Editing Primary and secondary gain

{{Short description|Psychoanalytic reason for disease}}
{{other uses|Gain (disambiguation)}}
'''Primary gain''' and '''secondary gain''', and more rarely '''tertiary gain''', are [[Terminology|terms]] used in [[medicine]] and [[psychology]] to describe the significant subconscious [[psychological]] [[motivation|motivators]] patients may have when presenting with symptoms. If these motivators are recognized by the patient, and especially if symptoms are fabricated or exaggerated for personal gain, then this is instead considered [[malingering]]. The difference between primary and secondary gain is that with primary gain, the reason a person may not be able to go to work is because they are injured or ill, whereas with secondary gain, the reason that person is injured or ill is so that they cannot go to work.<ref>{{Cite book|title=Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR)|publisher=[[American Psychiatric Association]]|year=2000|isbn=9780890420256|location=[[Washington, D.C.]]}}</ref>

==Primary gain==
Primary gain produces positive internal motivations. For example, a patient might feel guilty about being unable to perform some task. If a medical condition justifying an inability is present, it may lead to decreased psychological stress. Primary gain can be a component of any [[disease]], but is most typically demonstrated in [[conversion disorder]] — a psychiatric disorder in which stressors manifest themselves as physical symptoms without organic causes, such as a person who becomes [[Visual impairment|blind]] after seeing a [[murder]]. The "gain" may not be particularly evident to an outside observer.{{Citation needed|date=July 2021}}

==Secondary gain==
Secondary gain can also be a component of any disease, but is an external motivator. If a patient's disease allows them to miss work, avoid [[military]] duty, obtain [[financial]] compensation, obtain [[drugs]], avoid a [[jail]] sentence, etc., these would be examples of a secondary gain. For instance, an individual having household chores completed by someone else because they have [[stomach cramp]]s would be a secondary gain. In the context of a person with a significant psychiatric disability, this effect is sometimes called "secondary handicap".<ref>{{cite journal |last1=Jones |first1=Robert |last2=Harrison |first2=Carmel |last3=Ball |first3=Melany |title=Secondary Handicap & Learning Disability: A Component Analysis |journal=Mental Health and Learning Disabilities Research and Practice |date=October 2008 |volume=5 |issue=2 |pages=300–310 |doi=10.5920/mhldrp.2008.52300 |doi-access=free }}</ref>

==Tertiary gain==
Tertiary gain, a less well-studied process, is the benefit that a third-party receives from the patient's symptoms.<ref>{{cite journal |last1=Dansak |first1=Daniel A. |title=On the tertiary gain of illness |journal=Comprehensive Psychiatry |date=November 1973 |volume=14 |issue=6 |pages=523–534 |doi=10.1016/0010-440X(73)90038-2 |pmid=4764353 }}</ref> It includes [[gaslighting]] wherein a person, such as a family member or [[healthcare]] worker for financial or other reasons, manipulates a patient into believing that they are ill. Tertiary gain can also be received when, for example, a [[pharmaceutical]] company runs [[advertisements]] to convince viewers they have symptoms which require treatment with the company's drug.{{Citation needed|date=July 2021}}

==References==
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[[Category:Psychiatric diagnosis]]