel Graham for her assistance in data entry.
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