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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Firefighters ambushed by gunman while responding to house fire

A man with a criminal history shot and killed two West Webster, N.Y. firefighters and seriously injured two others as they responded to a fire at his home, police say.

William H. Spengler, Jr., 62, apparently started a 5:35 a.m. fire at his home on Lake Road  and then waited with an armament of weapons for first responders to arrive, Webster N.Y. Police Chief Gerald Pickering said at an afternoon news conference.

“He was shooting from high ground or a berm," Pickering said. "He was barricaded with weapons to shoot first responders."

After a brief exchange of gunfire with police, Spengler then shot and killed himself at the scene, Pickering said.

Spengler was convicted in 1981 in the death of his 92-year-old grandmother a year earlier. He served time in prison and was released in 1998, Pickering said.

Spengler beat Rose Spengler to death with a hammer 1980, the Rochester Democrat and Chronicle reported. Rose Spengler had lived in the home next to William Spengler on Lake Road at the time of her death.

Local police had not noted any criminal activity in his recent past, Pickering said.

Pickering said they are looking into the apparent disappearance of Spengler's sister who is unaccounted for at this time.

Police and fire officials are continuing to gather evidence and will inspect the seven homes that were destroyed in the fire that spread to nearby houses in the small lakeside town located 10 miles east of Rochester.

The victims in the shooting are Mike Chiapperini, also a lieutenant and public information officer with the local police department, and Tomasz Kaczowka, Pickering said.

"These people get up in the middle of the night to fight fires. They don't expect to be shot and killed," a tearful Pickering said at the press conference.

Chiapperini was described by Pickering as a lifelong firefighter who started with the department's explorer program and had about 20 years of experience. Kaczowka was a younger firefighter who was on the force for about two years and was also a 911 dispatcher, he said.

West Webster firefighters Joseph Hofsetter and Theodore Scardino were seriously injured and are at Strong Memorial Hospital with gunshot wounds, a hospital spokeswoman said.  Scardino  has  injuries to his chest and lungs. Hofsetter was injured in the pelvis, the spokeswoman said at a media briefing. Both are in guarded condition, she said.

An off-duty police officer from nearby Greece, N.Y., John Ritter was also injured by shrapnel during the shooting, Pickering said.

Pickering said that one of the firefighters who survived made his way across a bridge to safety. The other three did not make it across, Pickering said. Police arrived and rescued the other three firefighters, but two were fatally shot, Pickering said.

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.

“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 and Chronicle.  Pickering described Webster as resort lakeside community that is quiet and usually peaceful.

WHAM reported that an outpouring of support has come through the Webster community. Black flags reportedly have been draped at some homes and offices to honor those killed and injured.

N.Y. Gov. Andrew Cuomo tweeted of the incident: We as the community of #NY mourn their loss as now 2 more families must spend the holidays without their loved ones #Webster

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Taliban not demanding Afghan power monopoly

KABUL, Afghanistan (AP) — Taliban representatives at a conference did not insist on total power in Afghanistan and pledged to grant rights to women that the militant Islamist group itself brutally suppressed in the past, according to a Taliban statement received Sunday.

The pledges emerged from a rare meeting last week involving Taliban and Kabul government representatives.

The less strident substance and tone came in a speech delivered at a conference in France. The French hosts described it as a discussion among Afghans rather than peace negotiations.

It was hard to determine whether the softer line taken by the Taliban representatives reflected a real shift in policy or a salvo in the propaganda war for the hearts and minds of Afghans.

The speech said that a new constitution would protect civil and political rights of all citizens. It promised that women would be allowed to choose husbands, own property, attend school and seek work, rights denied them during Taliban rule, which ended with the 2001 U.S. invasion. The speech was emailed from Taliban spokesman Zabihullah Mujahid.

"We are not looking to monopolize power. We want an all-Afghan inclusive government," the speech said. It was delivered by two Taliban officials, Mawlawi Shahbuddin Dilawar and Muhammad Naeem during the conference on Thursday and Friday.

Afghanistan's Foreign Ministry spokesman said the government welcomed such talks but did not expect them to bridge the gap between the warring sides.

The United States started to embrace the idea of peace talks after President Barack Obama took office, but discussions stalled in recent years, despite the formation of an Afghan government council tasked with reaching out to the Taliban and the establishment of a Taliban political office in Qatar.

"The peace initiative is a process, and one or two or three meetings are not going to solve the problems. But we are hopeful for the future," Foreign Ministry spokesman Janan Mosazai said. He said the government's preconditions for the talks with the Taliban have not changed: a cease-fire, recognition of the Afghan constitution, cutting ties with international terrorists and agreeing to respect the rights of Afghan citizens including women and children.

The Taliban speech reiterated the group's own longtime policies, declaring that the current constitution was "illegitimate because it is written under the shadow of (U.S.) B-52 aircraft" and that the Taliban remained the legitimate government of the country, a reference to the U.S.-led campaign that drove the Taliban from power.

It also called for the withdrawal of all foreign forces and said a 2014 national election was "not beneficial for solving the Afghan quandary" because it would take place while the country was still under foreign occupation.

Most NATO forces are scheduled to be withdrawn by 2014. The Kabul government and its international backers hope that a peace deal can be brokered with the Taliban and other militant groups before the pullout. NATO still has more than 100,000 troops, including 66,000 U.S. soldiers, on the ground. Washington is now determining the size of a scaled down force the United States will keep in Afghanistan after 2014.

"The occupation must be ended as a first step, which is the desire of the entire nation, because this is the mother of all these tragedies," the speech said.

The conference was also attended by the Hezb-e-Islami group, which is allied with the Taliban, and political opponents of President Hamid Karzai, whom the Taliban regard as a puppet of Washington.

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Sri Lanka arrests 100 Chinese for cyber fraud, police say

COLOMBO (Reuters) – Sri Lanka on Saturday arrested at least 100 Chinese nationals accused of an internet fraud scheme targeting people in their home country, a police spokesman said.

The accused, all in Sri Lanka on tourist visas, are suspected of hacking into computers in China and then demanding their owners transfer them money, police spokesman Prishantha Jayakodi told Reuters.

Chinese police requested help from Sri Lanka, he said.

Officials at the Chinese embassy in Colombo were not available for comment.

China has been the top lender to Sri Lanka since the end of a 25-year war in May 2009 and thousands of Chinese are working in the country on Chinese-funded infrastructure projects.

(Reporting by Shihar Aneez; editing by Jason Webb)

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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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NRA’s LaPierre: New gun laws won't work

LaPierre speaks at Friday's press conference. (Getty)

Two days after suggesting a "good guy with a gun" be stationed at every school in the country in response to the deadly shootings in Newtown, Conn., National Rifle Association executive vice president Wayne LaPierre blasted critics of his plan.

In an interview broadcast on Sunday's "Meet The Press," LaPierre reiterated the statements he made Friday at a press conference in Washington, when he said the answer to preventing shootings like the one at Sandy Hook Elementary Sch00l is armed security in every school--in effect, protecting children with guns.

“If it’s crazy to call for putting police in and securing our schools to protect our children, then call me crazy," LaPierre said. “I think the American people think it’s crazy not to do it."

At one point during the often contentious exchange, host David Gregory held up a high-capacity magazine clip that carries 30 bullets, asking if the NRA would support a federal limit on the capacity of such clips.

"Isn't it just possible that we could reduce the carnage in a situation like Newtown?" Gregory asked.

"I don't believe that's going to make one difference," LaPierre responded.

"You're telling me that it's not a matter of common sense that if you don't have an ability to shoot off 30 rounds without reloading, that, just possibly, you could reduce the loss of life?" Gregory asked.

"I don't buy your argument for a minute," LaPierre said. "There are so many different ways to evade that, even if you had that."

“Is there no new gun regulation you would support?” an exasperated Gregory asked. LaPierre refused to answer.

At Friday's press conference, LaPierre--who did not take questions from reporters--argued that had someone at the school been armed, "innocent lives might have been spared."

"The only thing that stops a bad guy with a gun is a good guy with a gun," he said.

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Bombing at political rally kills 9 in Pakistan

PESHAWAR, Pakistan (AP) — A suicide bomber in Pakistan killed nine people including a provincial government official at a political rally held Saturday by a party that has opposed the Taliban, officials said.

The rally in Peshawar, the capital of northwestern Khyber Pakhtunkhwa province, was held by the Awami National Party, whose members have been repeatedly targeted by the Taliban.

Among the dead was Bashir Bilour, the second most senior member of the provincial Cabinet, said Ghulam Ahmed Bilour, the politician's brother and federal railways minister.

Over 20 others were wounded by the blast, said local police officer Sabir Khan.

U.N. Secretary-General Ban Ki-moon condemned the bombing in a statement, reiterating the United Nations' support for Pakistani efforts "to combat the scourge of terrorism."

Bilour was leaving the rally after delivering the keynote speech when the attack occurred, said Nazir Khan, a local Awami National Party leader.

"There was smoke and dust all around, and dead and wounded people were lying on the ground," he said.

The suicide bomber was on foot, said another police officer, Imtiaz Khan.

Mian Iftikhar Hussain, the Khyber Pakhtunkhwa information minister and a member of the Awami National Party, said both he and Bilour had repeatedly received threats from militants. He condemned the attack and said the government needed to intensify its battle against the Taliban.

"Terrorism has engulfed our whole society," said Hussain. "They are targeting our bases, our mosques, our bazars, public meetings and our security checkpoints."

Ten Taliban militants attacked the military area of an international airport in Peshawar with rockets and car bombs a week ago, killing four people and wounding over 40 others. Five of the militants were killed during the attack, and five others died the next day in a gunbattle with security forces.

Also Saturday, police said a mob in southern Pakistan stormed a police station to seize a mentally unstable Muslim man accused of burning a copy of Islam's holy book. The crowd beat him to death, and then set fire to his body.

The case is likely to raise further concerns about the country's harsh blasphemy laws, which can result in a death sentence or life in prison to anyone found guilty. An accusation or investigation alone can lead to deaths, as people take the law into their own hands and kill those accused of violating it. Police stations and even courts have been attacked by mobs.

Police arrested the man on Friday after being informed by residents that he had burned a Quran inside a mosque where he had been staying for a night, said local police official Biharud Deen.

An angry mob of more than 200 people then broke into the police station in the southern town of Dadu and took the accused man, who they say was under questioning. Deen said police tried their best to save the man's life but were unable to stop the furious crowd.

Police have arrested 30 people for suspected involvement in the attack, said Deen. The head of the local police station and seven officers had been suspended, he said.

Past attempts by governments in predominantly Muslim Pakistan to review these laws have met with violent opposition from hardline Islamist parties.

In southwestern Pakistan, gunmen late Friday killed 11 Pakistanis and Afghans who were trying to cross into neighboring Iran to travel on to Europe as illegal immigrants, said local government official Zubair Ahmed. The shooting took place in Sunsar town in Baluchistan province, he said.

It was not immediately clear who was behind the attack, but hundreds of Pakistanis and Afghans are captured by Iranian border guards every year for illegally trying to travel to Europe to find better jobs.

___

Associated Press writers Abdul Sattar in Quetta, Pakistan, and Adil Jawad in Karachi, Pakistan, contributed to this report.

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Is the Christmas card dead?

Author Nina Burleigh says the holiday photo is dead — and the internet killed it

Every year around the holidays, countless Americans sit down at their dining room tables to thoughtfully scribble pen-and-paper updates about how they are and what they’ve been doing with their lives to a select number of friends. These messages are usually written on the back of a recent family photograph (sometimes with Santa hats), before they’re sealed, stamped, and mailed around the country, where they’re displayed like a trophy over someone else’s fireplace.

Could that all be changing? This year, especially, there seems to be a dearth of dead-tree holiday cheer filling up mailboxes across the country. In a recent column for TIME, author Nina Burleigh says the spirit once distilled inside the Christmas card is dying, and a familiar, if fairly obvious perpetrator killed it: The internet. “There’s little point to writing a Christmas update now, with boasts about grades and athletic prowess, hospitalizations and holidays, and the dog’s mishaps, when we have already posted these events and so much more of our minutiae all year long,” she writes. “The urge to share has already been well sated.”

[Now] we already have real-time windows into the lives of people thousands of miles away. We already know exactly how they’ve fared in the past year, much more than could possibly be conveyed by any single Christmas card. If a child or grandchild has been born to a former colleague or high school chum living across the continent, not only did I see it within hours on Shutterfly or Instagram or Facebook, I might have seen him or her take his or her first steps on YouTube. If a job was gotten or lost, a marriage made or ended, we have already witnessed the woe and joy of it on Facebook, email and Twitter.

Burleigh says the demise of the Christmas card is deeply saddening. “It portends the end of the U.S. Postal Service,” she writes. “It signals the day is near when writing on paper is non-existent.” It’s true, says Tony Seifart at Memeburn — “my mantle is empty this year. In fact I haven’t received one Christmas card yet.”

SEE ALSO: The perks and perils of our newly indexed society

Let’s not get too nostalgic just yet, says Alexis Madrigal at The Atlantic. Research firm IBISWorld anticipates that purchases of cards and postage will be the highest it has been in five years — $ 3.17 billion total. And Hallmark, the industry’s biggest player, has seen revenue hold steady since the early 2000s despite the financial crisis. We could also think about this another way: That desire to share, the willingness to inform, could just be extending itself beyond the physical form of the holiday photo. 

No matter what time of the year, people now write contemplative letters with weird formatting to an ill-defined audience of “friends”; these are Christmas letters, whether Santa is coming down the chimney or not. There are reindeer horns on pugs in July. And humblebrags about promotions in April. There are dating updates in November. And you can disclose that you were voted mother of the year any damn day you please… For good or for ill, perhaps we’re seeing not the death of the holiday card and letter, but its rebirth as a rhetorical mode. Confessional, self-promotional, hokey, charming, earnest, technically honest, introspective, hopey-changey: Oh, Christmas Card, you have gone open-source and conquered us all. 

The spirit of the Christmas card is indeed alive and well. It’s just not necessarily in a Christmas card.

SEE ALSO: Poison pens and lipstick guns: 8 real-life spy weapons

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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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Final day of funerals for Newtown shooting victims

The final three victims of the massacre at Sandy Hook Elementary School will be laid to rest today, ending a somber week of funerals.

A mass will take place today at St. Rose of Lima Catholic Church for Josephine Gay, who had celebrated her 7th birthday on Dec. 11.

Friends and family have been asked to wear Josephine's favorite color, purple, in her honor.

PHOTOS: Victims of Sandy Hook Massacre

A homegoing celebration will take place at The First Cathedral in Bloomfield, Conn., for Ana Marquez-Greene. The 6-year-old with a beaming voice sang in a home video with her brother, who was also at Sandy Hook Elementary School during the massacre, and seemed destined to take after her father, a jazz musician.

Emilie Parker, the budding artist who carried her markers and pencils everywhere, will be laid to rest in Ogden, Utah today.

The 6-year-old would have been would one of the first to comfort her classmates at Sandy Hook Elementary School, had a gunman's bullets not claimed her life, her father said.

"My daughter Emilie would be one of the first ones to be standing and giving support to all the victims because that's the kind of kid she is," her father, Robbie Parker, said last Saturday.

"She always had something kind to say about anybody," Parker said. "We find comfort reflecting on the incredible person Emilie was and how many lives she was able to touch."

WATCH: Emilie's father speaks about his daughter

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