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

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Christmas Tornadoes Tear Across South

A nasty Christmastime storm system spawned blizzard conditions in some states and at least 15 reported tornadoes in the South, damaging homes, taking out power lines and dangerously snarling holiday travel.

Severe weather swept across the United States during the Christmas holiday, bringing tornadoes and intense thunderstorms to the Gulf Coast, while dumping heavy snow and freezing rain on the Southern Plains.

At least 15 tornadoes were reported today from Texas to Alabama, putting this storm system potentially on track to be one of the largest Christmas day tornado outbreaks on record.

One large tornado was reported in Mobile, Ala., where there are about 19,000 customers without power and 23,429 statewide, according to Alabama Power. Kerry Burns, a Mobile resident originally from Boston, said the storm "sounded like a freight train."

Some buildings in the area, including some churches and a local high school, were reportedly damaged. Ray Uballe, another Mobile resident, said his dad was shaken up.

"He was in his apartment," Uballe said. "He said it sounded like an airplane and then the door flung open and then there was just debris flying."

Douglas Mark Nix, president of the Infirmary Health System, said one of their Mobile hospitals lost power and sustained damage. There were no early reports of injuries to staff or patients.

"We are operating now on generator power," he said. "We do not have substantial damage but we do have a number of windows out and we have some ceiling tiles down, throughout the facility at the main hospital.

"We can run for at least two weeks but I saw power crews out all over the city so I fully expect power to be restored within the next day or so," Nix added.

Melinda Martinez/The Daily Town Talk/AP Photo

Winter Weather Causes Holiday Travel Problems Watch Video

At least eight states were issued blizzard warnings today, as the storms made highways dangerously slick heading into one of the busiest travel days of the year.

Oklahoma got about 7 inches of snow all over the state making for treacherous road conditions. ABC News affiliate KOCO-TV in Oklahoma City said the weather was being blamed for a 21-vehicle wreck on Interstate 40, but no one was seriously injured.

Ice accumulation in Arkansas bent trees and power lines, leaving at least 50,000 customers across the state without power. About 10 inches of snow fell on Fayetteville, Ark.

The storms, which first wreaked havoc on the West Coast before moving east, are being blamed for at least one death in Texas.

Investigators in the Houston area told ABC state KTRK-TV in Houston that a young man was trying to move a downed tree that was blocking the roadway when another one snapped and fell on top of him. He was later pronounced dead at a hopsital.

The last time a number of tornadoes hit the Gulf Coast area around Christmas Day was in 2009, when 22 tornadoes struck on Christmas Eve morning, National Weather Service spokesman Chris Vaccaro told ABC News over email.

The deadliest Christmastime tornado outbreak on record was Dec. 24 to 26, 1982, when 29 tornadoes in Oklahoma, Missouri, Arkansas, Tennessee and Mississippi killed three people and injured 32.

The last killer tornado around Christmas, Vaccaro said, was a Christmas Eve EF4 in Tennessee in 1988, which killed one person and injured seven. EF4 tornadoes can produce winds up to 200 mph.

No official word yet on the strength of the string of tornadoes reported today.

While some were preparing for a Christmas feast, others were hunkered down.

More than 180 flights nationwide were canceled by midday, according to the flight tracker FlightAware.com. More than half were canceled by American Airlines and its regional affiliate, American Eagle.

The storm system is expected to continue east into Georgia and the Carolinas Wednesday and could potentially spawn more tornadoes, according to the National Weather Service.

ABC News' Matt Gutman, Max Golembo and ABC News Radio contributed to this report.

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U.N. General Assembly voices concern for Myanmar's Muslims

UNITED NATIONS (Reuters) - The U.N. General Assembly expressed serious concern on Monday over violence between Rohingya Muslims and Buddhists in Myanmar and called upon its government to address reports of human rights abuses by some authorities.

The 193-nation General Assembly approved by consensus a non-binding resolution, which Myanmar said last month contained a "litany of sweeping allegations, accuracies of which have yet to be verified."

Outbreaks of violence between ethnic Rakhine Buddhists and the Rohingyas have killed dozens and displaced thousands since June. Rights groups also have accused Myanmar security forces of killing, raping and arresting Rohingyas after the riots. Myanmar said it exercised "maximum restraint" to quell the violence.

The unanimously adopted U.N. resolution "expressing particular concern about the situation of the Rohingya minority in Rakhine state, urges the government to take action to bring about an improvement in their situation and to protect all their human rights, including their right to a nationality."

At least 800,000 Muslim Rohingyas live in Rakhine State along the western coast of Myanmar, also known as Burma. But Buddhist Rakhines and other Burmese view them as illegal immigrants from neighboring Bangladesh who deserve neither rights nor sympathy.

The resolution adopted on Monday is identical to one approved last month by the General Assembly's Third Committee, which focuses on human rights. After that vote, Myanmar's mission to the United Nations said that it accepted the resolution but objected to the Rohingyas being referred to as a minority.

"There has been no such ethnic group as Rohingya among the ethnic groups of Myanmar," a representative of Myanmar said at the time. "Despite this fact, the right to citizenship for any member or community has been and will never be denied if they are in line with the law of the land."

(Reporting By Louis Charbonneau; Editing by Paul Simao)

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Four jawans killed in shooting at Chhattisgarh CRPF camp

RAIPUR: Four CRPF jawans were killed and one was injured after their colleague opened fire at them in Chhattisgarh's Dantewada district.

The shooting occurred on Monday night at the camp of 111 CRPF Battalion when a jawan Deep Kumar Tiwari opened fire on the jawans who were sleeping, Dantewada SP Narendra Khare told .

While three jawans died on the spot, one died while being taken to hospital, Khare said, adding that the injured has been referred to a Jagdalpur hospital.

While the exact cause is being ascertained Khare said the accused was suffering from some "psychological problems".

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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

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Newtown Christmas: 'We Know They'll Feel Loved'

People drawn to Newtown to share in its mourning brought cards and handmade snowflakes to town Monday while residents prepared to observe Christmas less than two weeks after a gunman killed 20 children and six educators at an elementary school.

On Christmas Eve, residents said they would light luminaries outside their homes in memory of the victims. Tiny empty Christmas stockings with the victims' names on them hung from trees in the neighborhood where the children were shot.

"We know that they'll feel loved. They'll feel that somebody actually cares," said Treyvon Smalls, a 15-year-old from a few towns away who arrived at town hall with hundreds of cards and paper snowflakes collected from around the state.

Organizers said they wanted to let the families of victims know they are not alone while also giving Connecticut children a chance to express their feelings about the shootings at Sandy Hook Elementary School.

At the Trinity Episcopal Church, less than 2 miles from the school, an overflow crowd of several hundred people attended Christmas Eve services. They were greeted by the sounds of a children's choir echoing throughout a sanctuary hall that had its walls decorated with green wreaths adorned with red bows.

The church program said flowers were donated in honor of Sandy Hook shooting victims, identified by name or as the "school angels" and "Sandy Hook families."

Julio Cortez, File/AP Photo

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The service, which generally took on a celebratory tone, made only a few vague references to the shooting. Pastor Kathie Adams-Shepherd led the congregation in praying "that the joy and consolation of the wonderful counselor might enliven all who are touched by illness, danger, or grief, especially all those families affected by the shootings in Sandy Hook."

Police say the gunman killed his mother in her bed before his Dec. 14 rampage and committed suicide as he heard officers arriving. Authorities have yet to give a theory about his motive.

While the grief is still fresh, some residents are urging political activism in the wake of the tragedy. A grassroots group called Newtown United has been meeting at the library to talk about issues ranging from gun control, to increasing mental health services to the types of memorials that could be erected for the victims. Some clergy members have said they also intend to push for change.

"We seek not to be the town of tragedy," said Rabbi Shaul Praver of Congregation Adath Israel. "But, we seek to be the town where all the great changes started."

Since the shooting, messages similar to the ones delivered Monday have arrived from around the world. People have donated toys, books, money and more. A United Way fund, one of many, has collected $3 million. People have given nearly $500,000 to a memorial scholarship fund at the University of Connecticut. On Christmas Day, police from other towns have agreed to work so Newtown officers can have the time off.

In the center of Newtown's Sandy Hook section Monday, a steady stream of residents and out-of-towners snapped pictures, lit candles and dropped off children's gifts at an expansive memorial filled with stuffed animals, poems, flowers, posters and cards.

"All the families who lost those little kids, Christmas will never be the same," said Philippe Poncet, a Newtown resident originally from France. "Everybody across the world is trying to share the tragedy with our community here."

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Egyptians back new constitution in referendum

CAIRO (Reuters) - An Islamist-backed Egyptian constitution won approval in a referendum, rival camps said on Sunday, after a vote the opposition said would sow deep social divisions in the Arab world's most populous nation.

The Islamist Muslim Brotherhood, which propelled President Mohamed Mursi to power in a June election, said an unofficial tally showed 64 percent of voters backed the charter after two rounds of voting that ended with a final ballot on Saturday.

An opposition official also told Reuters their unofficial count showed the result was a "yes" vote, while party spokesmen said there had been a series of abuses during the voting.

The main opposition coalition, the National Salvation Front, responded to the defeat by saying it was moving towards forming a single political party to challenge the Islamists who have dominated the ballot box since strongman Hosni Mubarak was overthrown two years ago.

Members of the opposition, taking heart from a low turnout of about 30 percent of voters, pledged to keep up pressure on Mursi through peaceful protests and other democratic means.

"The referendum is not the end of the road," said Khaled Dawoud, a spokesman for the National Salvation Front. "It is only the beginning of a long struggle for Egypt's future."

The referendum committee may not declare official results for the two rounds until Monday, after hearing appeals. If the outcome is confirmed, a parliamentary election will follow in about two months.

Mursi's Islamist backers say the constitution is vital for the transition to democracy, nearly two years after Mubarak was ousted in a popular uprising. It will provide the stability needed to help a fragile economy, they say.

The constitution was "a historic opportunity to unite all national powers on the basis of mutual respect and honest dialogue for the sake of stabilizing the nation," the Brotherhood said in a statement.

RECIPE FOR UNREST

The opposition accuses Mursi of pushing through a text that favors Islamists and ignores the rights of Christians, who make up about 10 percent of the population, as well as women. They say it is a recipe for further unrest.

The opposition said voting in both rounds was marred by abuses. However, an official said the overall vote favored the charter.

"The majority is not big and the minority is not small," liberal politician Amr Hamzawy said, adding that the National Salvation Front would use "all peaceful, democratic means" such as protests to challenge the constitution.

The vote was split over two days as many judges had refused to supervise the ballot, making a single day of voting impossible.

During the build-up to the vote there were deadly protests, sparked by Mursi's decision to award himself extra powers in a November 22 decree and then to fast-track the constitutional vote.

The new basic law sets a limit of two four-year presidential terms. It says the principles of sharia, Islamic law, remain the main source of legislation but adds an article to explain this. It also says Islamic authorities will be consulted on sharia - a source of concern to Christians and others.

ABUSES

Rights groups reported what they said were illegalities in voting procedures. They said some polling stations opened late, that Islamists illegally campaigned at some polling places, and complained of irregularities in voter registration.

But the committee overseeing the two-stage vote said its investigations showed no major irregularities in voting on December 15, which covered about half of Egypt's 51 million voters. About 25 million were eligible to vote in the second round.

The Brotherhood said turnout was about a third of voters.

The opposition says the constitution will stir up more trouble on the streets since it has not received sufficiently broad backing for a document that should be agreed by consensus, and raised questions about the fairness of the vote.

In the first round, the district covering most of Cairo voted "no," which opponents said showed the depth of division.

"I see more unrest," said Ahmed Said, head of the liberal Free Egyptians Party and a member of the opposition Front.

He cited "serious violations" on the first day of voting, and said anger against Mursi was growing. "People are not going to accept the way they are dealing with the situation."

At least eight people were killed in protests outside the presidential palace in Cairo this month. Islamists and rivals clashed in Alexandria, the second-biggest city, on the eves of both voting days.

(Writing by Edmund Blair and Giles Elgood; editing by Philippa Fletcher)

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"Bleach" creator Tite Kubo weds

TOKYO: The creator of the popular Japanese manga series "Bleach", Tite Kubo, revealed Saturday during the "Jump Festa 2013" anime and manga convention held in Tokyo that he has gotten married, reported Japanese media.

The 35-year-old manga artiste, whose real name is Noriaki Kubo, simply said "I got married", in handouts that contained notes from various manga authors, which were distributed during the event.

He did not mention who he married or when the wedding took place.

However, his short message was enough to prompt his fans to leave a deluge of congratulatory messages on his Twitter account.

Created in 2001, "Bleach" is one of the best-selling manga series in Japan, with over 500 chapters released to date.

"Bleach" traces the adventures of Ichigo Kurosaki, a young man who can see ghosts, and later acquires ever-stronger spiritual powers to fight evil.

-CNA/ha

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Putin targets arms deals, doubling trade on India visit today

NEW DELHI: Russian President Vladimir Putin pledged to tighten defence ties with India and double levels of bilateral trade within three years as he headed to New Delhi for a summit on Monday.

Accompanied by several senior ministers and military officials, Putin will meet Prime Minister Manmohan Singh on a one-day visit designed to highlight the strong ties between two traditional allies and fellow BRICS.

"I would like to stress that deepening of friendship and cooperation with India is among the top priorities of our foreign policy," Putin wrote in an article for The Hindu, an Indian daily, ahead of his visit.

India is now the world's largest arms importer and Russian-made military equipment accounts for 70 per cent of Indian arms supplies.

However, while Russia once had a virtual monopoly over India's arms market, New Delhi has been shopping around of late and the visit is seen in Moscow as a chance to regain lost ground and develop joint projects.

"The strategic nature of partnership between India and Russia is witnessed by the unprecedented level of our military and technical cooperation," Putin wrote in his article, saying "the joint development of advanced armaments rather than just purchasing military products" would be key to future relations.

His comments echoed those of Indian Foreign Minister Salman Khurshid who said Friday that "India is committed to strengthening and enhancing this relationship, both on economic and strategic ties".

"There is a lot of work in progress and a lot of issues and agreements will be taken up," he told reporters.

The Kremlin has said that a number of major contracts on military-technical cooperation would be inked during the visit — Putin's first to South Asia since his return to the Kremlin in May.

Likely tie-ups are expected to involve Russia's Sukhoi aircraft manufacturer, including a $3.77 billion deal for 42 Su-30MKI fighters and a deal to produce the fifth generation Sukhoi fighter — a joint Russia-India project, according to Igor Korotchenko, director of the Centre for Analysis of World Arms Trade.

Moscow has been worried recently by New Delhi's increasing preference for western suppliers, especially after Boeing was chosen last month over Russia's MiL plant for a major helicopter contract.

India has also been unhappy with delays of deliveries of some naval equipment, notably of the aircraft carrier Admiral Gorshkov, which is being refurbished for the Indian Navy at Russia's Sevmash naval yard.

Russia was originally to deliver the upgraded vessel in August 2008, but the date has now been pushed back to the end of 2013, while the price has more than doubled to $2.3 billion.

According to Indian government figures, bilateral trade has been growing steadily and is expected to reach around 10 billion dollars in 2012, up from 7.5 billion in 2009.

Putin set out a goal of doubling bilateral trade in just three years.

"Our trade turnover has overcome the consequences of global crisis, and in 2012 we expect to reach record numbers, over $10 billion. Our next goal is to reach $20 bln already by 2015," he said.

Russia and India are both so-called BRICS, the bloc of emerging powers which is seeking to act as a counterweight to western powers and which also includes Brazil, China and South Africa.

India is hoping Russia will help it achieve its ambition of joining an expanded UN Security Council which currently only has five permanent members — Russia, China, the United States, France and Britain.

The Kremlin said that Russia sees India "as one of the worthy and strong candidates for a permanent seat in the expanded UN Security Council".

As well as his talks with Singh, Putin is also due to meet the ruling Congress party chief Sonia Gandhi and Sushma Swaraj, leader of the opposition BJP.

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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..