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.N. Says South Sudan Threatens Its Peacekeeping Mission

KAMPALA, Uganda — The United Nations said Sunday that the shooting down of one of its helicopters in South Sudan last week was just the latest in a series of attacks or threats against its peacekeeping mission by South Sudan’s military.

A spokesman for the United Nations in New York said the peacekeeping mission in South Sudan had “shared all flight information” with South Sudanese authorities on Friday before the helicopter was shot down over the region of Jonglei, where the South Sudanese military is fighting an armed rebellion. All four Russian crew members on board were killed.

South Sudan has said that it contacted the United Nations about a helicopter in the area, and that the United Nations said it had no flights there. The military, known as the Sudan People’s Liberation Army, then shot down the helicopter, saying it suspected that it was supplying weapons to rebels.

The United Nations said Sunday that there had been similar episodes in the past.

“Since September of last year, there have been repeated incidents by the S.P.L.A., including shooting at U.N. aircraft, as well as some direct threats to U.N. peacekeepers,” said Kieran Dwyer, a spokesman for the United Nations peacekeeping division in New York. “If the U.N. peacekeeping mission is going to be able to fulfill its mandate, such as in vast areas as in Jonglei, we must be able to fly our aircraft.”

Mr. Dwyer said the peacekeepers’ Russian Mi-8 helicopter was on a reconnaissance mission to look for new landing areas.

South Sudan originally denied that it had shot down the helicopter. Later, a military spokesman said that South Sudan had told the United Nations and aid groups that certain parts of the country’s airspace were problematic because of rebel activity, including the area where the helicopter was shot down.

The military also claims that neighboring Sudan has been flying in weapons for the rebels with aircraft painted to resemble the aircraft of the United Nations or other humanitarian groups.

Read More..

RIM shares fall at the open after earnings

TORONTO (Reuters) – Research In Motion Ltd fell in early trading on Friday following the BlackBerry maker’s Thursday earnings announcement, when the company outlined plans to change the way it charges for services.

RIM, pushing to revive its fortunes with the launch of its new BlackBerry 10 devices next month, surprised investors when it said it plans to alter its service revenue model, a move that could put the high-margin business under pressure.

Shares fell 16.0 percent to $ 11.86 in early trading on the Nasdaq. Toronto-listed shares fell 15.8 percent to C$ 11.74.

(Reporting by Allison Martell; Editing by Gerald E. McCormick)

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Sandy Hook Shootings: How to Cope

By Howard Breuer

12/23/2012 at 06:00 PM EST

State police personnel lead children to safety away from the Sandy Hook Elementary School

Shannon Hicks/Newtown Bee/Reuters/Landov

The Sandy Hook massacre, in which 20 innocent children and six heroic elementary school faculty members were gunned down last Friday, is particularly difficult for people – even those thousands of miles away from Newtown, Conn. – to process, according to mental health experts.

"This tragedy is so deeply affecting the national psyche, reminding us of 9/11, because of its assault on Norman Rockwell's vision of America," psychiatrist Carole Lieberman tells PEOPLE.

Friday was proclaimed a national day of mourning for those lost a week ago, with a moment of silence called for at 9:30 a.m. Eastern time, as 26 churchbells rang in Newtown and elsewhere. In addition, First Lady Michelle Obama sent an open letter of condolence to the town, saying the entire nation "is holding you in our hearts."

But how do those directly involved with the tragedy find the strength to cope?

To do that, family members who lost loved ones need immediate counseling and to maintain their normal routines. They also need to draw support from other affected families who can relate to what they're going through, says Dr. Stephanie N. Marcy, a psychologist at Children's Hospital Los Angeles.

"I think the people on the ground are feeling a sense of hopelessness because there is no way to justify what happened," Marcy says. "They need to be around other people who have experienced and understand it. If you were all involved together, you can empathize and grieve together."

In many of these families, the remaining children might have survivor's guilt, she adds.

"They rethink what they did that day and wonder if they in some way contributed to the death of a sibling, or they wonder, why did I survive?" Marcy says.

Therapists will need to explain to kids who lost a sibling that their "false belief that they should have been able to prevent it is not correct," adds Marcy.

Children at Sandy Hook may also have Post-Traumatic Stress Disorder and will need therapy, Lieberman says.

What to Tell Children

And what do parents whose children were not involved in the tragedy tell their own youngsters about what happened? That, Marcy says, depends on how old they are and how much they know already.

"Kindergarteners and first graders don't need to be told about it unless you think they will hear it somewhere else. For older kids, you have to get to know what they know, answer any questions they might have, and be truthful – but don't say too much," Marcy says. "Say that a person who was having problems, that was sick, went into a school and injured some people for no particular reason. Tell them it would never happen at their school."

"Yes," she adds, "it could happen anywhere. But there's no point in letting your child think that, [because] they may be flooded with fear."

For the adults and children across the country who have been vicariously traumatized, Marcy says, "We need to regain our sense of control, because this type of event makes us feel completely helpless."

Lieberman adds that Americans "are also feeling a generalized anxiety, a fear that no place is safe anymore. They need to talk to friends and family, get involved in championing causes that make society better, to volunteer for charities, and to get psychotherapy if the sadness and anxiety persist."

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..

L.A. City Hall is one of painter's masterpieces

Joe Nicoletti started out painting houses in New Jersey. These days, he paints Los Angeles City Hall.

Since a major renovation of the historic building began nearly 20 years ago, Nicoletti has been the city's go-to guy when a skilled hand is needed to restore a frieze or touch up a mural.

His most recent assignment — repainting the elaborately decorated ceiling of the Main Street lobby — took the 50-year-old Santa Monica resident two weeks and eight assistants to complete. His crew toiled at night, the better to stay out of the way of city bureaucrats, and Nicoletti livened the work space with the sounds of Ella Fitzgerald, Frank Sinatra and the like. Around midnight, they would break for "lunch," usually takeout from downtown eateries such as Pete's Cafe or Cole's French Dip.

The last night of the job, Nicoletti and some members of his crew were finishing up a few final details. Some cracked plaster needed repairing, and a small section of gold didn't look quite rich enough. Nicoletti had brought several sheets of gold leaf that he hoped would do the trick.

"It's $1,700 an ounce," he said, waving the sheets like little flags. The gold is also edible, he added. "You can sprinkle it on some souffle."

He was standing atop precarious-looking scaffolding. An assistant, Luke Adkins, steadied the apparatus down below as Nicoletti excitedly pointed out noteworthy patterns in the ceiling's design. "This is a medallion, that's a ziggurat, and I think this is a cartouche," he said.

Then he dabbed some glue, pressed the gold leaf into place and gently peeled off the backing, as if applying a temporary tattoo.

"That is sweet," Adkins called up. "That is very nice. Man, you nailed it."

Nicoletti smiled.

His company, Chameleon Paintworks, has done custom jobs at downtown's Millennium Biltmore Hotel, an 89-year-old historic landmark, and for celebrity clients including Quentin Tarantino and Sting.

But there's something special about City Hall, he said. Over the years he has painted its hallways, ceilings and even the City Council chambers. He plans to bid on future contracts for restoration work in the building's rotunda and other areas.

"I'm really proud of this building," he said. "I like it a lot."

kate.linthicum@latimes.com

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Russian Bill Worries Adoptees and Families in U.S.

As word spread last week that a house of the Russian Parliament had voted to prohibit adoptions of Russian children by American parents, Russian adoptees in the United States made appeals to President Vladimir V. Putin, asking Russia not to hold needy children hostage to international politics.

With the proposed ban apparently rolling through Russia’s legislature, a loose network of hundreds of adoptees and their American parents started writing letters to the Russian leader, and they are planning a joint appeal to the country’s ambassador in Washington after Christmas.

One leader of the effort is Tatyana McFadden, who was adopted at age 6 with spina bifida, paralyzed from the waist down, by Deborah McFadden of Clarksville, Md.

“I probably wouldn’t have survived in that orphanage,” said Ms. McFadden, who is now 23 and a multiple medal winner at the London Paralympics, among other top racing honors. “Closing down adoptions would ruin thousands of lives.”

The bill to end American adoptions has passed one house of the Parliament and could pass the other next week. Mr. Putin has refused to say whether he will sign or seek to alter it. It arose in response to a new American law imposing sanctions on Russian officials accused of violating human rights, a law Mr. Putin has called an arrogant insult.

As the adoptees, many of them young adults or teenagers now, make their own appeals to Russia, several American groups involved with adoptions and child welfare have asked their members to write legislators and President Obama to call for strong diplomatic measures.

“Right now, the main thing is to ask Mr. Putin not to sign it,” said Randi Thompson, the executive director of Kidsave, a child-advocacy group based in Los Angeles and one of the organizations urging clients to contact Washington. While her group works in Russia to promote domestic adoptions, Ms. Thompson said, international adoptions remain the only alternative for thousands of children, many of them older or with disabilities that make them hard to place.

In Moscow on Friday, in the strongest public statement on the issue yet from the United States, Ambassador Michael A. McFaul sharply criticized the bill, saying in a statement and in Twitter messages, “The welfare of children is simply too important to be linked to other issues in our bilateral relationship.”

It is not clear whether the ban, if signed into law, would affect adoptions already in progress, but the threat has put adoption agencies and hopeful parents on edge, leading many to look to other countries. Even without the proposed ban, sending children to the United States had become more contentious within Russia in recent years, and some regions have slowed or virtually halted such adoptions.

Katherine Horton, 49, a research professor in Alexandria, Va., and mother of one girl she adopted from Russia in 2008, traveled there last February and spent a week getting to know Polina, a girl now 19 months old whom she was also working to adopt. Ms. Horton has spent thousands of dollars on repeated medical tests and screening procedures and had expected to return in May to make final arrangements.

But the months have dragged on without action or explanation from local Russian officials, and on Monday she made an excruciating decision.

She notified the orphanage that she would give up her application for Polina.

“As heartbreaking as it is for me, it is the right thing for Polina,” she said. “This could drag on for years, and the longer she stays in an institution the worse off she’ll be.”

“It kills me,” she added. “I wake up in the middle of the night thinking about her, wondering how she is, if she is warm.”

Some 45,000 Russian children have been adopted by Americans since 1999, according to State Department records, but after reaching a peak of 5,862 in 2004, the numbers have declined steeply, to 962 in 2011. Experts say the decline has resulted in part from a welcome push for domestic adoptions and foster care in Russia. But it also reflects increasingly stringent screening, paperwork and expenses for prospective foreign parents and a nationalistic reaction that has led some local officials, like those Ms. Horton faced, to hamper American adoptions.

That reaction and increased screening that some adoptive parents call unnecessarily repetitive and costly were stoked by wide news coverage in Russia of episodes in which adopted Russian children in the United States were abused and died — tragedies, all agree, but rare events that led to criminal punishments.

While adoption agencies applaud Russia’s efforts to nurture domestic adoption, which is not a strong tradition, they note that tens of thousands of children still languish in orphanages and that parents from other countries are unlikely to meet the need.

“If the ban is adopted, some number of children will end up living in orphanages until they are old enough to hit the streets,” said Adam Pertman, the executive director of the Evan B. Donaldson Adoption Institute, a research group in New York.

Erin and Keith Thompson of Huntsville, Tex., have visited Russian orphanages annually as part of a Christian mission. After having a son, they adopted Sasha, now 14, at age 12, and Losha, now 17, when he was 16.

“We have seen the hopelessness in those orphanages,” Ms. Thompson said. When they met Sasha, she recalled, an orphanage official told them that every year at Christmas, the boy would ask Santa Claus for a family.

“There are so many children just waiting,” she said.

Robbie Brown contributed reporting.

Read More..

Eric Ladin Welcomes a Son

Mom & Babies
Celebrity Baby Blog

12/23/2012 at 12:00 AM ET

Noah Graham/Noah Graham Photography

Eric Ladin is one killer new dad.

The former Killing actor and his wife Katy welcomed their first child, son Maxfield David Ladin, on Friday, Dec. 21 in Los Angeles, his rep confirms to PEOPLE exclusively.

“Wow! The last 24 hrs have been the best of my life. Forever changed, I am now a father,” the actor says.

Announcing the pregnancy in May, the first-time father admitted he and his fashion designer/stylist wife were thrilled to be starting a family — despite entering into the unknown.

“Katy and I couldn’t be happier, we have always wanted to be parents. Now what the hell do we do?” Ladin, 34, joked.

– Anya Leon with reporting by Michelle Tan

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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..

Obama Nominates Kerry for Secretary of State

WASHINGTON — With a patrician bearing, nearly three decades of service on the Senate Foreign Relations Committee, a highly decorated combat career in the Vietnam War, even a father who was a diplomat, John Kerry is the very picture of a secretary of state.

“In a sense, John’s entire life has prepared him for this role,” President Obama said on Friday at the White House, as he nominated Mr. Kerry to replace Hillary Rodham Clinton, the first step in filling out a national security team for his second term.

Mr. Obama praised Mr. Kerry, 69, a Massachusetts Democrat, for having been immersed in “every major foreign-policy debate for nearly 30 years.”

But though Mr. Kerry would bring even deeper experience to the job than Mrs. Clinton did, his appointment is likely to further centralize policy decisions in the White House, where for the past four years the president and a small circle of advisers have kept a tight grip on issues like Iran’s nuclear program, China, Pakistan, and the winding down of the war in Afghanistan.

“There’s every reason to believe that we’re going to have a very White House-centric foreign policy,” said David J. Rothkopf, the chief executive of the Foreign Policy Group. “Kerry is going to have to show his loyalty and willingness to work within the Obama system.”

In contrast to Mrs. Clinton, whom Mr. Obama named to his cabinet after they competed against each other in the 2008 presidential primaries, Mr. Kerry has been a loyal supporter of the Obama administration, guiding an arms-reduction treaty with Russia to ratification in the Senate and playing diplomatic troubleshooter for the White House in Afghanistan, Pakistan and Sudan.

He has also figured at critical moments in Mr. Obama’s career. At the 2004 Democratic National Convention that nominated him for president, Mr. Kerry gave the keynote speaking slot to Mr. Obama, then a little-known Illinois state senator, catapulting him to national prominence. In early 2008, Mr. Kerry endorsed him over Mrs. Clinton, and this fall he played the role of Mitt Romney in mock debates — sessions that by some accounts put the president’s teeth on edge.

“Nothing brings two people closer together than weeks of debate prep,” said Mr. Obama on Friday, looking at a grinning Mr. Kerry. “John, I’m looking forward to working with you instead of debating you.”

However lavish Mr. Obama’s praise, his instinctive choice for secretary of state was Susan E. Rice, the ambassador to the United Nations, who withdrew her name from consideration after Republicans threatened to block her nomination because of statements she made after the lethal attack on the American Mission in Benghazi, Libya.

Mr. Obama, his aides said, likes Ms. Rice’s blunt style and is in sync with her view of foreign policy, which places a premium on aggressively defending human rights.

As a result, Ms. Rice, who is staying in her post, remains a candidate for a major foreign-policy post in the second term, according to administration officials. Thomas E. Donilon, the national security adviser, is expected to stay on for a year or so, but Ms. Rice could be named to his job.

If she were to move into the White House, analysts said, that would pose a test for Mr. Kerry, given her access to Mr. Obama and their shared views on many foreign policy issues.

“The easiest model to see developing is one in which Kerry is on the road a lot, interfacing with foreign leaders, but the decision-making is done at the White House,” said Elliott Abrams, who held foreign-policy posts in the administrations of Ronald Reagan and George W. Bush.

Mr. Obama expressed confidence that Mr. Kerry would be confirmed by his Senate colleagues, a prediction that seemed safe, given that at a recent news conference, Senator John McCain, Republican of Arizona, one of Ms. Rice’s fiercest critics, jokingly referred to Mr. Kerry as “Mr. Secretary.”

Mrs. Clinton has not announced her resignation, but she has made it clear she would not stay beyond a single term. Because she is recovering from a concussion, she did not appear at the midday announcement. Mr. Obama said that he spoke to her on Friday morning, and reported that she was “in good spirits.”

In a statement, Mrs. Clinton said Mr. Kerry was a leader of the “highest caliber,” who had advocated on behalf of diplomacy and development in Congress.

Mr. Kerry is working with her to adopt the recommendations of a recent report that harshly criticized the State Department for lapses in security in Benghazi, she said. The Benghazi attack, analysts said, underscored the management challenge for a longtime senator like Mr. Kerry in taking over a sprawling worldwide bureaucracy. Former aides to Mr. Kerry point out that he did oversee a huge, if temporary, campaign operation in 2004, which, though criticized for tactical missteps, was not viewed as poorly managed.

Although Mr. Kerry is not a global celebrity like Mrs. Clinton, his background as a presidential nominee and his chairmanship of the Foreign Relations Committee have made him well known abroad, accustomed to meeting monarchs and presidents.

In October 2009, he was viewed as instrumental in persuading President Hamid Karzai of Afghanistan to accept the need for a runoff election. Mr. Kerry spent 20 hours over five days with Mr. Karzai, telling him over dinner and in long walks in the garden of the presidential palace in Kabul of his own frustrations at the ballot box in 2004.

“I told him, ‘Sometimes there are tough things,’ ” Mr. Kerry said in an interview at the time.

Before Syria exploded in violence, Mr. Kerry met several times with its president, Bashar al-Assad, hoping to draw him into a more constructive role in the Middle East. His failed effort at engagement may elicit some tough questions from Mr. McCain and other Senate hawks.

As a senator, Mr. Kerry compiled a strong record on climate change, and environmental groups issued enthusiastic responses to his nomination. But Mr. Obama, pressed at a recent news conference, said climate change would take a back seat to the economy, at least for now.

For Mr. Kerry, exerting influence internally is likely to be the greatest challenge of the job he has long coveted. Friends and former aides predicted he would carve out a role, just as Mrs. Clinton did.

“John was someone who from an early age dreamed of being president,” said Jim Gomes, a former chief of staff to Mr. Kerry. “As someone who grew up in a Foreign Service family, who testified before Senate Foreign Relations after coming home from Vietnam and who wanted to serve on Foreign Relations, this is a pretty terrific Plan B.”

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