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My site dropped from #1 to #2 in the directory while maintaining it's PR6. It even gained linkage, but a new site nudged in above mine that is owned by a huge institution, so it inherited large rank from the rest of the site.
Hasn't decreased my hits though. I actually think anywhere in the top 5 is about the same for some SERPs like Google. I know that when I search for pages, I look at the first set of listings, reading the description/page-snip before I choose which link to open. Although I'm sure there are many who automatically click the top listing.
Or even the top 10 or 20, if a keyword or keyphrase has several meanings. For example, a user searching on "Rome" will skip past the Rome, Italy listings if he's interested in pages about Rome, New York.