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 on defensive on U.S. fiscal worry, helps Nikkei

TOKYO (Reuters) - Uncertainty over whether U.S. lawmakers will strike a deal by an end-of-year deadline to avert a severe fiscal retrenchment undermined the yen and bolstered Japanese shares on Tuesday in low volume, with many participants away on Christmas holiday.

The dollar rose to a 20-month high of 84.965 yen early on Tuesday in Asia, as Japanese markets caught up with global investors who had reacted overnight to incoming Japanese Prime Minister Shinzo Abe's weekend comments that raised the pressure on the Bank of Japan.

During a meeting on Tuesday with officials from Japan's major business lobby, Keidanren, Abe reiterated calls on the BOJ to conduct bold monetary easing to beat deflation by setting an inflation target of 2 percent.

The head of Abe's coalition partner said on Tuesday the coalition party and Abe had agreed to set a 2 percent inflation target and compile a large stimulus budget to help the economy return to growth and overcome deflation.

The yen has come under pressure as a result of expectations that the BOJ will be compelled to adopt more drastic monetary stimulus measures next year.

The dollar was 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.

"The dollar is seen relatively well bid, with all focus on the fiscal cliff," said Yuji Saito, director of foreign exchange at Credit Agricole in Tokyo.

"Negotiations may be carried over the weekend, but markets still expect a deal to be struck by December 31. It is unthinkable that the U.S. will risk driving its economic growth sharply lower by not agreeing to avoid it."

U.S. lawmakers and President Barack Obama were on Christmas holiday and talks were unlikely to resume until later in the week.

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.

Japan's Nikkei stock average <.n225> resumed trading after a three-day weekend with a 1.1 percent gain, recapturing the key 10,000 mark it ceded on Friday after Boehner's failure sparked a broad market sell-off and the Tokyo benchmark closed down 1 percent. The Nikkei was likely to be supported as long as the yen stayed weak. <.t/>

"Ongoing optimism about the weak yen is lifting hopes that exporters' earnings will be better than expected," said Hiroichi Nishi, general manager at SMBC Nikko Securities.

Analysts say a near-term correction may be possible as the index is now in "overbought" territory after gaining 16.2 percent over the last six weeks, hitting a nine-month high last Friday. Its 14-day relative strength index was at 72.34, above the 70 level that signals an overbought condition.

MSCI's broadest index of Asia-Pacific shares outside Japan <.miapj0000pus> nudged up 0.1 percent, driven higher by surging Shanghai shares, as most Asian bourses were shut for Christmas.

The Shanghai Composite Index <.ssec> soared over 2 percent to five-month highs as investors bought property stocks on mounting optimism about the sector. Taiwan shares <.twii> jumped 1.3 percent on gains in technology and financial shares.

Asset performance in 2012: http://link.reuters.com/muc46s

2012 commodities returns: http://link.reuters.com/faz36s

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^>

U.S. HOLDS 2013 KEY

Goro Ohwada, president and CEO at Japan-based fund of hedge funds Aino Investment Corp, said investors were likely to focus on economic fundamentals and the United States for cues on investment direction in 2013.

"There is a feeling that an investment strategy based on economic fundamentals may finally work next year, with asset prices more closely reflecting fair value. The problem is, we don't know yet which asset is a better bet than others," Ohwada said, adding that oil and gold appeared to be near their highs.

Naohiro Niimura, a partner at research and consulting firm Market Risk Advisory, said commodities and energy prices will likely move in tight ranges in 2013, with investors eyeing political events, including the U.S. fiscal cliff outlook, Italian parliamentary election set for February 24-25, and Germany's elections in September.

"The macroeconomic policies taken this year around the world to support growth are expected to result in a moderate recovery in 2013 to reduce an excessive downside risk to prices. This will likely keep commodities, gold and energy prices near their highs," Niimura said.

(Additional reporting by Ayai Tomisawa in Tokyo; Editing by Edmund Klamann and Daniel Magnowski)

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Israel says has no proof poison gas used in Syria

JERUSALEM (Reuters) - Israel voiced doubt on Tuesday about the accuracy of Syrian activists' reports that chemical weapons had been used against rebels fighting to topple President Bashar al-Assad.

"We have seen reports from the opposition. It is not the first time. The opposition has an interest in drawing in international military intervention," Vice Prime Minister Moshe Yaalon said on Army Radio.

"As things stand now, we do not have any confirmation or proof that (chemical weapons) have already been used, but we are definitely following events with concern," he said.

The Syrian Observatory for Human Rights gathered activist accounts on Sunday of what they said was a poison gas attack in the city of Homs. The reports are difficult to verify, as the government restricts media access in Syria.

The Observatory, a British-based group with a network of activists across Syria, said those accounts spoke of six rebel fighters who died after inhaling smoke on the front line of Homs's urban battleground. It said it could not confirm that poison gas had been used and called for an investigation.

Syria has said it would never use chemical weapons against its citizens.

Asked about images purported to show patients being treated for possible gas poisoning, Yaalon said: "I'm not sure that what we're seeing in the photos is the result of the use of chemical weapons.

"It could be other things," he said, without elaborating.

On Sunday, senior Israeli defense official Amos Gilad said Syria's chemical weapons were still secure despite the fact that Assad had lost control of parts of the country.

As Syria's southern neighbor, Israel has been concerned about chemical weapons falling into the hands of Islamist militants or Lebanese Hezbollah fighters, cautioning it could intervene to stop such developments.

(Writing by Jeffrey Heller; Editing by Alistair Lyon)

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First photos of BlackBerry 10 ‘N-Series’ QWERTY smartphone leak

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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..

Budget uncertainty hangs over quiet stocks, FX

LONDON (Reuters) - World stock, commodity and currency markets were steady on Monday, with tensions over the U.S. budget dispute subdued by a holiday lull in Europe.

With a number of stock markets including in Germany, Italy and Switzerland closed for the Christmas holiday, the FTSEurofirst300 <.fteu3> was flat at 1,138.92 points by 1045 GMT and the MSCI index of global stocks <.miwd00000pus> was virtually unchanged at 339.97. The British, French, Dutch and Spanish markets were open for shortened sessions only.

Activity in other assets was also subdued, with spot gold edging up from a four-month low and Brent oil easing back under $109 a barrel.

Markets were left in limbo on Friday when President Barack Obama and U.S. lawmakers suspended talks until after Christmas on avoiding $600 billion of spending cuts and tax increases that threaten to send the economy back into recession.

Although there is no official date for talks to resume, the two sides still have few days after Christmas to find a compromise before the January 1 deadline when the measures start to take effect.

Most political experts and economists expect a deal of some form. If one isn't, the "fiscal cliff" could wipe as much as 4 percent off U.S. GDP next year, choking the global recovery before it gets going.

"The fiscal cliff is the only thing that is important for markets at the moment," said ABN Amro economist Aline Schuiling. "We were hoping the festive spirit would get everyone together and a deal would be done, but Obama has now gone to Hawaii for Christmas, so it looks like we'll have to wait."

YEN WEAKNESS

Most European bond markets were already shut for Christmas but one of the few to be open was in Britain where benchmark 10-year yields ticked higher.

Currency markets were also largely quiet. Against the backdrop of the fiscal cliff uncertainty, the dollar eased 0.2 percent versus a basket of major currencies while the euro climbed back above $1.32.

The major mover was the yen, which neared a 20-month low versus the dollar, after incoming premier Shinzo Abe renewed pressure over the weekend on the Bank of Japan to adopt a 2 percent inflation target.

The dollar was up 0.2 percent on the day at 84.42 yen. Chartists said the dollar needed to overcome 85.05 yen, its 200-week moving average, for it to make further gains.

"There has been some pretty significant yen selling all through the night and into this morning," said Peter Kinsella, currency strategist at Commerzbank.

"It is very noticeable we have not seen any retracement or dip in dollar/yen at all. The market is really saying they are convinced on yen weakness, and that is what we are going to see for the remainder of this year and in the course of next year."

STRONG FINISH

Trading on Wall Street was also expected to be subdued when it opens later, also for half a day. Futures pointed to the S&P 500 opening down 0.6 percent and the Dow Jones and Nasdaq 100 starting down 0.4 percent. <.n/>

The uncertainty over the U.S. budget is threatening to sour what has been a strong second half of the year for equity markets. The FTSEurofirst 300 is up 20 percent since June while the Euro STOXX 50 <.stoxx50e> has gained almost 30 percent. Both indexes are set to post their best annual performances since the post-Lehman crisis bounce of 2009.

Investors are now showing increasing appetite for European stocks. EPFR Global data reported that flows into equity funds have increased for the last 19 weeks.

"This year has been a year of transition, and now it's time to turn the page and move on, to start picking stocks again for the long term, companies exposed to the emerging consumer in places like Asia and Africa," said David Thebault, head of quantitative sales trading, at Global Equities.

Others warn that the euro zone crisis may still have some bite left, however. Elections are due next year in Italy and Germany, while Spain's government, companies and banks need to refinance huge amounts of debt.

"Policymakers in Spain will not be looking forward to the start of the year and January will probably be quite volatile in Europe," said ABN Amro's Schuiling. "The funding in the first quarter for Spain will be the test... Its deficit is now roughly the same as Greece's."

(Additional reporting by Blaise Robinson in Paris and Anooja Debnath in London; editing by David Stamp)

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Afghan policewoman kills coalition contractor in Kabul: NATO

KABUL (Reuters) - An Afghan woman wearing a police uniform shot dead on Monday a civilian contractor working for Western forces in the police chief's compound in Kabul, NATO said.

The incident is likely to raise troubling questions about the direction of an unpopular war.

It appeared to be the first time that a woman member of Afghanistan's security forces carried out such an attack.

There were conflicting reports about the victim.

A spokesman for the NATO-led International Security Assistance Force (ISAF) said a U.S. police adviser was killed by an Afghan policewoman. Then ISAF said in a statement only that it was a "contracted civilian employee" who was killed.

Mohammad Zahir, head of the police criminal investigation department, described the incident as an "insider attack" in which Afghan forces turn their weapons on Western troops they are supposed to be working with. He initially said the victim was a U.S. soldier.

After more than 10 years of war, militants are capable of striking Western targets in the heart of the capital, and foreign forces worry that Afghan police and military forces they are supposed to work with can suddenly turn on them.

The policewoman approached her victim as he was walking in the heavily guarded police chief's compound in a bustling area of Kabul. She then drew a pistol and shot him once, a senior police official told Reuters.

The police complex is close to the Interior Ministry where in February, two American officers were shot dead at close range at a time anger gripped the country over the burning of copies of the Muslim holy book at a NATO base.

"She is now under interrogation. She is crying and saying 'what have I done'," said the official, of the police officer who worked in a section of the Interior Ministry responsible for gender awareness issues.

TIPS FOR TROOPS

The insider incidents, also known as green-on-blue attacks, have undermined trust between coalition and Afghan forces who are under mounting pressure to contain the Taliban insurgency before most NATO combat troops withdraw by the end of 2014.

Security responsibilities in a country plagued by conflict for decades will be handed to Afghan security forces.

Many Afghans fear a civil war like one dominated by warlords after the withdrawal of Soviet occupying forces in 1989 could erupt again, or the Taliban will make another push to seize power if they reject a nascent peace process.

At least 52 members of the NATO-led International Security Assistance Force have been killed this year by Afghans wearing police or army uniforms.

Insider attacks now account for one in every five combat deaths suffered by NATO-led forces in Afghanistan, and 16 percent of all U.S. combat casualties, according to 2012 data.

Hoping to stop the increase in the attacks, Afghan Defense Ministry officials have given their troops tips in foreign culture.

They are told not to be offended by a hearty pat on the back or an American soldier asking after your wife's health.

NATO attributes only about a quarter of the attacks to the Taliban, saying the rest are caused by personal grievances and misunderstandings. Last year, there were 35 deaths in such attacks.

Afghan forces are vulnerable to "insider attacks" of their own. In Jawzjan province in the north, a police commander shot and killed five comrades overnight, the Interior Ministry said.

Last year, he defected from the Taliban, said the ministry.

Taliban spokesman Zabihullah Mujahid said in a statement that the commander had rejoined the Taliban. That could not be confirmed.

(Writing by Michael Georgy; Editing by Robert Birsel)

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Saudi website editor could face death for apostasy-rights group

RIYADH (Reuters) – The editor of a Saudi Arabian website could be sentenced to death after a judge cited him for apostasy and moved his case to a higher court, the monitoring group Human Rights Watch said on Saturday.

Raif Badawi, who started the Free Saudi Liberals website to discuss the role of religion in Saudi Arabia, was arrested in June, Human Rights Watch said.

Badawi had initially been charged with the less serious offence of insulting Islam through electronic channels, but at a December 17 hearing a judge referred him to a more senior court and recommended he be tried for apostasy, the monitoring group said.

Apostasy, the act of changing religious affiliation, carries an automatic death sentence in Saudi Arabia, along with crimes including blasphemy.

Badawi’s website included articles that were critical of senior religious figures, the monitoring group said.

A spokesman for Saudi Arabia’s Justice Ministry was not available to comment.

The world’s top oil exporter follows the strict Wahhabi school of Islam and applies Islamic law, or sharia.

Judges base their decisions on their own interpretation of religious law rather than on a written legal code or on precedent.

King Abdullah, Saudi Arabia’s ruler, has pushed for reforms to the legal system, including improved training for judges and the introduction of precedent to standardize verdicts and make courts more transparent.

However, Saudi lawyers say that conservatives in the Justice Ministry and the judiciary have resisted implementing many of the changes that he announced in 2007. (Reporting By Angus McDowall; Editing by Kevin Liffey)

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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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