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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Girlfriend denies helping actor kill college students

A woman accused of helping her former fiance cover up two gruesome murders pleaded not guilty Wednesday to three felonies she faces in connection with the crime.

Prosecutors say aspiring actress Rachel Buffett, 25, lied to police and repeated a fabricated account that Daniel Wozniak, 28, initially told detectives.

Wozniak is charged in the 2010 murders of Orange Coast College students Samuel Herr, 26, and Julie Kibuishi, 23.

At the time of the killings, Wozniak and Buffett were starring in a community theater production of the musical "Nine."

Prosecutors allege that on May 21, 2010, Wozniak lured Herr, his neighbor, to a theater facility at the Los Alamitos Joint Forces Training Base, then shot him twice in the head before stealing his ATM, wallet and cellphone.

Later that evening, Wozniak allegedly used Herr's cellphone to send a text message to Kibuishi, a friend of Herr's, to lure her to his apartment.

Authorities believe Wozniak shot Kibuishi twice in the head, and then removed some of her clothing to make it look like she was sexually assaulted.

Prosecutors say Wozniak later returned to the theater, where he allegedly cut off Herr's head, left arm and right hand before dispersing the body parts at a theater and in a local park.

Wozniak was arrested on May 26, 2010, at his bachelor party in Huntington Beach, after police traced money taken from Herr's account to him.

Prosecutors say that Wozniak wanted to steal Herr's savings account to pay for his wedding to Buffett and their honeymoon.

Wozniak has pleaded not guilty to two felony counts of special-circumstances murder and is still awaiting trial. He faces the death penalty if convicted.

Buffett was arrested Nov. 20 on suspicion of being an accessory to murder after the fact.

She faces three felony counts of accessory after the fact and is currently free on $1 million bail. Buffett could get a maximum of four years in state prison if convicted.

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-- Times Community News

Video: At a news conference in Long Beach earlier this month, Rachel Buffett discusses the charges she's facing. Credit: Ruben Vives / Los Angeles Times

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South Korea Seeks to Buy Spy Drones

WASHINGTON (Reuters) — The Obama administration formally proposed a sale of advanced spy drones to help South Korea take a more active role in its own defense from any attack by the heavily armed North.

Seoul has requested a possible $1.2 billion sale of four Northrop Grumman Global Hawks, remotely piloted aircraft with enhanced surveillance capabilities, according to a statement by the Pentagon’s Defense Security Cooperation Agency dated Monday and distributed Tuesday.

South Korea needs such systems to assume top responsibility for intelligence-gathering from the United States-led Combined Forces Command as scheduled in 2015, the security agency said in releasing a notice to American lawmakers. The aircraft “will maintain adequate intelligence, surveillance, and reconnaissance capabilities and will ensure the alliance is able to monitor and deter regional threats in 2015 and beyond,” the notice said.

The military partnership grew from the American role in the 1950-53 Korean War, and is being phased out. Seoul has shown interest in the high-altitude, long-endurance Global Hawk platform for at least four years.

The possible sale has been held up by discussions involving price, aircraft configuration and a deliberately slow pace in releasing of such technology, which is subject to a voluntary 34-nation arms control pact.

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Boston Cop Rescues Drowning Woman

A Boston police officer is being hailed a hero after he jumped into the frigid cold water to rescue a drowning woman.

Cell phone video showed police officer Edward Norton plunging into Fort Point channel Friday afternoon during a torrential downpour to rescue the unidentified woman who’d reportedly fallen in by accident.

Norton, who just happened to be in the right place at the right time, says he didn’t think twice about jumping in.

“It just kind of happened. I saw here there. Someone had to do it,” Norton told ABC News. “As I was in the air, I was thinking I don’t know what’s under the water.”

Once in the water, Norton’s bullet-proof vest weighed him down, making the rescue more complicated than he anticipated. Onlookers did their part by tossing in a life preserver, which helped keep the frantic woman afloat.

“She kept saying stuff like, ‘I can’t hold on.’ So, I told her, ‘Hold on. Help is coming,’” Norton said. The officer remained with the woman in the water until firefighters arrived on the scene and pulled them both out of the water to safety.

Both were taken to local hospitals and checked for hypothermia, but were released with a clean bill of health.

As for the people calling Norton a hero, he says, not really because it’s all in a day’s work.

“I feel like I did what I would expect to do for one of my loved ones. My wife, my daughter, anyone,” Norton said.

While everyone made it out of the water safely with no injuries, there was one casualty so to speak. Norton says his wedding band slipped off when he hit the water and hero or not, his wife is none too pleased.

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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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Affordable Care Act presents many unknowns for California officials

SACRAMENTO — As California positions itself at the vanguard of the national healthcare overhaul, state officials are unable to say for sure how much their implementation of the federal Affordable Care Act will cost taxpayers.

The program, intended to insure millions of Americans who are now without health coverage, takes states into uncharted territory. California, which plans to expand coverage to hundreds of thousands of people when the law takes effect in 2014, faces myriad unknowns. The Brown administration will try to estimate the cost of vastly more health coverage in the budget plan it unveils next month, but experts warn that its numbers could be way off.

Officials don't know exactly how many Californians will sign up for Medi-Cal, the public health insurance program for the poor. Computing the cost of care for each of them is also guesswork. And California is waiting for key rulings from federal regulators that could have a major effect on the final price tag, perhaps in the hundreds of millions of dollars.

"No one has ever tried to do anything like this before," said Michael Cannon, director of health policy studies at the conservative Cato Institute. "Any numbers attached to this are just a guess."

The uncertainty comes as the state's finances are improving but still precarious. Voters approved billions of dollars in new taxes last month, but Sacramento nevertheless faces a shortfall of $1.9 billion that must be bridged in fiscal 2013-14.

Unanticipated costs associated with the healthcare changes could undermine California's efforts to improve its standing on Wall Street and keep the economy moving. They could force fresh cuts in services if they consume much more of the state budget than Brown is able to approximate.

In addition, some Democrats in the Legislature hope to restore certain health benefits, such as dental coverage for Medi-Cal recipients, that have been eliminated or reduced amid the persistent financial crises of recent years. The cost of any services that are revived could rise as more people become eligible for them.

Gov. Jerry Brown expressed a new concern in an interview last week. He said recent signs from Washington suggest the federal government may not pay as much of the costs associated with the new law as originally promised, sticking states with a larger share of the bill.

"As the guardian of the public purse here, I have to watch very closely what may come out of Washington," the governor said. "So we're going to move carefully. We want to make sure the federal government is on board."

Cost estimates for California have differed widely.

In 2010, the year the Affordable Care Act was signed, state officials said California could be on the hook for $2.7 billion annually. The nonpartisan legislative analyst estimated this fall that initial costs would be in the "low hundreds of millions of dollars" annually for the next several years. A recent study from the nonprofit Kaiser Family Foundation pegged the price at nearly $14 billion over the next decade.

The main cost is expected to come from a sharp increase in the number of Medi-Cal enrollees. Sacramento and Washington split the bill for those Californians, who currently number roughly 8 million. The state's share was about $14.6 billion this year.

Sacramento will be responsible for half the cost of many new Medi-Cal recipients. That number could be anywhere from 200,000 to 440,000 people in 2014, according to Ken Jacobs, chairman of the Labor Center at UC Berkeley.

Jacobs says early estimates are that these new enrollees will be cheaper to treat than current Medi-Cal recipients because they are expected to be younger and healthier. But experts caution that nobody knows for sure.

"There is a high margin of error when trying to make these estimates," said Janet Coffman, a professor at the UC San Francisco Institute for Health Policy Studies. "And with the budget, there's always an element of politics in terms of which sets of numbers you decide to use."

With so many more Californians about to be insured, administration officials have suggested they would propose reducing the annual $1.4 billion Sacramento pays to counties to help them care for the uninsured. The administration is also contemplating cuts in state-funded programs aimed at the uninsured, such as breast-cancer screening and family-planning services. They say demand for such aid will fall as more people obtain coverage.

The counties, which by law are ultimately responsible for paying to treat the uninsured, would be likely to fight such moves.

"Counties will say there is still a need to keep the safety net intact and that [the state] can't take the money before people are actually enrolled," said Chris Perrone, deputy director of health reform and public programs at the California Healthcare Foundation, an Oakland-based nonprofit.

Even after the federal law is enacted, millions of Californians are expected to be without coverage. There are currently about 8.2 million uninsured, according to the UCLA Center for Health Policy Research. Models from UC Berkeley assume the number will be about half that by 2019.

Those who remain uninsured would still show up at hospital emergency rooms, and counties would still be responsible for their care.

Already, local officials are bracing for the worst. In a letter to Brown this month, the L.A. County Board of Supervisors expressed concern about any impending cuts.

Reducing payments to counties "prior to a full assessment and understanding" of the effects of the healthcare changes, the supervisors wrote, "is not reasonable."

anthony.york@latimes.com

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No Easy Route If Bashar al-Assad Opts to Go, or Stay

BEIRUT, Lebanon — President Bashar al-Assad of Syria sits in his mountaintop palace as the tide of war licks at the cliffs below.

Explosions bloom over the Damascus suburbs. His country is plunging deeper into chaos. The United Nations’ top envoy for the Syrian crisis, Lakhdar Brahimi, met with Mr. Assad in the palace on Monday in an urgent effort to resolve the nearly two-year-old conflict.

How Mr. Assad might respond to Mr. Brahimi’s entreaty depends on his psychology, shaped by a strong sense of mission inherited from his iron-fisted father and predecessor, Hafez al-Assad; his closest advisers, whom supporters describe as a hard-line politburo of his father’s gray-haired security men; and Mr. Assad’s assessment, known only to himself, about what awaits him if he stays — victory, or death at the hands of his people.

From his hilltop, Mr. Assad can gaze toward several possible futures.

East of the palace lies the airport and a possible dash to exile, a route that some say Mr. Assad’s mother and wife may have already taken. But the way is blocked, not just by bands of rebels, but by a belief that supporters say he shares with his advisers that if he flees, he will betray both his country and his father’s legacy.

He can stay in Damascus and cling to — even die for — his father’s aspirations, to impose a secular Syrian order and act as a pan-Arab leader on a regional and global stage.

Or he can head north to the coastal mountain heartland of his minority Alawite sect, ceding the rest of the country to the uprising led by the Sunni Muslim majority. That would mean a dramatic comedown: reverting to the smaller stature of his grandfather, a tribal leader of a marginalized minority concerned mainly with its own survival.

Mr. Brahimi was closemouthed about the details of his meeting, but has warned in recent weeks that without a political solution, Syria faces the collapse of the state and years of civil war that could dwarf the destruction already caused by the conflict that has taken more than 40,000 lives.

A Damascus-based diplomat said Monday that Mr. Assad, despite official denials, is “totally aware” that he must leave and was “looking for a way out,” though the timetable is unclear.

“More importantly,” said the diplomat, who is currently outside of Syria but whose responsibilities include the country, “powerful people in the upper circle of the ruling elite in Damascus are feeling that an exit must be found.”

Yet others close to Mr. Assad and his circle say any retreat would clash with his deep-seated sense of himself, and with the wishes of increasingly empowered security officials, whom one friend of the president’s has come to see as “hotheads.”

Mr. Assad believes he is “defending his country, his people, and his regime and himself” against Islamic extremism and Western interference, said Joseph Abu Fadel, a Lebanese political analyst who supports Mr. Assad and met with government officials last week in Damascus.

Analysts in Russia, one of Syria’s staunchest allies, say that as rebels try to encircle Damascus and cut off escape routes through Hama province to the coast, the mood in the palace is one of panic, evinced by erratic use of weapons: Scud missiles better used against an army than an insurgency, naval mines dropped from the air instead of laid at sea.

But even if Mr. Assad wanted to flee, it is unclear if the top generals would let him out alive, Russian analysts say, since they believe that if they lay down arms they — and their disproportionately Alawite families — will die in vengeance killings, and need him to rally troops.

“If he can fly out of Damascus,” Semyon A. Bagdasarov, a Middle East expert in Moscow, said — at this, he laughed — “there is also the understanding of responsibility before the people. A person who has betrayed several million of those closest to him.”

Many Syrians still share Mr. Assad’s belief that he is protecting the Syrian state, which helps explain how he has held on this long. At a lavish lunch hosted by a Lebanese politician in Beirut in September, prominent Syrian backers of Mr. Assad — Alawites, Sunnis and Christians — spoke of the president, over copious glasses of Johnnie Walker scotch, as the bulwark of a multicultural, modern Syria.

Reporting was contributed by Kareem Fahim and David D. Kirkpatrick from Beirut, Ellen Barry from Moscow, Sebnem Arsu from Istanbul, Rick Gladstone from New York, and an employee of The New York Times from Tartus, Syria.

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Facebook Shrugs Off Instagram’s New Class Action Lawsuit

For Instagram, there’s good news and there’s bad news about the class action lawsuit just filed against them. Bad news first: Somebody just filed a class action lawsuit. Good news: the lawyers from Instagram’s parent company, Facebook, have plenty of practice getting rid of these pesky things. That might explain why they’re so dismissive about the legal inconvenience a group of disgruntled Instagram users left under its tree this year. “We believe this complaint is without merit and we will fight it vigorously,” says Facebook spokesman Andrew Nusca. It’ll obviously take more than the half-hearted apology Instagram CEO and co-founder Kevin Systrom made at the end of last week.

RELATED: It’s Time to Accept the Existence of a Social Media Bubble

The lawsuit’s complaint is somewhat understandable. If you’ve so much as heard the word “Instagram” you’ve heard about how much their new terms of service stink. In it, the company declared that it “may share User Content and your information (including but not limited to, information from cookies, log files, device identifiers, location data, and usage data)” with Facebook, its subsidiaries and its “affiliates.” Instagram users understood this to mean that Instagram could sell their photos to advertisers, though Systrom pushed back at that in his blog post when he more or less said that the company would revert to its old terms of service. “We don’t own your photos – you do,” he said. 

RELATED: And the Actual Retail Price for Instagram Is…

Instagram kept three key new details in place, though. One, the company maintained the ability to serve ads in your feed. Two, it said “that we may not always identify paid services, sponsored content, or commercial communications as such.” Lastly, it left in place the mandatory arbitration clause that it added with the new terms of service, forcing users to waive their right to participate in class action lawsuit. That obviously didn’t discourage this group of plaintiffs who said in the lawsuit that “Instagram declares that ‘possession is nine-tenths of the law and if you don’t like it, you can’t stop us.’”

RELATED: Mark Zuckerberg Disappears from Google+ Due to Privacy Settings

No big deal. Instagram is a part of Facebook now, and Facebook has dealt with class action lawsuits before. Just seven months ago, it got slammed with a $ 15 billion class action suit from users who said that the social network was ”improperly tracking the internet use of its members even after they logged out of their accounts.” They haven’t settled yet, but if it winds up anything like the class action lawsuit over the Beacon advertising program a few years ago, it could take years to resolve and could cost Facebook millions. With some good lawyering, though, this latest lawsuit won’t cost as many millions as it could. But Instagram will never be the same.

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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 suddenly 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.

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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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