Temple Run was downloaded more than 2.5 million times on Christmas Day

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Kate Winslet Marries in Secret

By Mike Fleeman

12/26/2012 at 09:10 PM EST

Talk about a Titanic secret.

Kate Winslet has tied the knot with Richard Branson's nephew, Ned Rocknroll, her rep tells PEOPLE.

"I can confirm that Kate Winslet married Ned Rock'nRoll in NY earlier this month in a private ceremony attended by her two children and a very few friends and family," the rep says. "The couple had been engaged since the summer."

According to British media reports, Leonardo DiCaprio gave away the bride in a ceremony so secret that the bride and groom's parents didn't know about it.

The Oscar-, Golden Globe- and Emmy-winning actress, 37, has been dating Rocknroll, 34, (his legal name) since fall of 2011.

In August 2011, she and Rocknroll were on the same Caribbean island owned by Branson when a fire broke out and Winslet rescued Branson's 90-year-old mother.

Winslet previously was married to Sam Mendes and Jim Threapleton.

• Reporting by JULIE JORDAN

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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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Young Ugandan orphan treated at L.A. burn center

Adolf Baguma's caretakers at the orphanage call him their Christmas gift, because it was on Christmas two years ago when they found the 9-year-old in the bushes behind a building in a small Ugandan town.

Like many Ugandan children, Baguma was orphaned when AIDS claimed his parents. But he had an extra burden to bear. When he was about 5, the teenage aunt left to care for him got angry and hit him in the back of the legs with flaming banana leaves.

Scar tissue from the burns fused each of his legs into a permanently bent position so that he was unable to walk upright.

Townspeople said the young beggar was a "bad boy," whose aunt had abandoned him and left him to fend for himself. But the Home Again Children's Home in Kyenjojo took him in.

Soon, he was accompanying the other children to school, crawling on all fours down the road.

Despite his disability, he was a cheerful little boy, always playing and laughing, said Eva Mbabazi, 32, one of his caretakers at the orphanage.

"God gave him that gift," she said.

Baguma, now 11, got another gift this year, just in time for Christmas. Well-wishers from the United States brought him to the Grossman Burn Center in Los Angeles. After two surgeries, Baguma's legs are straight, and he is able to walk unassisted for the first time in years.

The boy's journey began in June, when Los Angeles attorney Laine Wagenseller traveled on a mission to Uganda and met him while volunteering at the orphanage.

Wagenseller reached out to the Children's Burn Foundation, a local nonprofit organization that provides services for young burn victims. Every year, the organization pays for full recovery services — including surgeries, physical therapy and other follow-up care — for about 200 children, according to Executive Director Carol Horvitz.

The group arranged for his visa and trip to Los Angeles.

Since he arrived last month, he has undergone two surgeries — one to release the scar tissue and stretch his compressed muscles and tendons to their full length, and a second to place a skin graft on his legs. A few days before Christmas, the boy stood and took his first steps upright, smiling from ear to ear, said Peter Grossman, medical director at the burn center.

Although the procedure was complicated, Grossman said the medical team was confident from the beginning that it could be performed successfully. But the price tag is far beyond what most Ugandans could afford. Horvitz estimated that Baguma's treatment will cost more than $50,000.

The boy still has a splint on each leg to keep them straight, and a walker that he avoids using. Grossman said it may take months of physical therapy and corrective splinting before Baguma's recovery is complete.

But, he said: "Kids tend to always surprise us with their rapid progress."

Baguma returned to the burn center Wednesday for doctors to check on how the grafts are healing. He also took several confident steps for TV cameras. For Grossman, he reserved a special hug and a series of high fives and fist bumps.

Baguma is staying with Wagenseller's brother and sister-in-law in Thousand Oaks while he recovers, playing with their four children and going to school at Westlake Hills Elementary School. Horvitz said some people had inquired about adopting the boy, but it's not yet clear whether he will be able to stay in the United States or will return to Uganda.

Baguma, who speaks little English, said only that he felt "good" and that when he recovers fully, "I want to play baseball."

Mbabazi, who accompanied him to Los Angeles, was more eloquent: "I'm seeing him walking with joy in my heart."

abby.sewell@latimes.com

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Giada De Laurentiis: My Daughter Still Believes in Santa

Courtesy Giada De Laurentiis

The tree’s done. The stockings are hung. Giada De Laurentiis and her family — husband Todd Thompson and their daughter Jade Marie — are officially ready to host the holidays.

“Christmas Eve is the big tradition in an Italian family. It’s when my entire family gets together,” the newest face of Clairol tells PEOPLE exclusively.

“This year, for the first time, it will be held at my house … so Jade and I and my husband are very excited.”

On the menu for the family festivities is “a big fish dinner,” one that no doubt Jade will help her mother to prepare. After all, adds the celebrity chef, she is the unofficial taste tester.

“My daughter loves to cook. We have a lot of laughs together. I spend a lot of time in the kitchen and she loves hanging out with me,” De Laurentiis, 42, shares. “The reason she loves it so much is because she can stick her finger in everything and taste it as she goes along.”

Once the big dinner is done with, and the evening starts to wind down, De Laurentiis and Jade will start to prepare for the night’s biggest guest to arrive: Santa Claus. At 4½-years-old, her little girl is still a strong believer in the magic of it all, notes her proud mama.

“She leaves him little treats — for the reindeer and for him too — and she’s very much a believer in Santa,” De Laurentiis says. “I hope she’ll be a believer for a long time, I think it’s really fun for kids to be able to do that.”

Recently, the pair sat down to write out Jade’s wish list, but after much pleading on Jade’s part over the past few weeks, it’s no surprise as to what she hopes to find under the tree this year.

“The one thing she keeps asking me for over and over again is clip-on earrings. She must have seen them on somebody else, but she has asked me for clip-on earrings for the past month,” De Laurentiis notes. “I am on a mission to find clip-on earrings for her because I don’t think she’ll ever forgive me if I don’t.”

But based on her newly transformed play space, the “girly girl’s” specific accessory request should come as no surprise.

“She’s opened up her own little salon in her playroom. She gives free makeovers, she curls people’s hair and gives them little manicures as well,” De Laurentiis says. “I’ve always been a girly girl my whole life — maybe she will, maybe she won’t — but it’s a lot of fun to play with her right now.”

– Anya Leon with reporting by Kate Hogan

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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..

Roots of pot cultivation in national forests are hard to trace

WELDON, Calif. — A few minutes after 4 a.m., agents in camouflage cluster in a dusty field in Kern County. "Movement needs to be slow, deliberate and quiet," the team leader whispers. "Lock and load now."

They check their ammunition and assault rifles, not exactly sure whom they might meet in the dark: heavily armed Mexican drug traffickers, or just poorly paid fieldworkers camping miserably in the brush.

Twenty minutes later, after a lights-off drive for a mile, the agents climb out of two pickup trucks and sift into the high desert brush.

The granite faces of the Southern Sierra are washed in the light of a full moon. Two spotters with night-vision scopes take positions on the ridge to monitor the marijuana grow, tucked deep in a cleft of the canyon.

The rest of the agents hunker down in some sumac waiting for the call to move in. The action has to be precisely timed with raids in Bakersfield, where they hope to capture the leaders of the organization.

They have no idea how many people are up here. Thermal imaging aircraft circling high above was not detecting anyone on the ground. And trail cameras hadn't captured images of men delivering supplies for more than a week. Maybe the growers have already harvested and cleared out.

Word comes on the radio to go into the site.

The agents fan out in the gray of dawn. A U.S. Forest Service agent unleashes a German shepherd and follows it up a piney slope. After several minutes, the dog begins barking furiously.

"We have movement," shouts the Forest Service officer. "Hands up."

::

Such raids have become commonplace in California, part of a costly, frustrating campaign to eradicate ever-bigger, more destructive marijuana farms and dismantle the shadowy groups that are creating them.

Pot cultivated on public lands surged in the last decade, a side effect of the medical cannabis boom. In 2001, several hundred thousand plants were seized in the state. By 2010, authorities pulled up a record 7.4 million plants, mostly on public land.

Law enforcement long called these grows on public land "cartel grows," and hoped to work from the busts in the forest up the drug hierarchy, maybe all the way to the Sinaloa Cartel or the Zetas.

But after years of raids and work with informants and wiretaps, agents realize the operations seemed to be run by independent groups of Mexican nationals, often using undocumented fieldworkers from their home regions.

Tommy Lanier, director of the National Marijuana Initiative, part of the Office of National Drug Control Policy, said there was scant evidence that the cartels exerted much control over marijuana growing in the national forests.

"Based on our intelligence, which includes thousands of cellphone numbers and wiretaps, we haven't been able to connect anyone to a major cartel," he said.

Lanier said authorities have long mislabeled marijuana grown on public land as "cartel grows" because Mexican nationals are arrested in the majority of cases, and the narrative of fighting drug cartels helps them secure federal funding.

He doesn't rule out that some of the cash flowing south of the border makes its way to members of those groups. He just doesn't believe they are actively directing activities up here.

"We've had undercover agents at the highest level of these groups, breaking bread and drinking tequila," says Roy Giorgi, commander of the Mountain and Valley Marijuana Investigation Team, a multi-agency organization headquartered in Sacramento. "Even at their most comfortable, the leaders never said, 'Hey, we're working for the Zetas.' "

In Giorgi's jurisdiction, the majority of the people arrested or investigated are originally from the state of Michoacan, where marijuana growing and immigration to the U.S. are entrenched.

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With a Parent at War, a Holiday of Pain and Pride

Ruth Fremson/The New York Times

Mercedes Patterson, 16, helped Tango Jackson, 17, with his R.O.T.C. uniform tie in the hallway at Fort Campbell High School at the Army post in Kentucky. More Photos »

FORT CAMPBELL, Ky. — Signs of the season have been everywhere at Fort Campbell High School over the last couple of weeks: a student soloist sang the Carpenters’ “Merry Christmas, Darling” at the annual holiday concert, a big tree sparkled in the cafeteria under the Screaming Eagle emblem of the 101st Airborne Division, and thousands of parents were deployed yet again in Afghanistan.

It is nothing unusual for Alexandra Alfield, a 17-year-old senior whose father, a Special Forces soldier, has been gone since August and for six of the last nine years. “I do miss him,” she said, “but I’m just so accustomed to it.”

As President Obama considers how quickly to withdraw the remaining 66,000 American troops from Afghanistan, the parents of Fort Campbell students are still going off to war.

Nearly 10,000 men and women from the 101st Airborne, a third of the active-duty troops based here, are either in Afghanistan or getting ready to go. Still more parents here have been deployed with units like the Fifth Special Forces Group and the 160th Special Operations Aviation Regiment, known as the Night Stalkers, whose members piloted the helicopters in the raid that killed Osama bin Laden.

That has made the high school, which is run by the Defense Department and is one of only four secondary schools on military bases in the United States, something of a window into the pain, pride and resentment felt by the families of the all-volunteer military force, which has borne the burdens of 11 years of war.

The high school, which has about 700 students and is open to any 9th to 12th grader who lives on the 100,000-acre post along the Kentucky-Tennessee border, is by definition physically and psychologically cut off from the world outside the gates. But at no time is that sense of isolation more acute than now, when many of the students’ parents are deployed while the rest of the country’s interest in Afghanistan has moved on.

“No one really cares,” Tyisha Smith, a 19-year-old senior, said of the outside world. “Your father goes, gets deployed. War — it’s normal. It’s not like a big deal that we’re still at war.”

But Ms. Smith said she was struggling to manage the pressures of her final year in high school while her father was away and she was living with her stepmother. The reality of his deployment with the 101st Airborne is never far away. “It’s starting to hit me that there’s a possibility that he could die,” she said. “I just hope he comes home.”

School administrators point to a bright spot: not as many parents are gone this year as there were at the height of the Iraq and Afghanistan wars, when nearly everyone in the school had a parent deployed and the post was a virtual ghost town. But that hardly makes the modest one-story school typical.

A strict dress code bans jeans and T-shirts, so students wear tucked-in collared shirts with khakis or dark pants. Presidents turn up a lot: Mr. Obama spoke at the post in May 2011, and George W. Bush visited three times while he was president. Vice President Joseph R. Biden Jr. met earlier in 2011 with the Fort Campbell High School football team. And the death of a parent is something to be mourned but overcome.

Only months after his father was killed in Afghanistan in June 2008, Josh Carter, a starting linebacker, helped lead the Falcons to their second of three straight state championships.

“My dad would want me to keep going,” Mr. Carter, now a student at Western Kentucky University, said in an interview over the summer. Administrators say that perhaps five other students have lost parents in the wars in recent years. Many other parents have been wounded or have received a diagnosis of post-traumatic stress disorder.

The students readily call their school a “bubble,” both comforting and claustrophobic, because of the dangers their parents face. “If you went to off-post schools, you couldn’t exactly talk to a teenager because they wouldn’t understand what you’re going through,” said Larissa Massie, a 17-year-old senior whose father is home but has had two deployments to Iraq.

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Jack Klugman, Odd Couple and Quincy, M.E. Star, Dies

By Stephen M. Silverman

12/24/2012 at 07:35 PM EST

Jack Klugman, The Odd Couple and Quincy, M.E. star beloved by TV, movie and theater audiences for five decades, died in Los Angeles on Monday, one of his sons told the Associated Press. He was 90.

"He had a great life and he enjoyed every moment of it and he would encourage others to do the same," son Adam Klugman said of his father, who had lost his voice to throat cancer in 1980 and then taught himself to speak again through breath control.

With Tony Randall on ABC's adaptation of the smash Neil Simon play and movie of the '60s, Klugman played sloppy Oscar Madison from 1970 to 1975 to Randall's Felix Unger, and though they really were an odd couple, offscreen they were adoring friends. Randall died in 2004.

Born in Philadelphia, Klugman started acting in college, and his film credits included the all-star courtroom drama 12 Angry Men. On Broadway he starred as the love interest Herbie in the original production of the quintessential backstage musical, Gypsy, with the legendary Ethel Merman.

Klugman's wife, actress-comedian Brett Somers, costarred on The Odd Couple as his ex-wife Blanche. According to the AP, they married in 1953 and had two sons, Adam and David, and had been estranged for years at the time of her death in 2007.

Besides their sons, Klugman is survived by Peggy Crosby, whom he married in February 2008.

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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..