@article{dd76fbef97f2456ca04604572aa9106e,
title = "Secondary gain concept. Definition problems and its abuse in medical practice",
abstract = "Secondary gain is claimed to be important to the generation and maintenance of disease or illness behavior. This concept is of major interest to the clinician dealing with the chronic pain patient, as these clinicians often encounter patients with whom secondary gain factors are suspected or inferred, or both. The author begins a critical examination of the concept of secondary gain. Primary, secondary, and tertiary gains and secondary losses are defined and described. Difficulties with and abuses of the secondary gain concept in chronic pain treatment are presented.",
keywords = "abuse of the secondary gain concept, primary gain, reinforcers, secondary gain, secondary losses, tertiary gain",
author = "Fishbain, {David A.}",
note = "Funding Information: he purpose of this focus article is to generate a scientific and meaningful dialogue about a troubling concept: secondary gain. This con-T cept is thought to be important to pain medicine and to medicine in general as it appears to have infiltrated the nomenclature of every medical speciality. For example, in preparing this article, the author was able to find and review 163 articles in which secondary gain, primary gain, and tertiary gain were mentioned in some way. These articles were categorized according to the medical specialty of origin and where possible by topic. In addition, any articles that were studied on secondary gain, whether controlled or not, were segregated as a group. The reports are categorized as follows: 15.3% from medicine, sur- From the Universityo f Miami School of Medicine, Miami Beach, FL. Partially supported by National Institute of Disability and Rehabilitation Research Grant H133A00032. Reprint requests: David A. Fishbain, MD, FAPA, University of Miami Comprehensive Pain Center, 600 Alton Road, Miami Beach, FL 33139.",
year = "1994",
doi = "10.1016/S1058-9139(05)80274-8",
language = "English (US)",
volume = "3",
pages = "264--273",
journal = "Journal of Pain",
issn = "1526-5900",
publisher = "Churchill Livingstone",
number = "4",
}