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.

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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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As winter storm bears down on Midwest, death toll climbs

OKLAHOMA CITY (AP) -- A winter storm system that blew through Christmas Day with Gulf Coast tornadoes and snow in the nation's midsection headed for the Northeast on Wednesday, spreading blizzard conditions that slowed holiday travel.

The death toll rose to six with car accidents on snow and sleet-slickened highways in Arkansas and Oklahoma.

Post-Christmas travelers braced for flight delays and a raft of weather warnings for drivers, a day after rare winter twisters damaged buildings in Louisiana, Mississippi and Alabama.

Snow blew across southern Illinois and southern Indiana early Wednesday as the storm tracked up the Ohio River valley toward the Eastern seaboard and New England.

There were whiteout conditions in parts of southwestern Indiana, where 6 inches or more of snow had fallen by midmorning around Evansville. State police reported dozens of vehicles stuck after not being able to get up a hill on a central Indiana highway, while some roads around Evansville were impassable with wind gusts around 30 mph.

A blizzard warning was in effect for much of the state's southern two-thirds and more than a dozen counties issued travel watches asking residents to make only essential driving trips.

"People need to not travel. They need to just go where they're going to be and stay there," said Rachel Trevino, a meteorologist at the National Weather Service bureau in Paducah, Ky., which covers southwestern Indiana.

In snowy Arkansas, the storm left more than 189,000 customers without electricity Wednesday, utility Entergy Arkansas said.

Severe thunderstorms were forecast for the Carolinas while a line of blizzard and winter storm warnings stretched from Arkansas up the Ohio River to New York and on to Maine.

Thirty-four tornadoes were reported in Texas, Louisiana, Mississippi and Alabama during the outbreak Tuesday, the National Weather Service said.

Rick Cauley's family was hosting relatives for Christmas when tornado sirens went off in Mobile. Not taking any chances, he and his wife, Ashley, hustled everyone down the block to take shelter at the athletic field house at Mobile's Murphy High School in Mobile.

It turns out, that wasn't the place to head.

"As luck would have it, that's where the tornado hit," Cauley said. "The pressure dropped and the ears started popping and it got crazy for a second." They were all fine, though the school was damaged, as were a church and several homes, but officials say no one was seriously injured.

Camera footage captured the approach of the large funnel cloud.

Mobile was the biggest city hit by numerous twisters. Along with brutal, straight-line winds, the storms knocked down countless trees, blew the roofs off homes and left many Christmas celebrations in the dark. Torrential rains drenched the region and several places saw flash flooding.

More than 750 flights around the U.S. were canceled as of Wednesday morning, according to the flight tracker FlightAware.com. The cancelations were mostly spread around airports that had been or soon would be in the path of the storm.

Holiday travelers in the nation's much colder midsection battled treacherous driving conditions from freezing rain and blizzard conditions from the same fast-moving storms. In Arkansas, highway department officials said the state was fortunate the snowstorm hit on Christmas Day when many travelers were already at their destinations.

Two passengers in a car on a sleet-slickened Arkansas highway died Wednesday when the vehicle crossed the center line and struck an SUV head-on. In Oklahoma, the Highway Patrol said a 76-year-old Wisconsin woman died Tuesday when the car she was riding in was hit head-on by a pickup truck on Interstate 44.

The Oklahoma Highway Patrol had earlier reported that a 28-year-old woman was killed in another crash Tuesday on a snowy highway. The storm's winds were blamed Tuesday for toppling a tree onto a pickup truck in Texas, killing the driver, and another tree onto a house in Louisiana, killing a man there.

Trees fell on homes and across roadways in several communities in southern Mississippi and Louisiana. Mississippi Gov. Phil Bryant declared a state of emergency, saying eight counties reported damages and some injuries.

It included McNeill, where a likely tornado damaged a dozen homes and sent eight people to the hospital, none with life-threatening injuries, said Pearl River County emergency management agency director Danny Manley.

The snowstorm that caused numerous accidents pushed out of Oklahoma late Tuesday, carrying with it blizzard warnings for parts of northeast Arkansas, where 10 inches of snow was forecast. Freezing rain clung to trees and utility lines in Arkansas and winds gusts up to 30 mph whipped them around, causing about 71,000 customers to lose electricity for a time.

Christmas lights also were knocked out with more than 100,000 customers without power for at least a time in Texas, Arkansas, Oklahoma, Mississippi, Louisiana and Alabama.

Blizzard conditions were possible for parts of Illinois, Indiana and Kentucky up to Cleveland with predictions of several inches to a foot of snow. By the end of the week, that snow was expected to move into the Northeast with again up to a foot predicted

Jason Gerth said the Mobile tornado passed by in a few moments and from his porch, he saw about a half-dozen green flashes in the distance as transformers blew. His home was spared.

"It missed us by 100 feet and we have no damage," Gerth said.

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Kazakhstan military plane crashes, killing 27

MOSCOW (AP) — Kazakhstan's acting border service chief was among 27 people killed in a military plane crash Tuesday near a southern city, another blow to the agency after he was appointed in June to deal with the aftermath of a mass killing involving a conscript.

The Russian-made An-72 crashed at 1255 GMT (7:55 a.m. EST) about 20 kilometers (12 miles) away from the city of Shymkent near the border with Uzbekistan, Kazakhstan's Committee for National Security said in a statement.

The fatalities included a crew of seven and 20 border guards, including the acting head of the ex-Soviet nation's border protection service, Col. Turganbek Stambekov, the statement said.

Without specifying further details, authorities said an investigation was opened into the crash. No cause was given, but southern Kazakhstan over recent weeks has been buffeted by winds, heavy snows and low temperatures, causing widespread flight delays.

Stambekov was appointed acting head of the border service in June, after a mass killing of 14 frontier troops in a remote Kazakh outpost near China the month before. Vladislav Chelakh, a 20-year-old conscript, was sentenced earlier this month to life in prison after being found solely responsible for the killings.

The border service has come under close scrutiny in Kazakhstan since the killings, which many argued showed the lack of readiness and professionalism among serving troops. Legislation approved Thursday by the upper house of parliament and supported by Stambekov was designed to improve the process for selecting conscripts for the service.

The Kazakh-Uzbek border stretches 2,200 kilometers (1,350 miles) of Central Asian steppes and deserts.

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Reaction to the death of actor Jack Klugman

Celebrities on Monday reacted to the death of "Odd Couple" star Jack Klugman, who died Monday at age 90. Here are samples of sentiments expressed on Twitter:

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"R.I.P. Jack Klugman, Oscar, Quincy a man whose career spanned almost 50 years. I first saw him on the Twilight Zone. Cool guy wonderful actor." — Whoopi Goldberg.

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"You made my whole family laugh together." — Actor Jon Favreau, of "Swingers," ''Iron Man" and other films.

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"I worked with Jack Klugman several years ago. He was a wonderful man and supremely talented actor. He will be missed" — Actor Max Greenfield, of the "New Girl" on Fox.

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"So sorry to hear that Jack Klugman passed away. I learned a lot, watching him on television" — Dan Schneider, creator of Nickelodeon TV shows "iCarly," ''Drake and Josh" ''Good Burger," ''Drake & Josh."

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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..

U.S. gun support runs far deeper than politics

BRYAN, Texas (AP) — Adam Lanza's mother was among the tens of millions of U.S. gun owners. She legally had a .223-caliber Bushmaster rifle and a pair of handguns, which her 20-year-old son used to kill 20 children and six adults in 10 efficient minutes inside a Connecticut school.

In the raw aftermath of the second-worst school shooting in U.S. history, countless gun enthusiasts much like Lanza's mother complicate a gun-owning narrative that critics, sometimes simplistically, put at the feet of a powerful lobby and caricatured zealots. More civilians are armed in the U.S. than anywhere else in the world, with Yemen coming in a distant second, according to the Small Arms Survey in Geneva.

Take Blake Smith, a mechanical engineer who lives near Houston and uses an AR-15 style rifle in shooting competitions.

Texas Gov. Rick Perry, who famously claimed to have shot a coyote while jogging with a pistol holstered to his running shorts, has signed a half-dozen certificates applauding Smith as one of the state's top marksmen. "But I won't call myself a fanatic," said Smith, 54, whose father first let him handle a gun around age 6.

"I sit at a desk all day. And when I get out to the range, I don't hear any gunfire going on," said Smith, who likens his emotional detachment to his guns to the way he would feel about a car or any other machine. "I'm so intent on my sight alignment, my trigger pull, my position. I don't worry about anything. I don't think about anything. It's relieving. It's therapeutic. Everybody has to have their Zen."

Since the school shooting, President Barack Obama has asked for proposals on reducing gun violence that he can take to Congress in January, and he called on the National Rifle Association, the country's most powerful gun-rights organization, to join the effort.

Gun laws in the U.S. vary from state to state — for instance, as of last month it is now legal to carry a gun in public view in Oklahoma — and are defended by a well-funded firearms industry and the NRA. On Friday, the NRA broke a weeklong silence since the Connecticut massacre by calling for armed volunteers at public schools, prompting criticism from many quarters.

But in the U.S., gun-control advocates are up against a sizeable bloc of mainstream Americans for whom guns is plainly central to their lives, whether for patriotism or personal sense of safety, or simply to occupy their spare time.

Dave Burdett, who owns an outdoors and adventure shop across the street from the sprawling Texas A&M University campus in College Station, says his affinity for guns is rooted in history, not sport.

"It isn't about hunting. Everyone says, 'Well, I can understand having a sporting rifle, but not an AR-15," Burdett said. "But wait a second — the idea of the Second Amendment was to preserve and protect the rights of individuals to have those guns."

"Remember that the (American) revolution was fought by citizen soldiers," he added. "To this day, that's one of the cornerstones of our military defense. We have an all-volunteer military."

An NRA poster picturing a bald eagle is taped to the glass door of his office. He started as a lawyer, dabbling in everything from commercial land to trying to block the deportation of an illegal immigrant, before seguing into selling guns.

When his daughter graduated with a business degree from Texas A&M, Burdett figured she would move somewhere cosmopolitan like Dallas and work in a downtown high-rise. She instead went to work in the store, built her own AR-15 out of spare parts and used it to join what her father described as the "let's-go-pig-hunting-tonight circuit." Those feral hog hunts often include high-powered rifles as well as night-vision goggles.

"The other thing is, shooting is fun. It really is," Burdett said.

Many think so. Smith, the mechanical engineer, said that includes teenage girls. At national shooting competitions, Smith has run into a group of girls around 13 or 14 years old who call themselves "The Pink Ladies," firing high-powered rifles at targets. He also recalls meeting Australians, whose country bans guns, who told him, "I love to shoot, so I'm going to the U.S."

Others add safety to the list of reasons for allowing people easy access to guns.

"To me it's obvious — the more people that have guns, or at least in their homes, it's more of a criminal deterrent," said Bill Moos, a local taxidermist in the small town of Bryan, near College Station. Moos, who owns more than 30 guns, can be spotted any given morning, prowling his roughly 40-acre (16-hectare) ranch with his dogs and a shotgun slung over his shoulder.

He tells a story of standing in the post office one day and hearing about a suspect driving around in a black car, wanted by the police. He thought of the woman behind the counter near him.

"My first thought was, 'How are you going to protect yourself?' Does she have a gun, in case someone tries to rob her?" he said. "It's the first thing you think of: How are you going to defend yourself?"

On the television in the corner of his workshop, above a stuffed gray fox and a clutch of animal jawbones dangling on a ring like a set of keys, Obama is holding his first press conference since the Connecticut tragedy. He's promising to send Congress legislation tightening gun laws and urging them to reinstate a ban on military-style assault weapons, like the one used by Lanza.

Moos turns down the volume.

"I guess it's something you get used to," he said of guns. "That you grow up around, and you enjoy them, and you accept the fact that you can own. It's a privilege. It's a whole different way of life. I guess I don't need three pick-ups and a Corvette. But I have them."

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Follow Paul J. Weber on Twitter: www.twitter.com/pauljweber

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Thousands sign US petition to deport Piers Morgan

LONDON (AP) — Tens of thousands of people have signed a petition calling for British CNN host Piers Morgan to be deported from the U.S. over his gun control views.

Morgan has taken an aggressive stand for tighter U.S. gun laws in the wake of the Newtown, Connecticut, school shooting. Last week, he called a gun advocate appearing on his "Piers Morgan Tonight" show an "unbelievably stupid man."

Now, gun rights activists are fighting back. A petition created Dec. 21 on the White House e-petition website by a user in Texas accuses Morgan of engaging in a "hostile attack against the U.S. Constitution" by targeting the Second Amendment. It demands he be deported immediately for "exploiting his position as a national network television host to stage attacks against the rights of American citizens."

The petition has already hit the 25,000 signature threshold to get a White House response. By Monday, it had 31,813 signatures.

Morgan seemed unfazed — and even amused — by the movement.

In a series of Twitter messages, he alternately urged his followers to sign the petition and in response to one article about the petition said "bring it on" as he appeared to track the petition's progress.

"If I do get deported from America for wanting fewer gun murders, are there any other countries that will have me?" he wrote.

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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..

Two firefighters shot and killed while responding to fire in western N.Y.

Residence near shooting and fire in Webster evacuated. (Max Schulte/Rochester Democrat&Chronicle via Twitter)

Two firefighters were shot and killed and two others injured while responding to an early morning fire in Webster, N.Y.

Webster Police Chief Gerald Pickering said shots were fired at West Webster firefighters when they arrived to battle the blaze along Lake Road in Webster, which is about 10 miles west of Rochester.

According to the Rochester Democrat & Chronicle, there are no active shooters at the scene and firefighters have resumed battling the blazes, according to Sheriff Patrick O’Flynn.

The two injured firefighters are in guarded condition at Strong Memorial Hospital with gunshot wounds, a hospital spokeswoman told the Democrat & Chronicle. The newspaper reported firefighters made their way across a bridge to get to safety.

The morning scene was described as chaotic as police and firefighters dealt with an immense blaze as well as gunshots,  local news station WHAM-TV  reports. The station also reports the firefighters who are involved are volunteer firefighters.

“I’m not aware of anything like this happening in Webster, obviously not a firefighter being fired upon,” Webster Fire Marshal Rob Boutillier told the Democrat & Chronicle.

There at least three houses that have been damaged by the fire along Lake Road, WHAM-TV reported. Firefighters had to leave the scene and stop battling the blazes while police secured the scene. They are back to fighting the fires, the station reports.

More details are expected to come from officials in an upcoming media briefing.

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In Afghan Taliban birthplace, US troops step back

FORWARD OPERATING BASE PASAB, Afghanistan (AP) — President Barak Obama will decide in the coming weeks how many American troops to send home from Afghanistan next year. A major factor in his decision will be the question of how successful U.S. troops have been in preparing the Afghans to secure their country at bases like this one, located in one of the country's most violent areas — the birthplace of the Taliban.

There have been calls in Congress for Obama to increase the size of a planned drawdown of U.S. forces before the end of summer 2013, when the Afghan military is supposed to take the lead in security across the country. Afghan President Hamid Karzai, as well, has suggested he wants the drawdown accelerated.

"We are working to make this transition of security happen sooner. We want all the foreign forces to come out of the villages and go to their bases so the Afghan forces can carry out security," Karzai said last week.

But too large a pullout too soon could undermine the fight against the Taliban insurgency if Afghan forces are not fully prepared. It is widely thought that Gen. John Allen, the top military commander in Afghanistan, and his senior staff want to keep a large force in place for the summer fighting season, before international forces move into an entirely back-up and training role behind the Afghan forces by the start of autumn — an event known as "Milestone 13."

Obama is expected to decide on the size of the withdrawal after meeting with Karzai in Washington in early January. Their talks will also be key on determining what the U.S. military's role will be in Afghanistan after December 2014, when the foreign combat mission is set to end and almost all international troops are scheduled to leave. The U.S. currently has 66,000 thousand troops in Afghanistan out of an international force totaling about 102,000.

The work of training Afghan army units being done at this dusty base in the Zhari district of Kandahar province and at other bases scattered around the country will help shape Obama's decision.

U.S. and Afghan officers here say the district is a success story: Violence has not gone up more than two months after the American presence here was brought down from around 3,500 troops to around 300, with Afghan forces taking the lead in more areas.

But the situation remains tenuous. Residents say Taliban fighters remain in control of large parts of the district.

Zhari is where Taliban leader Mullah Omar was born, where he founded the movement that ruled Afghanistan in the 1990s and has battled U.S. and Afghan forces for the past 11 years. Three years ago, Taliban forces controlled the district, and it has been one of the three most violent areas of Kandahar, the province that is the Taliban's traditional heartland.

U.S soldiers had a hard fight in Zhari when they moved into the south in large force as part of the surge in American troops early in the Obama administration. The district has rich farmland that produces pomegranates and grapes used for raisins, and the fields, covered in dirt mounds, formed natural trenches the Taliban could fight from. Food, which was abundant, was easily coerced by the Taliban from villagers.

Lt. Col. Tim Davis, commander of Combined Task Force Buffalo, said, "the density of mines was impressive" when his task force arrived and that it required "an entire combat operation just to put a road in."

The commander of international forces in Kandahar and three other southern provinces, U.S. Army Maj. Gen. Robert Abrams, told reporters recently that progress in Zhari had been "astounding." Afghan forces are already in the lead of security duties in many parts of the district, he said. Across the south, the Afghans carry out 400 to 500 daily patrols without coalition assistance.

Afghan military officers in Zhari contend they can now handle the fight without much help from the U.S.-led International Security Assistance Force.

"Zhari is about 70 percent safe now," said Col. Abdul Rahimi, operations officer of the Afghan army's 3rd Brigade 205th Corps at Pasab base, though he acknowledged neighboring Maiwand district remains a problem. The number of Taliban fighters was down to around 100 in Zhari and Maiwand, compared to some 900 two years ago, he said.

"The enemy is not able right now to fight against the government, nor can it take over if ISAF leaves," Rahimi said.

Residents in Zhari, however, give a different picture. Some said the government has control of the main highway but not much else.

"Government claims that they control most of the area are just a dream not related to any reality," Allahnoor Taraki, a 38-year-old farmer, said.

Mohammed Salim Danghar, a taxi driver, said the province remains hotly contested. While the government has improved its position, he said, "we all know that most of the area is controlled by the Taliban."

The American drawdown in Zhari is a model of plans for the pullback elsewhere.

Here, large American combat units have been replaced by smaller teams made up of about 18 soldiers each. The teams are embedded with Afghan units, advising them on tactics, leadership and strategy — but not fighting.

In Zhari, attacks "have not only decreased, but significantly decreased," said Davis.

"The challenge is when we start pulling back," he said. The key to a successful transition will be "to see if the local security forces can take up the slack."

The U.S. military plans to repeat that process elsewhere in the south and east by creating 400 such teams. At the same time, eight of the 14 U.S. brigades in Afghanistan will be reduced in size to 1,400-1,900 personnel, down from 3,500, to act as support for the teams. That role change alone will mean a reduction of between 13,000 to 17,000 NATO troops.

The U.S. military has not made public its recommendations to Obama about the size or timing of next year's drawdown. Outgoing Defense Secretary Leon Panetta said recently that NATO and the Afghan government intend to begin the final phase of transition by the mid to latter part of 2013 — suggesting he prefers a later start to the drawdown, as opposed to earlier in 2013.

The top contender for Panetta's job, former Nebraska Sen. Chuck Hagel, is thought to support a more rapid withdrawal of U.S. troops.

British Prime Minister David Cameron has already announced that about 3,800 of his country's troops will leave by the end of 2013, leaving 5,000 to stay into 2014.

The Afghan army now numbers about 350,000 and has taken the lead on security in areas that are home to 76 percent of Afghanistan's population of 30 million. Still, despite their progress, only one of Afghanistan's 23 brigades around the country can operate on its own without coalition help of some kind, the U.S. Defense Department said in its most recent semi-annual report to Congress.

Attacks by insurgents around the country have not decreased, but the violence has been pushed out of most population centers, the report said. Civilian and NATO casualties have fallen. But Afghan forces are taking an increasing toll. More than 300 Afghan soldiers and policemen are dying each month, according to Afghan Defense Ministry spokesman Gen. Mohammad Zahir Azimi, who said that represented an increase, though he did not provide comparative figures.

"We still face challenges in southern Afghanistan," Abrams acknowledged in his headquarters at Kandahar Air Field.

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