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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Yen falls as Japan forms new government, supporting Nikkei

TOKYO (Reuters) - The yen fell to a 20-month low against the dollar on Wednesday, buoying the benchmark Nikkei stock average, as Japan ushers in a new prime minister eager to pursue drastic stimulus steps to drive the country's economy out of deflation.

Asian shares and other assets were capped in thin holiday trade, with investors focusing on the fate of U.S. negotiations to avert a budget crunch looming at the end of the year.

Markets in Singapore <.ftsti>, Malaysia <.klse>, Indonesia <.jkse>, the Philippines <.psi> and South Korea <.ks11> were closed on Tuesday for the Christmas holiday, reopening on Wednesday.

Hong Kong and Australia remain closed on Wednesday. Europe also will not trade but, U.S. markets reopen later in the day.

MSCI's broadest index of Asia-Pacific shares outside Japan <.miapj0000pus> inched up 0.1 percent, after rising 0.3 percent the previous day on the back of a surge in Shanghai shares <.ssec> to five-month highs and a jump in Taiwan shares <.twii>.

Shinzo Abe, whose party won a landslide victory in an election earlier this month, will be sworn in as Japan's premier on Wednesday, when he is also expected to appoint his cabinet. He is prescribing a mix of aggressive monetary policy easing and big fiscal spending to beat deflation and rein in the strong yen.

He has kept up pressure on the Bank of Japan to deliver much stronger monetary easing policies and called for a 2 percent inflation target to beat deep-rooted deflation, pushing the yen to a 20-month low of 85.38 yen on trading platform EBS on Wednesday. Traders eyed the dollar's 2011 high of 85.53 yen as the next target.

The euro rose as high as 112.47 yen on EBS, approaching its 16-month high of 112.59 yen hit on December 19.

The weaker yen has bolstered hopes for better earnings from Japanese companies and underpinned the Nikkei, which has gained some 17 percent since mid-November when the election was scheduled, fuelling expectations for Abe's party to win. The yen has lost nearly 8 percent against the dollar in the same period.

The Nikkei <.n225> was up 0.4 percent, holding above the key 10,000 mark. <.t/>

"Most foreign funds have added Japanese shares and there are fewer participants today, but there still is a reason for the Nikkei to rise," said Hideyuki Okoshi, general manager at Chibagin Securities. "Not only exporters but investors are buying other stocks which could benefit under the new government."

Japanese government debt prices fell, with the 10-year bond futures falling to a three-month low of 143.65 in active trade. The 10-year JGB yield rose 1.5 basis points to 0.780 percent, matching a six-week high hit on December 19.

"We continue to see equities going high, so the pressure is on the long end of the JGB curve. For the short end of the curve, we continue to see the BOJ ease aggressively, so there is no change in that," said Tadashi Matsukawa, head of Japan fixed income at PineBridge Investments.

Minutes of the BOJ's policy-setting meeting in November showed on Wednesday that some board members said the central bank must act decisively, without ruling out any policy options, if the outlook for the economy and prices worsens further.

The dollar was also expected to stay firm this week as investors repatriate dollars, and as the U.S. fiscal impasse is likely to continue to sap investor appetite for risky assets and raise the dollar's safe-haven appeal.

President Barack Obama may return to Washington from his Hawaiian holiday as early as Wednesday evening to address the unfinished "fiscal cliff" negotiations with Congress, an administration official said on Tuesday.

House of Representatives Speaker John Boehner failed to gain support for a tax plan at the end of last week, raising fears that the United States may face the fiscal cliff of some $600 billion in automatic spending cuts and tax increases set to start on January 1.

"The main index is rebounding after treading water on Monday and dropping on Friday, as investors eye the progress of U.S. fiscal negotiations," Kim Soo-young, an analyst at KB Securities, said of South Korean shares <.ks11> which turned 0.7 percent higher in low holiday volume.

Activity is likely to remain subdued, with volume low and without major economic news.

Later in the session, Thailand will release trade data, which is expected to show exports in November posting very high annual growth compared with low levels last year that reflected the damage from the flooding.

South Korea's key consumer sentiment index held steady in December from November and stood below the neutral point for a fifth consecutive month, the central bank said on Wednesday, diminishing hopes of a quick economic rebound.

Gold edged lower on Wednesday on uncertainty over whether the fiscal cliff, but a weaker yen sparked a rally in bullion futures on the Tokyo Commodity Exchange (TOCOM).

(Additional reporting by Ayai Tomisawa and Dominic Lau in Tokyo and Joyce Lee in Seoul; Editing by Daniel Magnowski and Chris Gallagher)

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Hugo Chávez Aides Want to Postpone Swearing-In

CARACAS, Venezuela — Top officials in the government of President Hugo Chávez, who is recuperating from cancer surgery in Cuba, say they will postpone his inauguration, now set for Jan. 10, if he is too ill to return to Venezuela to begin his new term.

Opposition politicians and commentators have said that if Mr. Chávez is not in Venezuela to be sworn in on that date, a constitutional provision would kick in requiring that a new election be held within 30 days.

But government officials loyal to Mr. Chávez have forcefully rejected that notion and said the swearing-in could take place at a later date.

“Jan. 10 is a date that the Constitution holds as a formality for the swearing-in,” Attorney General Cilia Flores said Monday in televised remarks to reporters after a church service during which top government officials prayed for Mr. Chávez’s recovery. She said the Constitution allowed the date to be postponed.

“What we have is a president who has been re-elected, and he will be sworn in on that day or on another later date,” she said.

Information Minister Ernesto Villegas announced Monday that Mr. Chávez had shown a “slight improvement” in his slow recovery from cancer surgery and had sent a greeting wishing the nation a Merry Christmas.

Officials have released little specific information about the emergency surgery Mr. Chávez underwent on Dec. 11 but have described it as complex and difficult. They have said Mr. Chávez encountered complications arising from the surgery, including bleeding and a lung infection. More recently, they described his condition as stable but delicate.

Mr. Chávez was re-elected president on Oct. 7 with 55 percent of the vote, compared with 44 percent for his rival, Henrique Capriles, a state governor.

The Constitution calls for a newly elected president to take office on Jan. 10 by being sworn in before the National Assembly. It goes on to say that “if, for any unexpected reason, the president of the republic cannot take possession before the National Assembly, he will do it before the Supreme Court of Justice.”

Diosdado Cabello, the head of the National Assembly, said last week that because the second clause did not contain a date or indicate a place, the swearing-in could happen at any time.

On Monday, Vice President Nicolás Maduro also said there was room in the Constitution to delay the swearing-in. The president had received permission from the National Assembly to be out of the country indefinitely for his cancer operation, and the permission could be extended past Jan. 10, said Mr. Maduro, whom Mr. Chávez said he wanted to succeed him if he could not continue in office. “The Constitution is very clear,” Mr. Maduro said.

José Vicente Haro, a professor in constitutional law at Andrés Bello Catholic University, had a different view. He said government officials were trying to argue that because Mr. Chávez was re-elected, his old term could simply be extended without a formal swearing-in. He called that an incorrect interpretation and said that after Jan. 10 the cabinet ministers appointed by Mr. Chávez in his current term could no longer hold office.

Mr. Haro, who has served as a consultant to the political coalition opposed to Mr. Chávez, said, “Without doubt there is a constitutional crisis, and it is of such gravity that the legislative power, the executive power and the Supreme Court have had to make statements trying to clear up the doubts and uncertainty that they themselves have created because they don’t want to follow the Constitution.”

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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..

Lawmakers play waiting game with "fiscal cliff" deadline in sight

WASHINGTON (Reuters) - With only a week left before a deadline for the United States to go over a "fiscal cliff," lawmakers played a waiting game on Monday in the hope that someone will produce a plan to avoid harsh budget cuts and higher taxes for most Americans from New Year's Day.

Though Republicans and Democrats have spent the better part of a year describing a plunge off the cliff as a looming catastrophe, the nation's capital showed no outward signs of worry, let alone impending calamity.

The White House has set up shop in Hawaii, where President Barack Obama is vacationing.

The Capitol was deserted and the Treasury Department - which would have to do a lot of last-minute number-crunching with or without a deal - was closed.

So were all other federal government offices, with Obama having followed a tradition of declaring the Monday before a Tuesday Christmas a holiday for government employees, notwithstanding the approaching fiscal cliff.

Expectations for some 11th-hour rescue focused largely on Senate Minority Leader Mitch McConnell, a Republican, in part because he has performed the role of legislative wizard in previous stalemates.

But McConnell, who is up for re-election in 2014, was shunning the role this year, his spokesman saying that it was now up to the Democrats in the Senate to make the next move.

"We don't yet know what Senator Reid will bring to the floor. He is not negotiating with us and the president is out of town," said McConnell's spokesman, referring to Senate Majority Leader Harry Reid, a Democrat. "So I just don't know what they're going to do over there," he said.

Two-day-old tweets on leadership websites told the story insofar as it was visible to the public.

House Speaker John Boehner's referred everyone to McConnell. McConnell's tweet passed the responsibility along to Obama, saying it was a "moment that calls for presidential leadership."

Reid's tweet said: "There will be very serious consequences for millions of families if Congress fails to act" on the cliff.

The next session of the Senate is set for Thursday, but the issues presented by across-the-board tax hikes and indiscriminate reductions in government spending, were not on the calendar.

The House has nothing on its schedule for the week, but members have been told they could be called back at 48 hours notice, making a Thursday return a theoretical possibility.

However, aides to the Republican leaders in Congress said there were no talks with Democrats on Monday and none scheduled after negotiations fell off track last week when Boehner failed to persuade House Republicans to accept tax increases on incomes of more than $1 million a year.

"Nothing new, Merry Christmas," an aide to Boehner responded when asked if there was any movement on the fiscal cliff.

SCALED-BACK EXPECTATIONS

If there is some last-minute legislation, Republicans and Democrats agreed on Sunday news shows that it will not be any sort of "grand bargain" encompassing taxes and spending cuts, but most likely a short-term deal putting everything off for a few weeks or months, thereby risking a negative market reaction.

A limited agreement would still need bipartisan support, as Obama has said he would veto a bill that does not raise taxes on the wealthiest Americans.

On Monday, Texas Senator Kay Bailey Hutchison urged fellow Republicans to be flexible.

"We're now at a point where we're not going to get what we think is right for our economy and our country because we don't control government. So we've got to work within the system we have," she told MSNBC.

Two bills in Congress could conceivably form the basis for a last-minute stopgap measure.

Last spring, Republicans in the House passed a measure that would extend Bush-era tax cuts for everyone, reflecting the party's deep reluctance to increase taxes.

The Democratic-controlled Senate passed a bill in August, extending lower tax rates for everyone except the wealthiest Americans - a group defined at that point as households with a net income of $250,000 or above. Obama has since increased that to $400,000 a year, in an effort to win Republican support.

Analysts say Democrats might be able to get the backing of enough Republicans in both the House and Senate, especially if they are willing to raise the number to $500,000.

Under that scenario, lawmakers might also put off spending cuts of $109 billion that would take effect from January and agree to Republican demands for cuts in entitlement programs such as Medicare and Medicaid, the government-run health insurance plans for seniors and the poor.

However, with only a few work days left in Congress after Christmas, there is a good chance that no deal can be worked out and tax rates would then go up, at least briefly, until an agreement is reached in Washington.

"We may go off the cliff on January 1, but we would correct that very quickly thereafter," Democratic Representative John Yarmuth told MSNBC.

The prospects of the United States going over the fiscal cliff dampened enthusiasm on Wall Street for a "Santa rally" in the holiday season, when stocks traditionally rise.

The Dow Jones industrial average dropped 51.76 points, or 0.39 percent, in Monday's shortened holiday session.

Failure to work out tax rates in the coming days would cause chaos at the Internal Revenue Service, said analyst Chris Krueger of Guggenheim Securities.

"Next weekend is going to be a total, total debacle," he said. The IRS is unlikely to have enough time to revise its tables for withholding taxes.

"The withholding tables are sort of like an aircraft carrier, you can't turn the thing on a dime." he said.

(Additional reporting by Alina Selyukh, Patrick Temple-West and David Lawder; Editing by Alistair Bell, Fred Barbash and David Brunnstrom)

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Citing Broken System, Critics Fight Russia’s Adoption Ban

MOSCOW — The orphans’ faces can be called up on screen, their photos the size of postage stamps, along with a few data points and a note about their personalities, often just a word or two.

Kirill P., age 6, from Rostov in the south — hazel eyes, brown hair — wears a sweatshirt with dragons on it and is described simply as “sociable.” Angelina F., 16 months, from Khabarovsk in the Far East — gray eyes, brown hair — is actively developing an interest in her surroundings and “responds to any caring and affection.”

Maksim N., who just turned 11, is “mobile, restless, outgoing, likes to play games.” This is Russia’s “federal database of orphans and children without parental care,” a publicly available electronic repository of the forlorn and forgotten — more than 118,000 of them.

Child-welfare advocates say that it is orphans like these who are likely to be hurt most if Russian lawmakers succeed in banning adoptions by Americans — a move intended as retaliation for American criticism of Russian rights abuses. The advocates say a ban would end up further fraying a disastrously overwhelmed foster care and orphanage system here.

“Members of Parliament today say, ‘Russia Without Orphans,’ ” said Boris L. Altshuler, the chairman of the advocacy group Right of the Child who also serves on a Kremlin advisory panel, his voice sputtering in anger as he described the incongruous slogan of a bill that would make it harder to find homes for the children. “They know the slogan. The motto is very good, but there is nothing in their minds behind it.”

The bill’s rapid advance, in less than a week, has ignited an emotional debate here, with critics of the ban using the moment to focus attention on Russia’s troubled child protection system, even as supporters say they are trying to keep children out of foreign hands.

More than 650,000 children are living without parental supervision in Russia, according to statistics maintained by the Ministry of Education and Science, with more than 500,000 in foster care and more than 100,000 in orphanages — including the children in the federal database, which is available to prospective adoptive families, even though some of the children are not eligible for adoption.

By contrast, the Children’s Bureau of the Department of Health and Human Services in the United States has reported only about 400,000 living without parents, and only about 58,000 living in institutions or group homes, in a country with a population more than twice Russia’s.

In a telephone interview, Mr. Altshuler described the proposed adoption ban as the latest in a long series of bad policy decisions related to housing, education and social services, resulting in a system that actually encourages parents in financial trouble to cede custody of their children to the state, at least temporarily.

While more Russian children are adopted into homes in the United States each year than any other foreign nation, the overall numbers are relatively small — fewer than 1,000 out of 3,400 international adoptions in 2011. More than 7,400 were adopted by Russian families that year, according to the education and science ministry.

Still, Mr. Altshuler said a ban would be devastating. Some of Russia’s orphanages are badly overcrowded, with children institutionalized throughout their young lives, and many are ill-equipped to deal with the wide array of physical and mental problems common among the children, including fetal alcohol syndrome and congenital disabilities.

“A thousand kids per year will not go to the United States and will stay in Russian institutions with all the tragic consequences,” he said. As for members of Parliament, he said: “They are cannibals. They kill the country and they kill the children.”

Supporters of the ban say the United States government has not done enough to protect adopted Russian children and has not lived up to an agreement on heightened oversight that went into effect on Nov. 1. Though there is a strong nationalist streak in their arguments, occasionally ugly cases have generated international attention: including a 7-year-old boy sent back to Russia alone by his adoptive mother in Tennessee in 2010.

Yekaterina F. Lakhova, a member of Parliament and sponsor of the ban, said that years of working on child welfare issues led her to conclude that the international adoption process is overly profit-driven, and she said Russians should take care of their own.

“If the country is self-sufficient, if it believes in itself, you have to do it here,” Ms. Lakhova said, in an interview published by the news site PublicPost. “No normal, economically developed country gives away their children. I am a patriot of Russia.”

In many ways the insistence by some officials that Russia should handle its own child welfare echoes efforts by President Vladimir V. Putin to restore Russia’s standing as a world power after the decline following the collapse of the Soviet Union.

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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."

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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.

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Online:

American Academy of Child & Adolescent Psychiatry: http://www.aacap.org

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

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Asian shares steady, U.S. budget concerns weigh

TOKYO (Reuters) - Asian shares steadied in quiet pre-holiday trade after a slump late last week, but markets have become more jittery about the risk of the United States failing to avert a fiscal crisis.

Activity in other assets was also subdued, with spot gold steadying as investors took to the sidelines, while oil extended losses, with U.S. crude inching down 0.2 percent to remain below $89 a barrel while Brent futures also eased 0.2 percent to $108.78.

MSCI's broadest index of Asia-Pacific shares outside Japan <.miapj0000pus> was up 0.07 percent after falling to a near two-week low on Friday when House of Representatives Speak John Boehner failed to gain support for a tax plan, raising fears the U.S. may not be able to avert the "fiscal cliff" of automatic spending cuts and tax increases set to start January 1.

The White House on Friday tried to rescue stalled talks but there was little headway as lawmakers and President Barack Obama abandoned Washington for Christmas.

Many market players still expect both sides to reach a compromise before the year-end deadline but heightening tensions were likely to stifle trade already slowed by the holidays.

U.S. Treasuries gained a safety bid on Friday from fiscal cliff worries, which put many investors on edge and drove down global equities markets, the euro and oil futures.

Australian shares <.axjo> were up 0.2 percent but trade was extremely thin, with Monday's session shortened ahead of the two-day Christmas holiday and many players already away.

South Korean shares <.ks11> edged up 0.1 percent in light trading before Christmas Day, with the weakening Japanese yen and U.S. fiscal uncertainty keeping investors uneasy.

"With a dearth of good news, shares will undergo corrections in the final week of this year, albeit within a limited range" said Park Hyeong-joong, an analyst at Meritz Securities.

"A chance is growing that the U.S. fiscal issue will not be resolved by this year-end," Park said.

Japanese financial markets are closed for a public holiday and will resume trading on Tuesday.

The dollar inched up 0.2 percent to 84.38 yen, having fallen below 84 yen on Friday. The dollar hit a 20-month high of 84.62 yen on December 19.

The yen has been pressured by expectations the Bank of Japan will be compelled to adopt more drastic monetary stimulus measures next year as incoming prime minister Shinzo Abe has demanded bolder action by the central bank to bring Japan out of decades-long deflation.

Abe stepped up pressure over the weekend, saying on Japanese television on Sunday that he will try to revise a law guaranteeing the BOJ's independence if his demand for a binding inflation target is not met.

Currency speculators increased their bets against the U.S. dollar in the latest week, according to data from the Commodity Futures Trading Commission released on Friday. Bets against the yen fell after reaching a more than five-year peak.

But market players generally see the dollar staying firm for now as a U.S. fiscal impasse will likely continue to sap investor appetite for risky assets and raise the dollar's safe-haven appeal.

"It looks like all momentum for the fiscal cliff negotiations is gone," said Rob Ryan, strategist for RBS in Singapore. While the dollar could sway by year-end flows, "on balance I would see a stronger U.S. dollar into the end of the year," Ryan said.

EPFR Global, a fund-tracking firm, said on Friday that investors around the world pulled $4.1 billion from bond funds worldwide during the week ending December 19, the most since August 2011, and favored riskier stock exchange-traded funds despite the U.S. budget worry.

ETFs are generally believed to represent the behavior of institutional investors, and can be used opportunistically to bet on various indexes.

The euro stood steady around $1.3180.

In Italy, Mario Monti announced on Sunday he would consider seeking a second term as Italian prime minister if approached by allies committed to backing his austere brand of reforms. Monti resigned on Friday but has faced growing calls to seek a second term at a parliamentary election on February 24-25.

At stake is the leadership of the world's eighth largest economy, where recession and public debt of more than 2 trillion ($2.6 billion) have aggravated investor concerns about growth and stability in the euro zone.

Italy faces a huge bond redemption in the first quarter of 2013 and its failure to secure funding could refuel concerns about sovereign financing not only in Italy but also similarly indebted Spain, hurting sentiment towards the euro.

(Additional reporting by Hyunjoo Jin in Seoul and Masayuki Kitano in Singapore; Editing by Eric Meijer)

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