Date of Award


Document Type


Degree Name

Doctor of Psychology (PsyD)



First Advisor

Laurie Roehrich, Ph.D.

Second Advisor

Maureen McHugh, Ph.D.

Third Advisor

Mark McGowan, Ph.D.


This study aims to extend the current research on secondary gain among chronic pain patients. Previous research identified the concept of secondary gain having evolved from Freudian neurosis and an unfair association with malingering. Current research recognizes a more complete construct that includes secondary gains and losses as well as the gains and losses from tertiary levels. These levels of gains and loss create an overall economy that is theorized to have an effect on the treatment outcomes of chronic pain patients. From a biopsychosocial perspective, the current study hypothesized that the maintenance of social roles would serve as a predicting factor for the effect of gains and losses on treatment outcome for chronic pain patients. Although there are currently minimal studies utilizing clinical population data to quantify secondary gain effects, this study recruited 52 chronic pain patients identified by physicians at a regional, rural Trauma 1 hospital. These participants completed self-report questionnaires on demographics, chronic pain, social roles, and quality of life. Aggregate data responses were analyzed through multiple single, linear regressions. Social roles were not found to have a significant predictive effect on the outcome quality of life for this study. Possible explanations include a limited sample size and statistical power, a weak measurement for social role construct, and the possibility that gains and losses are less influential than previously theorized.