Predicting who's at risk for violence isn't easy

CHICAGO (AP) — It happened after Columbine, Virginia Tech, Aurora, Colo., and now Sandy Hook: People figure there surely were signs of impending violence. But experts say predicting who will be the next mass shooter is virtually impossible — partly because as commonplace as these calamities seem, they are relatively rare crimes.

Still, a combination of risk factors in troubled kids or adults including drug use and easy access to guns can increase the likelihood of violence, experts say.

But warning signs "only become crystal clear in the aftermath, said James Alan Fox, a Northeastern University criminology professor who has studied and written about mass killings.

"They're yellow flags. They only become red flags once the blood is spilled," he said.

Whether 20-year-old Adam Lanza, who used his mother's guns to kill her and then 20 children and six adults at their Connecticut school, made any hints about his plans isn't publicly known.

Fox said that sometimes, in the days, weeks or months preceding their crimes, mass murderers voice threats, or hints, either verbally or in writing, things like "'don't come to school tomorrow,'" or "'they're going to be sorry for mistreating me.'" Some prepare by target practicing, and plan their clothing "as well as their arsenal." (Police said Lanza went to shooting ranges with his mother in the past but not in the last six months.)

Although words might indicate a grudge, they don't necessarily mean violence will follow. And, of course, most who threaten never act, Fox said.

Even so, experts say threats of violence from troubled teens and young adults should be taken seriously and parents should attempt to get them a mental health evaluation and treatment if needed.

"In general, the police are unlikely to be able to do anything unless and until a crime has been committed," said Dr. Paul Appelbaum, a Columbia University professor of psychiatry, medicine and law. "Calling the police to confront a troubled teen has often led to tragedy."

The American Academy of Child & Adolescent Psychiatry says violent behavior should not be dismissed as "just a phase they're going through."

In a guidelines for families, the academy lists several risk factors for violence, including:

—Previous violent or aggressive behavior

—Being a victim of physical or sexual abuse

—Guns in the home

—Use of drugs or alcohol

—Brain damage from a head injury

Those with several of these risk factors should be evaluated by a mental health expert if they also show certain behaviors, including intense anger, frequent temper outbursts, extreme irritability or impulsiveness, the academy says. They may be more likely than others to become violent, although that doesn't mean they're at risk for the kind of violence that happened in Newtown, Conn.

Lanza, the Connecticut shooter, was socially withdrawn and awkward, and has been said to have had Asperger's disorder, a mild form of autism that has no clear connection with violence.

Autism experts and advocacy groups have complained that Asperger's is being unfairly blamed for the shootings, and say people with the disorder are much more likely to be victims of bullying and violence by others.

According to a research review published this year in Annals of General Psychiatry, most people with Asperger's who commit violent crimes have serious, often undiagnosed mental problems. That includes bipolar disorder, depression and personality disorders. It's not publicly known if Lanza had any of these, which in severe cases can include delusions and other psychotic symptoms.

Young adulthood is when psychotic illnesses typically emerge, and Appelbaum said there are several signs that a troubled teen or young adult might be heading in that direction: isolating themselves from friends and peers, spending long periods alone in their rooms, plummeting grades if they're still in school and expressing disturbing thoughts or fears that others are trying to hurt them.

Appelbaum said the most agonizing calls he gets are from parents whose children are descending into severe mental illness but who deny they are sick and refuse to go for treatment.

And in the case of adults, forcing them into treatment is difficult and dependent on laws that vary by state.

All states have laws that allow some form of court-ordered treatment, typically in a hospital for people considered a danger to themselves or others. Connecticut is among a handful with no option for court-ordered treatment in a less restrictive community setting, said Kristina Ragosta, an attorney with the Treatment Advocacy Center, a national group that advocates better access to mental health treatment.

Lanza's medical records haven't been publicly disclosed and authorities haven't said if it is known what type of treatment his family may have sought for him. Lanza killed himself at the school.

Jennifer Hoff of Mission Viejo, Calif. has a 19-year-old bipolar son who has had hallucinations, delusions and violent behavior for years. When he was younger and threatened to harm himself, she'd call 911 and leave the door unlocked for paramedics, who'd take him to a hospital for inpatient mental care.

Now that he's an adult, she said he has refused medication, left home, and authorities have indicated he can't be forced into treatment unless he harms himself — or commits a violent crime and is imprisoned. Hoff thinks prison is where he's headed — he's in jail, charged in an unarmed bank robbery.

___

Online:

American Academy of Child & Adolescent Psychiatry: http://www.aacap.org

___

AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

Read More..

Afghan policewoman kills U.S. adviser in police chief's compound

KABUL (Reuters) - An Afghan policewoman shot dead on Monday a U.S. forces member in the chief of police's compound in Kabul, police and NATO said, another "insider attack" that is bound to raise troubling questions about the direction of an unpopular war.

It appeared to be the first time that a woman member of Afghanistan's security forces shot a member of the Western coalition force supporting and training Afghanistan's military and police.

"A U.S. police adviser was killed in an attack by an Afghan policewoman," a spokesman for the NATO-led International Security Assistance Force (ISAF) said.

Mohammad Zahir, head of the police criminal investigation department, described the incident as an "insider attack" in which Afghan forces turn their weapons on Western troops they are supposed to be working with.

After more than 10 years of conflict, militants are capable of staging attacks on Western targets in the heart of the capital, and foreign forces worry that members of the Afghan police and military they are supposed to work with can suddenly turn on them.

The policewoman approached the American adviser as he was walking in the heavily guarded police chief's compound in a bustling area of the capital. She then drew a pistol and shot him once, a senior police official told Reuters.

The police compound is close to the Interior Ministry where in February, two American officers were shot dead at close range at a time anger gripped the country over the burning of copies of the Muslim holy book at a NATO base.

"She is now under interrogation. She is crying and saying 'what have I done'," said the official of the police officer who worked in a section of the Interior Ministry responsible for gender awareness issues.

The insider incidents, also known as green-on-blue attacks, have undermined trust between coalition and Afghan forces who are under mounting pressure to contain the Taliban insurgency before most NATO combat troops withdraw by the end of 2014.

Security responsibilities in a country plagued by conflict for decades will be handed to Afghan security forces.

Many Afghans fear a civil war like one dominated by warlords after the withdrawal of Soviet occupying forces in 1989 could erupt again, or the Taliban will make another push to seize power if they reject a nascent peace process.

At least 52 members of the NATO-led International Security Assistance Force have been killed this year by Afghans wearing police or army uniforms.

Insider attacks now account for one in every five combat deaths suffered by NATO-led forces in Afghanistan, and 16 percent of all U.S. combat casualties, according to 2012 data.

Hoping to stop the alarming rise in the attacks, Afghan Defense Ministry officials have given their troops tips in foreign culture, telling them not to be offended by a hearty pat on the back or an American soldier asking after your wife's health.

NATO attributes only about a quarter of the attacks to the Taliban, saying the rest are caused by personal grievances and misunderstandings. Last year, there were 35 deaths in such attacks.

(Writing by Michael Georgy; Editing by Robert Birsel)

Read More..

S'pore's top social issues in 2012

SINGAPORE: Singaporeans are under significant environmental and psychological pressure, say sociologists.

Stress from competitive workplaces and dense living conditions is just one reason people are showing more signs of intolerance and ungraciousness towards one another.

As the population gets older and more diverse, Singapore will continue to grapple with its social consciousness in the year ahead.

Over the course of 2012, in Woodlands, Bishan, Toh Yi Drive, and Jalan Batu, residents have spoken up strongly against new nursing homes, day care centres, and even studio apartments for the elderly in their neighbourhoods.

The concerns cited included fear of lower property prices, or the belief that old people are "unlucky".

"There is a gap between what we aspire to be and what we really are. We aspire to be a compassionate, a considerate society, we want to make sure people who are disadvantaged or need a leg up are included, like the elderly, the disabled, and the poor," commented Denise Phua, deputy chair of the government parliamentary committee for family and social development.

"But at the same time when it comes to difficult decisions as to whether I should locate that elderly centre right in my block or near my block or near where I live, that is another story altogether."

"We've seen the population of Singapore increase quite dramatically over the last five to eight years. We are also in the middle of very rapid population ageing," explained Asst Prof Angelique Chan from the National University of Singapore (NUS).

"Therefore people are feeling the population density. Singapore is the second densest population as a country in the world, so people are worried about their space and they're also trying to get used to having more older people in the environment."

Anti-foreigner sentiments also took a more strident tone on the Internet, in the wake of a horrific car crash where a Chinese national slammed his Ferrari into a taxi, killing himself and two others.

Online forums and websites were swamped with posts attacking the Chinese driver.

Other foreigners living and working in Singapore were also blamed for adding to the competition for jobs and space.

"This is something society has to find ways to avoid. Which means the Singaporean dream has to be kept alive," said Dr Reuben Wong, associate professor of political science at NUS.

"There must be this sense that if I work hard in my society, meritocracy still works so that I can get a better life than my parents. And if I can't find a better life in Singapore, then I have opportunities to go abroad to work, to get my degree, to get my job, and possibly even to raise my family, and then there will always be a Singapore I can come home to later on.

"This is something which, not just Singaporeans but the government has to get used to, that in an increasingly inter-connected world, Singaporeans will move and may even have to move in, some cases."

Observers say louder voices from the ground, even negative ones against foreigners or the elderly, are part of the country's political liberalisation.

"What tends to happen, if you look at the US for example, the baby boomers moved a lot of the major policy changes that occurred for employment of older adults, for placement of long term care services," said Asst Prof Chan.

"And in Singapore I think baby boomers will actually be a real changing force. Because they will form 30 per cent of the population, they will be the ones who'll be vocal, more vocal than the current generation of elderly, they may actually induce significant changes in how we view our work lives, retirement, and health care."

"People are more comfortable with writing online, writing to newspapers, writing to MPs or ministers directly, criticising them, giving feedback, telling them what they're doing that's wrong," said Dr Wong.

"This is a good thing because it means we have a system where people don't just get up and leave."

- CNA/xq

Read More..

India, Russia sign weapons deals worth billions of dollars

NEW DELHI: Russia and India signed new weapons deals worth billions of dollars on Monday as President Vladimir Putin sought to further boost ties with an old ally.

Putin and Prime Minister Manmohan Singh hailed cooperation between their countries as officials signed a $1.6 billion deal for India to purchase 42 Sukhoi Su-30 fighter jets and a $1.3 billion contract for the delivery of 71 Mil Mi-17 military helicopters.

Singh said the talks included discussions on the security situation in the region, including Afghanistan.

"India and Russia share the objective of a stable, united, democratic and prosperous Afghanistan, free from extremism," Singh told reporters after the talks.

While the volume of Russian-Indian trade has risen six-fold since 2000 and is expected to reach $10 billion this year, the growth has slowed in recent years. And even though India remains the No. 1 customer for Russia's arms industries, Moscow has recently lost several multibillion-dollar contracts to Western weapons makers.

Russia and India have shared close ties since the Cold War, when Moscow was a key ally and the principal arms supplier to New Delhi.

The ties slackened after the collapse of the Soviet Union, but grew stronger again after Putin came to power in 2000, seeking to revive Moscow's global clout and restore ties with old allies.

Russia has maintained its strong positions in the Indian market with $30 billion worth of arms contracts with India signed in 2000-2010 that envisaged supplies of hundreds of fighter jets, missiles, tanks and other weapons, a large part of which were license-produced in India. The countries have cooperated on building an advanced fighter plane and a new transport aircraft and have jointly developed a supersonic cruise missile for the Indian Navy.

But the military cooperation has hit snags in recent years, as New Delhi shops increasingly for Western weapons. The Indians also haven't been always happy with the quality of Russian weapons and their rising prices.

In one notable example, in 2004 Russia signed a $1 billion contract to refurbish a Soviet-built aircraft carrier for the Indian Navy. While the deal called for the ship to be commissioned in 2008, it is still in a Russian shipyard and the contract price has reportedly soared to $2.3 billion. The target date for the carrier's completion was moved back again this year after it suffered major engine problems in sea trials. Russian officials now promise to hand it over to India in the end of 2013.

India has also demanded that Russia pay fines for failing to meet terms under a 2006 contract for building three frigates for its navy, the third of which is yet to be commissioned.

Russia recently has suffered major defeats in competition with Western rivals in the Indian arms market.

Read More..

Predicting who's at risk for violence isn't easy

CHICAGO (AP) — It happened after Columbine, Virginia Tech, Aurora, Colo., and now Sandy Hook: People figure there surely were signs of impending violence. But experts say predicting who will be the next mass shooter is virtually impossible — partly because as commonplace as these calamities seem, they are relatively rare crimes.

Still, a combination of risk factors in troubled kids or adults including drug use and easy access to guns can increase the likelihood of violence, experts say.

But warning signs "only become crystal clear in the aftermath, said James Alan Fox, a Northeastern University criminology professor who has studied and written about mass killings.

"They're yellow flags. They only become red flags once the blood is spilled," he said.

Whether 20-year-old Adam Lanza, who used his mother's guns to kill her and then 20 children and six adults at their Connecticut school, made any hints about his plans isn't publicly known.

Fox said that sometimes, in the days, weeks or months preceding their crimes, mass murderers voice threats, or hints, either verbally or in writing, things like "'don't come to school tomorrow,'" or "'they're going to be sorry for mistreating me.'" Some prepare by target practicing, and plan their clothing "as well as their arsenal." (Police said Lanza went to shooting ranges with his mother in the past but not in the last six months.)

Although words might indicate a grudge, they don't necessarily mean violence will follow. And, of course, most who threaten never act, Fox said.

Even so, experts say threats of violence from troubled teens and young adults should be taken seriously and parents should attempt to get them a mental health evaluation and treatment if needed.

"In general, the police are unlikely to be able to do anything unless and until a crime has been committed," said Dr. Paul Appelbaum, a Columbia University professor of psychiatry, medicine and law. "Calling the police to confront a troubled teen has often led to tragedy."

The American Academy of Child & Adolescent Psychiatry says violent behavior should not be dismissed as "just a phase they're going through."

In a guidelines for families, the academy lists several risk factors for violence, including:

—Previous violent or aggressive behavior

—Being a victim of physical or sexual abuse

—Guns in the home

—Use of drugs or alcohol

—Brain damage from a head injury

Those with several of these risk factors should be evaluated by a mental health expert if they also show certain behaviors, including intense anger, frequent temper outbursts, extreme irritability or impulsiveness, the academy says. They may be more likely than others to become violent, although that doesn't mean they're at risk for the kind of violence that happened in Newtown, Conn.

Lanza, the Connecticut shooter, was socially withdrawn and awkward, and has been said to have had Asperger's disorder, a mild form of autism that has no clear connection with violence.

Autism experts and advocacy groups have complained that Asperger's is being unfairly blamed for the shootings, and say people with the disorder are much more likely to be victims of bullying and violence by others.

According to a research review published this year in Annals of General Psychiatry, most people with Asperger's who commit violent crimes have serious, often undiagnosed mental problems. That includes bipolar disorder, depression and personality disorders. It's not publicly known if Lanza had any of these, which in severe cases can include delusions and other psychotic symptoms.

Young adulthood is when psychotic illnesses typically emerge, and Appelbaum said there are several signs that a troubled teen or young adult might be heading in that direction: isolating themselves from friends and peers, spending long periods alone in their rooms, plummeting grades if they're still in school and expressing disturbing thoughts or fears that others are trying to hurt them.

Appelbaum said the most agonizing calls he gets are from parents whose children are descending into severe mental illness but who deny they are sick and refuse to go for treatment.

And in the case of adults, forcing them into treatment is difficult and dependent on laws that vary by state.

All states have laws that allow some form of court-ordered treatment, typically in a hospital for people considered a danger to themselves or others. Connecticut is among a handful with no option for court-ordered treatment in a less restrictive community setting, said Kristina Ragosta, an attorney with the Treatment Advocacy Center, a national group that advocates better access to mental health treatment.

Lanza's medical records haven't been publicly disclosed and authorities haven't said if it is known what type of treatment his family may have sought for him. Lanza killed himself at the school.

Jennifer Hoff of Mission Viejo, Calif. has a 19-year-old bipolar son who has had hallucinations, delusions and violent behavior for years. When he was younger and threatened to harm himself, she'd call 911 and leave the door unlocked for paramedics, who'd take him to a hospital for inpatient mental care.

Now that he's an adult, she said he has refused medication, left home, and authorities have indicated he can't be forced into treatment unless he harms himself — or commits a violent crime and is imprisoned. Hoff thinks prison is where he's headed — he's in jail, charged in an unarmed bank robbery.

___

Online:

American Academy of Child & Adolescent Psychiatry: http://www.aacap.org

___

AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

Read More..

Get 'em While You Can? Gun Sales Soar

The National Rifle Association may still get its way and defeat the lawmakers calling for a ban on the sale of assault ridles, but some gun store owners say it seems their customers aren't taking any chances.

"We have never seen anything like this," said Larry Hyatt, who owns a gun shop in Charlotte, N.C. "We have the Christmas business, the hunting season business, and now we have the political business.

"We have seen a lot of things, but we have never seen anything like this, this is probably four times bigger than the last time we saw a big rush," he said.

Some of the customers in his store said it is the talk of stricter gun control in the wake of the shooting at the Sandy Hook Elementary School in Newtown, Conn., that is driving the rush.

"The way they are trying to approach it, they are just making people who have never thought about buying a gun, now they want to come in here and buy a gun," one customer said.

At NOVA Firearms in Falls Church, Va., there have been "skyrocketing" sales following the Newtown shooting, chief firearms instructor Chuck Nesby said.

"They've been off the charts. Absolutely skyrocketing," Nesby said. "If I could give an award to President Obama and Senator Feinstein would be sales persons of the year."

He was referring to Sen. Dianne Feinstein, D-Calif., who said she will introduce an assault weapons ban in January.

Sales are up 400 percent, he said.

"We're completely out of the so-called assault weapons, semi automatic firearms that are rifles," Nesby said. "Forty percent of those sales went to women and senior citizens. We can't get them now. Everybody, nationwide is out of them the sales have just been off the charts nationwide."

National Rifle Association News Conference Interrupted by Protesters Watch Video

The horrific shooting, when 20-year-old Adam Lanza broke in to the elementary school and killed 20 children and six adults with a semi-automatic rifle, has even some former NRA supporters saying it's time to change the rules on assault weapons.

Those guns were banned from 1994 until 2004, when the ban expired and was not renewed.

Now it's not just lawmakers who have traditionally advocated stricter gun control talking about the need to act.

Republican Sen. Kay Bailey Hutchison of Texas suggested today on CBS' "Face the Nation" that new regulation should be considered.

"We ought to be looking at where the real danger is, like those large clips, I think that does need to be looked at," Hutchison said. "It's the semi-automatics and those large magazines that can be fired off very quickly. You do have to pull the trigger each time, but it's very quick."

Virginia Sen. Mark Warner, a Democrat but a long-time opponent of gun control who like Hutchison has received an A rating from the NRA, has also come out in support of strengthening gun laws.

NRA chief Wayne LaPierre said Friday that more gun control is not the way to stop such shooting from happening again: the answer is more guns, in the form of armed guards in every school.

After being criticized for two days for the proposal, LaPierre today stuck by his guns.

"If it's crazy to call for putting police and armed security in our schools to protect our children, then call me crazy," he said on NBC's "Meet the Press."

"When that horrible monster tried to shoot his way into Sandy Hook school, that if a good guy with a gun had been there, he might have been able to stop [it]," LaPierre said.

LaPierre and the NRA said that the media, the entertainment culture and lack of proper mental health care are to blame, not the proliferation of guns in the United States.

Asa Hutchinson, the former congressman who will lead the effort by the NRA to place armed security guards in schools across the country, said today on "This Week" that gun control efforts would not be part of the "ultimate solution" to gun violence.

Read More..

Israel says Syria chemical weapons are secure for now

JERUSALEM (Reuters) - Syria's chemical weapons are still secure despite the fact that President Bashar al-Assad has lost control of parts of the country, a senior Israeli defense official said on Sunday.

Amos Gilad told Army Radio that the civil war between Assad and opposition forces fighting to topple him had become deadlocked, but that the Syrian leader showed no signs of heeding international calls to step down.

"Suppose he (Assad) does leave, there could be chaos ... in the Middle East you never know who will come instead. We need to stay level-headed; the entire world is dealing with this. At the moment, chemical weapons are under control," Gilad said.

As Syria's southern neighbor, Israel has been concerned about chemical weapons falling into the hands of Islamist militants or Lebanese Hezbollah fighters, warning it could intervene to stop such developments.

Western countries said three weeks ago that Assad's government might be preparing to use poison gas to repel rebel fighters who are encamped around Damascus, the capital, and who control rural Aleppo and Idlib in the north.

"The opposition is not managing to defeat him and he is not defeating the opposition, though more and more parts of Syria are no longer under his control and that is what matters," Gilad said.

The rebels - mainly Sunni Muslims - are pushing southwards from their northern strongholds into the central province of Hama.

But Assad, who is from the Alawite minority linked to Shi'ite Islam, has responded with artillery, air strikes and, according to NATO, with Scud-type missiles.

Western powers and some Arab countries have called for Assad to step down, but Russia's Foreign Minister Sergei Lavrov said on Saturday that international efforts to persuade Assad to quit would fail.

Lavrov said Russia had rejected requests from countries in the region to pressure Assad to go or to offer him safe haven. If Assad did exit the political scene, it could lead to an upsurge in the fighting that activists say has killed 44,000 people since the uprising began in March 2011, Lavrov said.

(Writing by Maayan Lubell; Editing by Jeffrey Heller and Andrew Osborn)

Read More..

More renting cars & yachts this festive season

SINGAPORE: More Singaporeans are renting cars and yachts for their celebrations this festive season.

Short-term car rentals at Prime Car Rental has gone up by about 50 per cent during the festive period.

The company said MPVs are particularly popular, compared to other cars.

For some, it is all about splurging a bit more to celebrate in style.

"We don't really visit the Southern Islands that much and we don't come out to sea very often. So it's something new," said a Singaporean who had rented a yacht.

A four to five-hour cruise on a yacht can cost between S$1,500 and S$4,000, depending on the size.

MarineBookings said almost all of its vessels have been booked for Christmas Eve and the New Year period.

- CNA/xq

Read More..

Native village prays for Delhi gang rape victim's recovery

BALLIA, UTTAR PRADESH: Amid outrage across the country against the gang rape of a young woman student in Delhi, people in her native village are praying for her recovery and well-being.

Since the news of the incident came, locals of Medwara Kalan village are praying day and night in the local temple for the early recovery of the 23-year-old and that she succeeds in overcoming this testing phase, former village head Parasnath Yadav said.

The villagers have demanded capital punishment for the accused who brutalised the paramedic student in a Delhi bus.

"We will continue to struggle till the time the accused are hanged," Yadav said.

One of the victim's uncle, who lives in the village, said he and his family had gone to Delhi to see the young woman.

"People of the family are very worried after the incident," a family member said.

The native of Ballia was gang-raped by six men in a moving bus and later thrown out from the vehicle in South Delhi area on December 16.

The incident has resulted in protests across the country with people staging demonstrations and demanding stringent punishment to the accused.

Read More..

Predicting who's at risk for violence isn't easy

CHICAGO (AP) — It happened after Columbine, Virginia Tech, Aurora, Colo., and now Sandy Hook: People figure there surely were signs of impending violence. But experts say predicting who will be the next mass shooter is virtually impossible — partly because as commonplace as these calamities seem, they are relatively rare crimes.

Still, a combination of risk factors in troubled kids or adults including drug use and easy access to guns can increase the likelihood of violence, experts say.

But warning signs "only become crystal clear in the aftermath, said James Alan Fox, a Northeastern University criminology professor who has studied and written about mass killings.

"They're yellow flags. They only become red flags once the blood is spilled," he said.

Whether 20-year-old Adam Lanza, who used his mother's guns to kill her and then 20 children and six adults at their Connecticut school, made any hints about his plans isn't publicly known.

Fox said that sometimes, in the days, weeks or months preceding their crimes, mass murderers voice threats, or hints, either verbally or in writing, things like "'don't come to school tomorrow,'" or "'they're going to be sorry for mistreating me.'" Some prepare by target practicing, and plan their clothing "as well as their arsenal." (Police said Lanza went to shooting ranges with his mother in the past but not in the last six months.)

Although words might indicate a grudge, they don't necessarily mean violence will follow. And, of course, most who threaten never act, Fox said.

Even so, experts say threats of violence from troubled teens and young adults should be taken seriously and parents should attempt to get them a mental health evaluation and treatment if needed.

"In general, the police are unlikely to be able to do anything unless and until a crime has been committed," said Dr. Paul Appelbaum, a Columbia University professor of psychiatry, medicine and law. "Calling the police to confront a troubled teen has often led to tragedy."

The American Academy of Child & Adolescent Psychiatry says violent behavior should not be dismissed as "just a phase they're going through."

In a guidelines for families, the academy lists several risk factors for violence, including:

—Previous violent or aggressive behavior

—Being a victim of physical or sexual abuse

—Guns in the home

—Use of drugs or alcohol

—Brain damage from a head injury

Those with several of these risk factors should be evaluated by a mental health expert if they also show certain behaviors, including intense anger, frequent temper outbursts, extreme irritability or impulsiveness, the academy says. They may be more likely than others to become violent, although that doesn't mean they're at risk for the kind of violence that happened in Newtown, Conn.

Lanza, the Connecticut shooter, was socially withdrawn and awkward, and has been said to have had Asperger's disorder, a mild form of autism that has no clear connection with violence.

Autism experts and advocacy groups have complained that Asperger's is being unfairly blamed for the shootings, and say people with the disorder are much more likely to be victims of bullying and violence by others.

According to a research review published this year in Annals of General Psychiatry, most people with Asperger's who commit violent crimes have serious, often undiagnosed mental problems. That includes bipolar disorder, depression and personality disorders. It's not publicly known if Lanza had any of these, which in severe cases can include delusions and other psychotic symptoms.

Young adulthood is when psychotic illnesses typically emerge, and Appelbaum said there are several signs that a troubled teen or young adult might be heading in that direction: isolating themselves from friends and peers, spending long periods alone in their rooms, plummeting grades if they're still in school and expressing disturbing thoughts or fears that others are trying to hurt them.

Appelbaum said the most agonizing calls he gets are from parents whose children are descending into severe mental illness but who deny they are sick and refuse to go for treatment.

And in the case of adults, forcing them into treatment is difficult and dependent on laws that vary by state.

All states have laws that allow some form of court-ordered treatment, typically in a hospital for people considered a danger to themselves or others. Connecticut is among a handful with no option for court-ordered treatment in a less restrictive community setting, said Kristina Ragosta, an attorney with the Treatment Advocacy Center, a national group that advocates better access to mental health treatment.

Lanza's medical records haven't been publicly disclosed and authorities haven't said if it is known what type of treatment his family may have sought for him. Lanza killed himself at the school.

Jennifer Hoff of Mission Viejo, Calif. has a 19-year-old bipolar son who has had hallucinations, delusions and violent behavior for years. When he was younger and threatened to harm himself, she'd call 911 and leave the door unlocked for paramedics, who'd take him to a hospital for inpatient mental care.

Now that he's an adult, she said he has refused medication, left home, and authorities have indicated he can't be forced into treatment unless he harms himself — or commits a violent crime and is imprisoned. Hoff thinks prison is where he's headed — he's in jail, charged in an unarmed bank robbery.

___

Online:

American Academy of Child & Adolescent Psychiatry: http://www.aacap.org

___

AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

Read More..