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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Toyota Agrees to $1B Settlement in Acceleration Case












Toyota has agreed to pay more than $1 billion to customers to settle a class action lawsuit that alleged its vehicles accelerated dangerously and without warning, according to statements by the carmaker and the plaintiffs' attorney.


The deal, which still needs approval by a federal judge in California, includes a $250 million fund to be paid to Toyota owners who sold their cars at a loss following reports of vehicle malfunctions, as well as the installation of a brake override system in about 3.25 million vehicles


An additional $250 million fund will be created to pay those owners whose vehicles are not eligible for the retrofitted brakes.






David Zalubowski/AP PHoto







Toyota recalled more than 14 million vehicles after reports of sudden, unexplained acceleration in several models began to surface between 2009 and 2010. There were also reports of brake problems with the Prius hybrid.


Toyota insists that it was not an electrical flaw that caused the acceleration problems, but driver error, floor mats and sticky gas pedals.


Both the National Highway Traffic Safety Administration and NASA have said there is nothing in wrong with programs that run the vehicles' onboard computers


"From the very start, this was a challenging case," said Steve Berman, the plaintiffs' lawyer. "We brought in automotive experts, physicists and some of the world's leading theoreticians in electrical engineering to help us understand what happened to drivers experiencing sudden acceleration."


The settlement also includes $30 million to be given to outside groups to study automotive safety.


In a statement, Toyota agreed to the deal.


"In keeping with our core principles, we have structured this agreement in ways that work to put our customers first and demonstrate that they can count on Toyota to stand behind our vehicles." said Toyota spokesman Christopher P. Reynolds.



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Egypt approves constitution drafted by Mursi allies


CAIRO (Reuters) - Egyptian voters overwhelmingly approved a constitution drafted by President Mohamed Mursi's allies, results announced on Tuesday showed, proving that liberals, leftists and Christians have been powerless to halt the march of Islamists in power.


Final elections commission figures showed the constitution adopted with 63.8 percent of the vote in the referendum held over two days this month, giving Mursi's Islamists their third straight electoral victory since veteran autocrat Hosni Mubarak was toppled in a 2011 revolution.


Opposition groups had taken to the streets to block what they see as a move to ram through a charter that mixes politics and religion dangerously and ignores the rights of minorities.


Mursi says the text - Egypt's first constitution since Mubarak's fall - offers enough protection for minorities, and adopting it quickly is necessary to end two years of turmoil and political uncertainty that has wrecked the economy.


"I hope all national powers will now start working together now to build a new Egypt," Murad Ali, a senior official in the Muslim Brotherhood's Freedom and Justice Party, told Reuters.


"I see this as the best constitution in Egypt's history."


In a sign that weeks of unrest have taken a further toll on the economy, the government ordered new restrictions on foreign currency apparently designed to prevent capital flight. Leaving or entering with more than $10,000 cash is now banned.


Two years since waves of unrest broke out across the Middle East and North Africa - sweeping away long-entrenched rulers in Tunisia, Libya and Yemen as well as Egypt - well-organized Islamist parties have emerged as the main beneficiaries.


Urban secularists and liberals who were behind the revolts complain that their success has been hijacked.


"We need a better constitution," said Khaled Dawood, an opposition spokesman. "It does not represent all Egyptians."


Mursi's opponents say the new constitution could allow clerics to intervene in lawmaking, while offering scant protections to minorities and women. Mursi dismisses those criticisms, and many Egyptians are fed up with street protest movements that have prevented a return to normality.


Immediately after the announcement, a small group of protesters set tires on fire and blocked traffic near the central Tahrir square, the cradle of Egypt's uprising, but there were no immediate signs of violence or major demonstrations.


Washington, which provides billions of dollars a year in military and other support for Egypt and regards it as a pillar of security in the Middle East, called on Egyptian politicians to bridge divisions and on all sides to reject violence.


"President Mursi, as the democratically elected leader of Egypt, has a special responsibility to move forward in a way that recognizes the urgent need to bridge divisions," State Department spokesman Patrick Ventrell said. He noted that many Egyptians had voiced "significant concerns" over the constitutional process.


WORSENING ECONOMY


The government says its opponents are worsening the economic crisis by prolonging political upheaval. It has pledged to impose unpopular tax increases and spending cuts to win a loan package from the International Monetary Fund.


The ban on travelling with more than $10,000 in cash followed a pledge by the central bank to take unspecified measures to protect Egyptian banks. Some Egyptians have begun withdrawing their savings in fear of more restrictions.


"I am not going to put any more money in the bank and neither will many of the people I know," said Ayman Osama, father of two young children.


He said he had taken out the equivalent of about $16,000 from his account this week and planned to withdraw more, adding that he had also told his wife to buy more gold jewellery.


The "yes" vote paves the way for a parliamentary election in about two months, setting the stage for another battle between surging Islamists and their fractious opponents.


The final result, announced by the election commission, matched - to the last decimal place - an earlier unofficial tally announced by Mursi's Muslim Brotherhood.


But the opposition said it was disappointed - it had appealed for the result to be amended to reflect what it described as major vote violations during the two-round vote.


Officials said there were no violations serious enough to change the result significantly. "We have seriously investigated all the complaints," said judge Samir Abu el-Matti of the Supreme Election Committee. The final turnout was 32.9 percent.


SENSE OF CRISIS


The referendum has sharpened painful divisions in the Arab world's most populous nation and a growing atmosphere of crisis has gripped Egypt's polarized society.


Anxiety about the economy deepened this week when Standard and Poor's cut Egypt's long-term credit rating. Prime Minister Hisham Kandil told the nation of 83 million on Tuesday the government was committed to fixing the economy.


"The main goals that the government is working towards now is plugging the budget deficit, and working on increasing growth to boost employment rates, curb inflation, and increase the competitiveness of Egyptian exports," he said.


The referendum follows Islamist victories in parliamentary and presidential elections, representing a decisive shift in a country at the heart of the Arab world where Mursi's Muslim Brotherhood was suppressed for generations by military rulers.


However, secularist and liberal opposition members hope they can organize better in time for the next parliamentary vote.


Hossam El-Din Ali, a 35-year-old newspaper vendor in central Cairo, said he agreed the new constitution would help bring some political stability but like many others he feared the possible economic austerity measures lying ahead.


"People don't want higher prices. People are upset about this," he said. "There is recession, things are not moving. But I am wishing for the best, God willing."


(Additional reporting by Patrick Werr, Tamim Elyan, Ahmed Tolba and Marwa Awad; Writing by Maria Golovnina)



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Myanmar probes deadly plane crash-landing






HEHO, Myanmar: Myanmar was on Wednesday probing the cause of an air accident that left two people dead and 11 injured when a passenger jet packed with foreign tourists crash-landed and caught fire.

The incident raised fresh questions about the safety standards of Myanmar's fast-growing but overstretched aviation and tourist industries as foreign visitors flock to the country which is emerging from decades of junta rule.

The ageing Fokker 100 jet came down in heavy fog Tuesday in a field short of the runway at Heho airport -- the gateway to the popular tourist destination of Inle Lake -- breaking its tail and catching fire, according to officials.

One Burmese tour guide on board was killed along with a motorcyclist on the ground. The government earlier said an 11-year-old passenger had died but it appeared to be a case of mistaken identity.

The airline said the injured included two Americans who were flown to Bangkok for treatment, as well as two Britons, one Korean man and the two pilots.

"We are still working to find out the cause," Civil Aviation Department deputy director general Win Swe Tun, who is heading the investigation into the crash, told AFP at Heho airport.

He said the plane appeared to have hit a power cable while approaching the runway.

"Seventy of the 71 people on board survived and one died -- it's very rare," he added.

Air Bagan, which described the accident as an "emergency landing", said it had retrieved the plane's black box data recorder.

One eyewitness said flames were already spewing from the plane before it crash-landed.

"We followed the plane as it flew on fire," said 27-year-old villager Phoe La Pyae.

"When we saw the plane, the wing was broken already," he said. "It was so lucky. If the emergency exit had not been opened, no one would have survived".

"We helped to send some seriously injured people to hospital. Their skin was burnt because of fire. Foreigners seemed really scared about what happened," he added.

The body of the aircraft was almost entirely burned while part of a wing was seen lying next to a nearby road, according to an AFP reporter at the scene.

The carrier said 26 passengers were flown to Yangon on a special flight Tuesday and taken to hospital for examination while others would follow.

"Air Bagan deeply regret the deaths of two persons and tender its condolences to the bereaved families," the airline said in an English-language statement posted on its Facebook page.

"Air Bagan in collaboration with the Ministry of Transport is investigating into the cause of the accident. We will take full responsibility for all passengers and will release further information as we received it."

The airline is one of several domestic carriers seeking to profit from a tourist boom in Myanmar as it emerges from decades of military rule.

It is owned by tycoon Tay Za, who is known for his close links to the former junta and has been blacklisted by the US Treasury which once described him as "a notorious regime henchman and arms dealer".

The Fokker 100, which is no longer manufactured, was one of two operated by the airline along with four ATR turboprop aircraft, according to the company's website.

A surge in demand for air travel as Myanmar opens up has stretched the impoverished country's aviation infrastructure, in particular in remote airports.

- AFP/ck



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Home ministry announces Rs 10 lakh ex-gratia for family of dead constable Subhash Tomar

NEW DELHI: The home ministry announced on Wednesday an ex-gratia of Rs 10 lakh to the next of kin of Delhi Police constable Subhash Chand Tomar, who died here on Tuesday morning.

An ex-gratia of Rs 10 lakh will be given to the family of Tomar in addition to the financial and other relief announced by the Delhi Police, a home ministry spokesperson said.

The 47-year-old constable, who was injured during violent protests at India Gate on Sunday, died on Tuesday after battling for life in a city hospital.

Tomar was posted in Karawal Nagar area and was called for maintaining law and order at India Gate area during the weekend protests over the gangrape of a 23-year-old girl.

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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..

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".

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..