Secondary gain concept

A review of the scientific evidence

David A Fishbain, H. L. Rosomoff, R. B. Cutler, R. S. Rosomoff

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

The 'secondary gain' concept originated in the psychoanalytic literature, where it was never vigorously examined. The purpose of this review is to determine if there are scientific studies that have explored the validity of this concept. Design: A computer and manual literature review yielded 166 references in which primary, secondary, and tertiary gain were mentioned. Twenty-four (14.5%) of these reports were 'secondary gain' studies. Fourteen 'reinforcement' studies were also found. These 38 studies were grouped according to topics and reviewed in detail. Setting: Any medical treatment setting including pain treatment was utilized in the review procedure, i.e., no exclusion criteria. Patients: Any patient type, including those suffering from chronic pain, were utilized in the review procedure, i.e., no exclusion criteria. Results: A significant but limited number of studies have investigated the 'secondary gain' concept, and the results of some of these studies are in conflict. Results of some studies, however, are remarkably consistent in supporting the importance of 'secondary gain' to behavior. Some studies have methodological flaws, usually relating to how the presence of secondary gain was established. Conclusions: Overall the results of the reviewed studies support the potential importance of the 'secondary gain' concept to understanding illness behavior and underscore a need for future research in this area.

Original languageEnglish
Pages (from-to)6-21
Number of pages16
JournalClinical Journal of Pain
Volume11
Issue number1
StatePublished - Jan 1 1995
Externally publishedYes

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Illness Behavior
Chronic Pain
Pain
Therapeutics
Conflict (Psychology)
Reinforcement (Psychology)

Keywords

  • Review
  • Scientific evidence
  • Secondary gain

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Clinical Neurology

Cite this

Fishbain, D. A., Rosomoff, H. L., Cutler, R. B., & Rosomoff, R. S. (1995). Secondary gain concept: A review of the scientific evidence. Clinical Journal of Pain, 11(1), 6-21.

Secondary gain concept : A review of the scientific evidence. / Fishbain, David A; Rosomoff, H. L.; Cutler, R. B.; Rosomoff, R. S.

In: Clinical Journal of Pain, Vol. 11, No. 1, 01.01.1995, p. 6-21.

Research output: Contribution to journalArticle

Fishbain, DA, Rosomoff, HL, Cutler, RB & Rosomoff, RS 1995, 'Secondary gain concept: A review of the scientific evidence', Clinical Journal of Pain, vol. 11, no. 1, pp. 6-21.
Fishbain DA, Rosomoff HL, Cutler RB, Rosomoff RS. Secondary gain concept: A review of the scientific evidence. Clinical Journal of Pain. 1995 Jan 1;11(1):6-21.
Fishbain, David A ; Rosomoff, H. L. ; Cutler, R. B. ; Rosomoff, R. S. / Secondary gain concept : A review of the scientific evidence. In: Clinical Journal of Pain. 1995 ; Vol. 11, No. 1. pp. 6-21.
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