Talk:Primary gain
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I am new to Wikipedia, so I want to start here so as not to step on any toes. However, the entry for Primary Gain is in error, and major rewrites are needed. I will enter a first draft here - please tell me if this might be an appropriate start at a rewrite:
Source: DSM-IV-TR
Patients' symptoms often have a significant psychological component, and physicians sometimes categorize psychological motivators into primary and secondary gain. Primary gain is an internal, unconscious motivator. For example, if a patient might particularly guilty about being unable to perform some task, their medical symptoms may be amplified as a psychological defense against the guilt. Primary gain can be a component of any disease, but is most dramatically demonstrated in Conversion Disorder (a psychiatric disorder in which stressors manifest themselves as physical symptoms without organic causes - such as a person who becomes blind 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 her to miss work, gains 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 she is deliberately exaggerating symptoms for personal gain, then she is malingering. However, secondary gain may simply be an unconscious psychologic component of symptoms.
A less-well studied process is tertiary gain: the extent to which the patients symptoms may become more pronounced to subconsciously please health care providers. Riffington 04:20, 22 November 2006 (UTC)
