Sometimes, the patient might have significant psychological motivators for reporting of symptoms. These motivators have been divided into primary and secondary gain.
Secondary gain 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.
A less well-studied process is tertiary gain, when a third party such as a relative or friend is motivated to gain sympathy or other benefits from the illness of the victim.