I. Hypothetical Suicidal Person
socio-cultural variables (age, sex, state, county, pol-econ.)
unrealsitic "love" in value system
achievement (high role expectations)
family (imp. of mother)
decline of self-worth; self criticism; guilt ridden
behavior which goes unrewarded, while all behavior is seen as failure; guilt (never good enough);self-destruction
Anglo-Saxon notion of achievement
identify deprivation (intra and inter-personal development)
inflexibility in behavior
attempt vs. accomplished suicide (1/50-100 ratio)

II. Identity Theories (and their relation to suicide)
threaten leads to attempt leads to suicide (is a "career")
Symbolic Interaction - all reference point to "others"
ego-psychologist also tell us of the importance of "others" in the development of identity formation. (seen in theories of Baldwin, Mead, Goffman, Cooley, etc.) conduct is not "I" but response to acts
Lichenstein's work stresses importance of mother in interpersonal development and in family interactionand creates identity theme
Goffman work stresses notion of "stigma" as part of identity formation; one's spoiled "identity" is "stigma" and person is reducedto discredited person (person requires significant others)
Erikson's eight stages of identification are individual and social, complimentary role integration and synthesis in group:

1. Trust vs. Mistrust (0-1 years of age)
2. Autonomy vs. shame and doubt (2)
3. Initiative and guilt (4 years)
4. Industry vs. Inferiority (6-11)
5. Identity and identity confusion
6. Intimacy vs. Isolation (young adult)
7. Generality vs. stagnation (adulthood)
8. Integrity vs. Despair/disgust

III. Childhood/Adolescent Suicide
interpersonal vs. intrapersonal (more common in older person)
male and female differences (although suicide is higher among males, and the use of firearms affiliated with feelings of shame; guilt; despair;loneliness; blame of love object; self-failure; lacking confidence and seeing expectations far beyondwhat one can accomplish)
female suicide often linked to abandonment by family and/or lover; shy, lonely, never achieve; inflexible; poor self image
identity less existent in children since identity hasn't formed
700-800 suicides annually are in this category
inter-personal involving "others"
middle of identity confusion and receive little satisfactions; feels inferior; insecure;mistrustful of others; detachment
female syndrome is to feel abandoned by lover
has few friends and is shy
desperate reaction to never being able to achieve
inflexible

IV. Middle Age
interpersonal - marital partner involved
rejection by symbiotic partner
male involves problems and work; while female involes being abandoned by lovermale in this age gambles with death
three conditions necessary: suicidal person; available methods; and unavailability of counseloror intervention/preventive circumstances

V. Age and Suicide
to alleviate pain and emotion; more lethal in adults than in young
change in life situation which is unacceptable to the person;
change occurs in identity; loss of friends and network, job, home, health; bonds of integrationare gone
society has degrading attitude toward aged; routinization and detachment are existent in nursing homes and other institutionsfor the sick and elderlynursing homes are examples of identity deprivation ("demoralization process and career") therefore identity, sense of integrity is lost, meaningless;meaningful sources of identity and significant others are taken away

VI. Identity Reformation
brainwashing is technique which creates discomfort with existing environment
identity deprivation is withdrawing from lifelong interpersonal relationships with other

• Dramatic changes in work force with regard to women who entered and have pre-adolescent children in 1970's
• Dual-Career Families are fast growing segment of work force today
• Stress is inherent part of the lifestyle of dual-career families
• "Social Stress" is a result of multiple role demads (for example, overload, parenting), gender differences and corporate pressures
• Few companies understand or recognized "dual career" couples as an issue for corporate policy
• Women who work haveless stress than women who stay at home; however, women with pre-adolescent children appear to have the gravest problems of allocating time in familly/work responsibilities
• Corporations that attempt to work with couples, who are part of dual-career families have implemented programs as flex time, relocationassistance, and child care benefits as part of their policies
• Women have conflict over parenting, child care, and housework demands, while men have more strain between family and work roles
• Dual-Career couples have forced distinct changes on the composition, values, and mobility patterns of corporations
• Executives are refusing to relocate due to work role of their spouse
• Women relocate more for their spouse's career opportunity, than the reverse
• Singlehood, childlessness and higher divorce rate is directly related to dual-career lifestyle
• Corporations do not think that dual-career couples have affected their operations
• Lack of clear-cut corporate policy in this area; their is ambivalence and think problem doesn't exist
• What can be done: flexitime; job sharing; relocation; child care; "cafeteria" benefits

(26m two-income; 4.5m couples; 60% women full time with children)
Advantages: more income, lifestyle choices, higher satisfaction
Disadvantages: scheduling problems, psychological spillover, role overload, excessive work time, rigid roles by partners
Resolutions: educational programs, couple committment, involvement by father, redefine roles, re-establishpriorities, renegotiate values, gov. & corp. policies (i.e. day care, changed benefit plans, consortium programs, flexi-time, maternity/paternity leaves, corp. transfers & loans)

Donor Rates Affected by:

• Race
• Gender
• Income
• Age

1. nature of Donor programs/Donor Network
2. access to donor programs
3. assertiveness and knowledge of donor programs
4. costs, travel, and time allocations
5. medical biases
6. blacks suffer from hypertension, have lower success rate, therefore, self-fulfilling
7. age - race and age are most significant factors in kidney transplants

Comparisons of the Characteristics of and Implications Derived from the Medical model and the Social-Psychological Model

PATTERNS/RATES OF DEATH
Observing differences allows us to look at how societal changes affect nature and definition of disease.
Deaths of children under 15 years attributed to Scarlet Fever, Diptheria, Whooping Cough, Measles--successivedecline from 1850 to 1965.
Mortality from major communicable diseases--U.S. decline from 1900 to 1974 (including pneumonia and influenza).
Maternal mortality--decline from 1915 to 1974.
Mortality from diabetes--increase from 1900 to 1940, then rapid decline.
Increase in viral diseases-HIV.

LEADING CAUSES OF DEATH IN THE UNITED STATES

1900 Influenza and pneumonia Tuberculosis Gastroenteritis Heart Disease Strokes Chronic nephritis (renal disease) Accidents Cancer Diseases of early infancy Diptheria	1974 Heart disease Cancer Strokes Accidents Pneumonia Diabetes Cirrhosis of theliver Suicide Homocide Emphysema
1967 Heart disease Cancer Strokes Accidents Influenza and Pneumonia Arteriosclerosis Diabetes Other circulatory diseases Other bronchopulmonic diseases	1985-1989 Heart Cancer Stroke Pneumonia Liver Diabetes Arteriosclerosis HIV Accidents Suicide Homocide

What do these figures indicate:

1. medical technology
2. definitionsof illness
3. expectations of health/illness behavior
4. germ theory of medicine and its role in research and curative measuresvs. a preventative approach to medicine
5. trend from infectious disease to degenerative diseases
6. trend toward "social" diseases