This behavior pattern has been conceptualized as being largely a difference in verbal behavior, but other differences are reported to exist and are marshaled as evidence for this disorder. That is, the individuals who exhibit these behaviors are reported to be different in intelligence and pharmaceutical needs, and have different corrective prescriptions for vision, allergies, and so on (American Psychiatric Association, 1994). Some of these reported differences are explainable in the analysis presented here. For instance, a person's intelligence quotient score consists of his ability to answer specific types of questions and his attempts to perform some nonverbal tasks. Some of these are a person's verbal behaviors (Staats, 1963), in that the person, when displaying some personalities, does not "know as much" as when executing other personalities. The person simply answers fewer questions correctly when performing Bob’s repertoire than when performing the personality repertoire of Jose. In terms of nonverbal tasks, "I can't figure this one out" or "I don't know what to do here" can end the trial, just as performing slower or faster can alter the score. The score is taken as a measure of intelligence when all that are being measured are test-taking skills (Staats, 1993) which are largely self-reports. The reported differences in corrective lenses are explainable by differential self-report but the differences in medical conditions may be more difficult to explain.
Pain complaints, paralysis, blindness, etc., also consist of a self-report of a private event. Each of these may be accompanied by publicly observable behaviors such as wincing, reluctantly moving, reporting or appearing to be unable to move or see (Fordyce, 1976; Skinner, 1974). Both the self-reports and the public display of these differences are under stimulus control of the different personality repertoires. When such an individual displays a specific personality, the self-report of pain or other symptom comes or goes with the other behaviors. Originally, the public signs of pain were authentic afflictions in the past as the result of abuse; months or years later, such indications could be self-produced, rule-governed behavior as part of the personality repertoire. These pains and related behaviors could be reinforced and shaped into a "real" affliction by well meaning others as the verbal behavior acquired differential stimulus control of operant pain behavior. The reports of pain and the display of pain-related behaviors can persist as operant behavior maintained by its consequences in the absence of the original painful stimuli (Bonica & Chapman, 1986; Fordyce, 1976; Rachlin, 1985).
As for the reports in the literature of allergic and other responses being present in some personalities and not i n others, these too can potentially be accounted for via verbal behavior mechanisms. There are reports that individuals can develop rashes, a wound or a burn or other physiological symptoms in response to another's verbal suggestions, i.e., under hypnosis (Barker, 2001), although it has been argued that many of these symptoms are likely self-inflicted when observers are not present (Johnson, 1989). Verified reports of hypnotically-induced dermatological changes are difficult to substantiate; such effects are difficult to produce and are not as common an occurrence as often reported (Johnson). These reports are not all due to the acts of the person showing the symptoms; instead, these symptoms may be due to an interaction of verbal behavior and conditioning mechanisms, (Barker). Verbal behavior can also facilitate the development of stimulus control via respondent or operant conditioning (Skinner, 1957). If an experimenter were to flash a light in your eyes and then shock you, then you would be expected to recoil to the light after some number of such pairings. If the experimenter were to explain the contingency between the light and the shock, it would be expected for you to recoil to the light after fewer trials (Wilson, 1968). Such instructions are “ . . . not intended to change the subject’s beliefs about what events are to occur, but about the contingency between them” (Boakes, 1989, p. 385).
Relating this to the differential report and display of symptoms is not a big leap. Here, the individuals who display the divergent personalities have self-instructed and subsequently conditioned themselves to display symptoms when performing different behavioral repertories. Over time, the symptoms may come under the stimulus control of the emotions displayed, in addition to the person's verbal behavior, and appear spontaneous to the person him- or herself. To support the argument for conditioning mechanisms producing somatic symptoms, biofeedback has successfully been applied to treat autonomic dysfunctions as diverse as dysmenorrhea and seizure activity (Adler & Adler, 1989), hypertension (Dubbert, 1995), and psoriasis (Goodman, 1994), among others.