Primary and secondary gain
Primary gain or secondary gain are used in medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....

 to describe the significant psychological motivators
Motivation is the driving force by which humans achieve their goals. Motivation is said to be intrinsic or extrinsic. The term is generally used for humans but it can also be used to describe the causes for animal behavior as well. This article refers to human motivation...

 patients may have in reporting symptoms.

Primary gain produces positive internal motivations. For example, a patient might feel guilty about being unable to perform some task. If he has a medical condition justifying his inability, he might not feel so bad. Primary gain can be a component of any disease, but is most dramatically demonstrated in conversion disorder
Conversion disorder
Conversion disorder is a condition in which patients present with neurological symptoms such as numbness, blindness, paralysis, or fits without a neurological cause. It is thought that these problems arise in response to difficulties in the patient's life, and conversion is considered a psychiatric...

 (a psychiatric disorder in which stressors manifest themselves as physical symptoms without organic causes, such as a person who becomes blindly inactive after seeing a murder). The "gain" may not be particularly evident to an outside observer.

Secondary gain can also be a component of any disease, but is an external motivator. If a patient's disease allows him/her to miss work, gains him/her sympathy, or avoids a jail sentence, these would be examples of secondary gain. These may, but need not be, recognized by the patient. If he/she is deliberately exaggerating symptoms for personal gain, then he/she is malingering
Malingering is a medical term that refers to fabricating or exaggerating the symptoms of mental or physical disorders for a variety of "secondary gain" motives, which may include financial compensation ; avoiding school, work or military service; obtaining drugs; getting lighter criminal sentences;...

. However, secondary gain may simply be an unconscious psychological component of symptoms and other personalities. In the context of a person with a significant mental or psychiatric disability, this effect is sometimes called secondary handicap.

Tertiary gain, a less well-studied process, is when a third party such as a relative or friend is motivated to gain sympathy or other benefits from the illness of the victim.
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