Experts debate North Korea's missile goals and capability

WASHINGTON — When North Korea launched a small satellite into orbit last month for the first time, U.S. officials called it a cover for a more ominous goal: a ballistic missile that could carry a nuclear weapon as far as the continental United States.

But North Korea is a long way from building a workable intercontinental missile and, at the current pace of testing, it could take many years before they are close, missile technology experts say.

"They could put up something that would look like a credible missile but ... it's not really much of a threat," said Boston-based physicist David Wright, who follows the North Korean program for the nonpartisan Union of Concerned Scientists. "They have no idea whether it's going to blow up on the launch pad or dump one of their precious nuclear weapons into the Pacific Ocean."

This week, Bill Richardson, a former governor of New Mexico, is visiting Pyongyang, the North Korean capital, with Eric Schmidt, the executive chairman of Google, on what they are calling a private humanitarian trip. Richardson said Wednesday that he was pressing the government to stop all missile launches and nuclear tests and to allow more cellphones and an open Internet for its citizens.

Some experts outside the U.S. government contend that North Korea's failure-prone missile program is essentially a bluff aimed at spurring concessions from the international community.

U.S. intelligence officials disagree. They say North Korea is intent on developing a capability to threaten the West with nuclear weapons. In 2011, then-Defense Secretary Robert Gates said North Korea would have a missile that could strike the continental United States by 2016, although some U.S. officials believe that timetable has now slipped.

The North Koreans "haven't tested a lot, which slows development," said a U.S. official familiar with the latest intelligence. "But they're still moving forward."

North Korean leader Kim Jong Un hailed the Dec. 12 satellite launch in a televised New Year's Day speech, calling on the nation to rebuild its ailing economy "in the same spirit and mettle as were displayed in conquering space."

But progress has been halting. In recent years, North Korea has attempted one or two rocket tests annually, most of which failed. In April, a rocket carrying a satellite exploded 90 seconds after takeoff.

Building a dependable intercontinental ballistic missile would require "flight tests every other month, over several years," said Markus Schiller, who wrote a paper about the missile program in October for Rand Corp., a Santa Monica-based think tank. "First-generation long-range missiles require dozens of flight tests until they are reliable and accurate enough for deployment."

Schiller said in his Rand paper that the main purpose of the North's rocket launches is to deter the United States and South Korea, and "to gain strategic leverage in foreign politics."

The three-stage Unha rocket that put a small satellite into orbit last month "was developed as a satellite launcher and not as a weapon," Schiller said in a telephone interview from Germany. "The technology was only suited for satellite launch."

The rocket's third stage took a dog leg turn to avoid flying over Taiwan and the Philippines, said Brian Weeden, a former U.S. Air Force space expert now with the Secure World Foundation, a Washington think tank.

"That is definitely something more associated with a space launch than with a ballistic missile launch," he said. "It's not what you would expect to see with a missile test."

Any successful rocket launch could theoretically help North Korea improve its missile technology, Weeden said. But launching a satellite is easier than perfecting a missile that can carry a weapons payload into space and then deliver it to a specific target without burning up in the atmosphere.

Other analysts believe North Korea made a major technological advance with the satellite launch. Bruce Klingner, a former CIA analyst now at the Heritage Foundation, a Washington think tank, called it "a huge step forward in their capabilities."

Jeffrey Lewis, a nonproliferation expert at the nonpartisan Monterey Institute of International Studies, worries that North Korea is making just enough progress to be dangerous.

"The North Koreans might just be willing to deal with less reliable systems," he said. "They might just be happy with 50% reliability. My starting assumption is that they are serious, that this is something that they intend to build. I presume that they are competent enough that this is not an impossible missile."

ken.dilanian@latimes.com

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Video: Watch the Entire <em>Dark Knight</em> Movie Trilogy in Three Minutes

Director Christopher Nolan’s Batman trilogy, which concluded last summer with The Dark Knight Rises, is probably one of the most well-executed comic book hero franchises in recent memory. So good, in fact, that every now and then it’s nice just to have a little taste – even when there isn’t time to watch all three flicks back to back.

Luckily, the folks at Screen Rant have done us all a solid and crammed all of the best moments from the three films into one three-minute clip (above) for those who need a Bat-fix, even when there isn’t a lot of Bat-time. Three movies. Three minutes. One great way to bask in the world of Bruce Wayne.

“To do justice to this almost seven-hour-long trilogy in only three minutes, we chose to focus on the story of Gotham City – especially since many viewers consider Gotham to be the ‘true’ main character in Nolan’s films,” the video’s editor wrote on the site. “It’s [sic] fall from glory spawned a man determined to help restore it and, in the end, he does just that, but not without some bumps along the way. If you can call Ra’s and Talia al Ghul, the Scarecrow, the Joker, Two-Face, Bane and Catwoman just ‘bumps.’”

Check out the (obviously spoiler-riffic) clip above. Think they missed anything?

[via Vulture]

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Postponed by U.S. violence, “Gangster Squad” opening in theaters

LOS ANGELES (Reuters) – After having its release delayed and scenes reshot because of last summer’s mass movie-theater killing in Aurora, Colorado, crime drama “Gangster Squad” finally hits theaters on Friday.

“Gangster,” set in 1949 Los Angeles, stars Sean Penn as real-life gangster Mickey Cohen, who is ultimately brought down by a band of cops led by Josh Brolin and Ryan Gosling.

After the Colorado tragedy, Time Warner Inc’s Warner Bros. studio, which is releasing the film, removed the scene in “Gangster” that eerily depicted a similar movie-theater shooting.

It substituted a new sequence, set in Chinatown.

At a press event in December, “Gangster Squad” director Ruben Fleischer said, “We should all respect the tragedy and not draw associations to our film.”

But ironically, after “Gangster’s” initial September 7 release date was pushed back four months – presumably to allow for time after the Colorado rampage – the film will now open less than a month after the massacre of 20 children and six adults by a gunman at an elementary school in Newtown, Connecticut.

Brolin also cautioned at the December event against linking “Gangster” and other movies with real-world violence and suggested the public look at the “grand scheme of things” including social problems such as drug abuse and unenmployment.

“There’s no one reason” for mass attacks, Brolin told reporters. “There will always be violence in movies. And whether it lends (itself) to the one psychotic that’s out there thinking the worst thoughts you can possibly think is always going to be a mystery.”

Details of the Aurora multiplex shooting that left 12 dead and 58 wounded during a showing of the new Batman film were relived this week at a preliminary hearing of the accused gunman, former grad student James Holmes.

ACTORS RESEARCHED ROLES WITH THEIR CHARACTERS’ FAMILIES

“Gangster,” based on the non-fiction book of the same name by Paul Lieberman, depicts a battle between a small group of Los Angeles cops who secretly take on Cohen and his crew to wrestle away control of the city from Cohen’s mob.

Former Los Angeles Police Department homicide detective Will Beall wrote the script to the film, which also stars Emma Stone, Nick Nolte, Anthony Mackie, Giovanni Ribisi and Michael Pena.

Rather than dwelling on connections drawn by others to real-life tragedies, Fleischer sought to underscore positive themes.

“I think this movie is about people standing up for their beliefs, doing what’s right,” he said. “It’s a celebration of these cops who rid L.A. of organized crime of vice and corruption.”

And, he added, “It’s to honor the memory of these police officers who stood up for justice and didn’t allow crime to overtake the city.”

Brolin, a seventh-generation Californian who plays a cop based on an actual police sergeant named John O’Mara, said he spoke with O’Mara’s daughter to glean some insights about the man before creating “a composite character.”

His own father, 72-year old actor James Brolin, visited the set and recounted to his son personal stories from his days as a 9-year-old boy in Los Angeles during that era and going to the backdoors of Sunset Strip nightclubs “looking for Mickey Cohen.”

Gosling also had a chance to speak to relatives of his character, Sergeant Jerry Wooters, and learned “a lot of great stories and lot of great details” from Wooters’ children.

“Apparently when he ashed his cigarettes, he would ash in the cuff of his pants, and at the end of the day he would dump out his cuffs and dump out all his ashes,” Gosling said.

Still, no one ever expected the kind of eerie parallels that occurred between the movie’s theater-shooting scene and the real gun violence on July 20, when a man armed with a semi-automatic rifle a shotgun and a pistol walked into midnight screening of the “The Dark Knight Rises” and sprayed the audience with bullets.

In an interview with Reuters TV, Brolin said the scene in question in “Gangster Squad” was “bizarrely similar” to the Aurora event, and praised Warner Bros. for replacing the scene.

“The fact that is was as parallel as it was, I think there was no way to keep it in,” he said.

“The Aurora shooting was an unspeakable tragedy, and out of respect for the families of the victims, we felt it was necessary to reshoot that sequence,” Fleischer said.

“I’m proud of the fact that we did that. I think that we didn’t compromise the film or our intent.”

(Editing by Cynthia Osterman)

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Pap Test May Prove Useful at Detecting More Types of Cancer, Study Suggests

The Pap test, which has prevented countless deaths from cervical cancer, may eventually help to detect cancers of the uterus and ovaries as well, a new study suggests.

For the first time, researchers have found genetic material from uterine or ovarian cancers in Pap smears, meaning that it may become possible to detect three diseases with just one routine test.

But the research is early, years away from being used in medical practice, and there are caveats. The women studied were already known to have cancer, and while the Pap test found 100 percent of the uterine cancers, it detected only 41 percent of the ovarian cancers. And the approach has not yet been tried in women who appear healthy, to determine whether it can find early signs of uterine or ovarian cancer.

On the other hand, even a 41 percent detection rate would be better than the status quo in ovarian cancer, particularly if the detection extends to early stages. The disease is usually advanced by the time it is found, and survival rates are poor. About 22,280 new cases were expected in the United States in 2012, and 15,500 deaths. Improved tests are urgently needed.

Uterine cancer has a better prognosis, but still kills around 8,000 women a year in the United States.

These innovative applications of the Pap test are part of a new era in which advances in genetics are being applied to the detection of a wide variety of cancers or precancerous conditions. Scientists are learning to find minute bits of mutant DNA in tissue samples or bodily fluids that may signal the presence of hidden or incipient cancers.

Ideally, the new techniques would find the abnormalities early enough to cure the disease or even prevent it entirely. But it is too soon to tell.

“Is this the harbinger of things to come? I would answer yes,” said Dr. Bert Vogelstein, director of the Ludwig Center for Cancer Genetics and Therapeutics at Johns Hopkins University, and a senior author of a report on the Pap test study published on Wednesday in the journal Science Translational Medicine. He said the genomes of more than 50 types of tumors had been sequenced, and researchers were trying to take advantage of the information.

Similar studies are under way or are being considered to look for mutant DNA in blood, stool, urine and sputum, both to detect cancer and also to monitor the response to treatment in people known to have the disease.

But researchers warn that such tests, used for screening, can be a double-edged sword if they give false positive results that send patients down a rabbit hole of invasive tests and needless treatments. Even a test that finds only real cancers may be unable to tell aggressive, dangerous ones apart from indolent ones that might never do any harm, leaving patients to decide whether to watch and wait or to go through surgery, chemotherapy and radiation with all the associated risks and side effects.

“Will they start recovering mutations that are not cancer-related?” asked Dr. Christopher P. Crum, a professor at Harvard Medical School who was not involved in the research.

But he also called the study a “great proof of principle,” and said, “Any whisper of hope to women who suffer from endometrial or ovarian cancer would be most welcome.”

DNA testing is already performed on samples from Pap tests, to look for the human papillomavirus, or HPV, which causes cervical cancer. Dr. Vogelstein and his team decided to try DNA testing for cancer. They theorized that cells or DNA shed from cancers of the ovaries and the uterine lining, or endometrium, might reach the cervix and turn up in Pap smears.

The team picked common mutations found in these cancers, and looked for them in tumor samples from 24 women with endometrial cancer and 22 with ovarian cancer. All the cancers had one or more of the common mutations.

Then, the researchers performed Pap tests on the same women, and looked for the same DNA mutations in the Pap specimens. They found the mutations in 100 percent of the women with endometrial cancer, but in only 9 of the 22 with ovarian cancer. The test identified two of the four ovarian cancers that had been diagnosed at an early stage.

Finally, the team developed a test that would look simultaneously for cancer-associated mutations in 12 different genes in Pap samples. Used in a control sample of 14 healthy women, the test found no mutations — meaning no false-positive results.

Dr. Luis A. Diaz, the other senior author of the report and an associate professor of oncology at Johns Hopkins, called the research a step toward a screening test that at first blush appears very effective at detecting endometrial cancer, though obviously less so at finding ovarian cancer.

“Probably one of the most exciting features of this approach,” Dr. Diaz said, “is that we wanted a test that would seamlessly integrate with routine medical practice that could be utilized with the same test that women get every day all over the world, the Pap smear.”

But, he added: “We can’t say it’s ready for prime time. Like all good science, it needs to be validated.”

He and other members of the team said it might be possible to improve the detection rate for ovarian cancer by looking for more mutations and by changing the technique of performing Pap tests to increase the likelihood of capturing cells from the ovary. The change might involve timing the test to a certain point in a woman’s monthly cycle, using a longer brush to collect cells from deeper within the cervix or prescribing a drug that would raise the odds of cells being shed from the ovary.

The technique also needs to be tested in much larger groups of women, including healthy ones, to find out whether it works, particularly at finding cancers early enough to improve survival. And studies must also find out whether it generates false positive results, or identifies cancers that might not actually need to be treated.

Michael H. Melner, a program director in molecular genetics and biochemistry for the American Cancer Society, called the research “very promising,” in part because it is based on finding mutations.

“It tells you not just that cancer is there, but which mutation is there,” Dr. Melner said. “As we learn more and more about which mutations are associated with more or less severe forms of cancer, it’s more information, and possibly more diagnostic.”

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James M. Buchanan, Economic Scholar, Dies at 93

James M. Buchanan, a scholar and author whose analyses of economic and political decision-making won the 1986 Nobel in economic sciences and shaped a generation of conservative thinking about deficits, taxes and the size of government, died on Wednesday in Blacksburg, Va. He was 93.

Alex Tabarrok, the director of the Center for Study of Public Choice at George Mason University, which Mr. Buchanan founded, confirmed his death.

Dr. Buchanan, a professor emeritus at George Mason, in Fairfax, Va., was a leading proponent of public choice theory, which assumes that politicians and government officials, like everyone else, are motivated by self-interest — getting re-elected or gaining more power — and do not necessarily act in the public interest.

He argued that their actions could be analyzed, and even predicted, by applying the tools of economics to political science in ways that yield insights into the tendencies of governments to grow, increase spending, borrow money, run large deficits and let regulations proliferate.

The logic of self-interest was nothing new. Machiavelli’s 16th-century treatise “The Prince” detailed cynical rules of statecraft to extend political power. Thomas Hobbes, in his 17th-century book “Leviathan,” held that aggressive, self-serving acts were “natural” unless forbidden by law. Adam Smith’s “The Wealth of Nations,” published in 1776, noted that people pursuing their own good also produced benefits for society at large.

But Dr. Buchanan contended that the pursuit of self-interest by modern politicians often led to harmful public results. Courting voters at election time, for example, legislators will approve tax cuts and spending increases for projects and entitlements favored by the electorate. This combination can lead to ever-rising deficits, public debt burdens and increasingly large governments to conduct the public’s business.

Indeed, he said, governments had grown so vast and complex that it was no longer possible for elected officials to make more than a fraction of the policy decisions that genuinely affect the people. Thus, he said, much discretionary power is actually held by civil functionaries who can manipulate priorities, impose barriers to entitlements and pressure legislators for rules and budgets favorable to their own interests.

Dr. Buchanan did not invent the theory of public choice, an idea whose origins are obscure but that arose in modern economics literature in the late 1940s. But from the 1950s onward, he became its leading proponent, spearheading a group of economists in Virginia that sought to change the nature of the political process, to bring it more into line with what the group considered the wishes of most Americans.

In lectures, articles and more than 30 books, Dr. Buchanan amplified on the theory of public choice and argued for smaller government, lower deficits and fewer regulations — a spectrum of policy objectives that were ascendant in the 1980s conservative agenda of President Ronald Reagan.

Over the years since Dr. Buchanan won the Nobel, much of what he predicted has played out. Government is bigger than ever. Tax revenue has fallen far short of public programs’ needs. Public and private borrowing has become a way of life. Politicians still act in their own interests while espousing the public good, and national deficits have soared into the trillions.

Dr. Buchanan partly blamed Keynesian economics for what he considered a decline in America’s fiscal discipline. John Maynard Keynes argued that budget deficits were not only unavoidable but in fiscal emergencies were even desirable as a means to increase spending, create jobs and cut unemployment. But that reasoning allowed politicians to rationalize deficits under many circumstances and over long periods, Dr. Buchanan contended.

In a commentary in The New York Times in March 2011, Tyler Cowen, an economics professor at George Mason, said his colleague Dr. Buchanan had accurately forecast that deficit spending for short-term gains would evolve into “a permanent disconnect” between government outlays and revenue.

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Syria conflict blocks aid to 1 million needy, U.N. agency says

BEIRUT — The World Food Program said Tuesday that Syria's civil war has blocked the United Nations agency from delivering aid to at least 1 million people who are in desperate need of help.

The Syrian Arab Red Crescent, the U.N. agency's local partner, has been stretched to capacity and violence between forces loyal to President Bashar Assad and the armed opposition has prevented aid workers from reaching some needy Syrians, said Abeer Etefa, an agency spokeswoman.

Truck drivers have been reluctant to transport food into conflict areas, and World Food Program staff members have had to ride in armored vehicles to monitor food distribution in some areas, Etefa said.

She said the U.N. agency also has had difficulty accessing its main warehouse in Damascus, the capital.

"There are serious bread and fuel shortages across the country, with large numbers of Syrians who are displaced and seeking shelter," she said. "We are already helping 1.5 people million in Syria, but we estimate that 1 million are still in need of food assistance."

Damascus and surrounding areas have seen intense fighting. Airstrikes have targeted rebel-held areas, and antigovernment fighters have carried out assassinations and set off bombs in the city.

Conditions have forced the World Food Program to find alternative access points into Syria, including sending food overland from Lebanon instead of relying on the main harbor in Tartus. Shipments to the port were cut off after a shipping company refused to deliver there, but have since resumed.

An estimated 597,240 Syrian refugees are facing harsh winter weather, many equipped with only flimsy canvas tents and insufficient clothing. In northern Jordan, a riot broke out Tuesday over bread shortages at the Zaatari refugee camp near the Syrian border, an aid worker said. No more information was immediately available.

Zaatari has been inundated by heavy rain over the last two days, making some parts of the camp uninhabitable. Twenty-four families were moved to prefabricated huts because of mud and pools of water, said Mohammad Askar, a spokesman for the U.N. refugee agency.

"The problem is that there are only 2,500 of these prefabricated huts from Saudi Arabia. This is not enough to provide the necessary humanitarian assistance," Askar said.

Also Tuesday, Yarmouk, a sprawling enclave of mostly Palestinian refugees, was shelled and saw fighting between Syrian rebels and government supporters. The opposition Syrian Observatory for Human Rights, a Britain-based nongovernmental organization, said four people in the camp, in southern Damascus, were killed by shelling and a fifth by a sniper.

Syria's 21-month-old civil war has split Yarmouk's Palestinians into armed pro- and anti-Assad factions. In December, the camp was shelled as pro-rebel fighters tried to take it over and clashed with Assad's supporters.

Fourteen Palestinian factions issued a statement calling for calm and urging fighters to withdraw from the camp "in order not to bear the responsibility of the continuing displacement of [Yarmouk's] residents," the Associated Press reported.

ned.parker@latimes.com

Bulos is a special correspondent.

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Rogue Planet Confirmed Orbiting Around 'Eye of Sauron'

LONG BEACH, California – Astronomers have confirmed that a controversial exoplanet called Fomalhaut b actually does exist and have calculated its potential orbit. The results show that the object is even stranger than scientists could have imagined, dubbing it a “rogue planet.”

The uncertainty about this object started in 2008, when scientists released an image taken with NASA’s Hubble space telescope of a tiny dot of light in the debris disk of a young, bright star called Fomalhaut, which is about 25 light-years away in the constellation Piscis Austrinus. At the time, they presented only two data points, showing the exoplanet as it existed in 2004 and 2006. It was a sensational image — the enormous debris disk made the star resemble the “Eye of Sauron” from the Lord of the Rings movies — and was one of the first directly imaged extrasolar planets ever seen.

But follow-up from other researchers failed to find the purported world. The original instrument on Hubble that saw Fomalhaut b broke in 2007 and was never replaced, meaning the team that discovered the exoplanet couldn’t reproduce their results either. When they spotted it in 2010 with another instrument, the object seemed to have drifted too far to the right to be in orbit around the star. This led some astronomers to discount the discovery of Fomalhaut b.

But late in 2012, a few other telescopes managed to snap images of the exoplanet. And now, the original team has presented their own new data. “We have three times as many orbits and there you see it very clearly in 2012,” said astronomer Paul Kalas of the University of California at Berkeley and the SETI Institute, pointing to a new image released today during a press conference here at the American Astronomical Society 2013 meeting.

With their four data points, the original team has been able to calculate several potential orbits for the object. They show the exoplanet moving on a highly eccentric orbit around its parent star, coming in as close at 40 astronomical units (AU) and then swinging out to 350 AU. (An AU is the distance between the Earth and the sun). There is some indication that the planet’s orbit is very inclined relative to the debris disk around Fomalhaut, meaning that the exoplanet doesn’t pass through it, instead moving above and then underneath the dust.

This movement suggests to Kalas and his team that Fomalhaut b is a rogue planet, acting much more like a comet or icy body in our solar system’s Kuiper belt, which generally orbits far from the sun but may sometimes come in closer. The astronomers think the mass of the exoplanet is at least as much as an icy dwarf world, like Sedna in our solar system, but it could be as big as Jupiter. In either case, it’s unlike anything seen in our own system and shows that the architecture of other planetary systems could greatly differ from our own.

Image: NASA, ESA, and Paul Kalas (University of California, Berkeley and SETI Institute). Video: NASA/STSCI

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“Snakes on a Plane” director David R. Ellis dies in South Africa

JOHANNESBURG (Reuters) – David R. Ellis, the child actor and former stuntman who went on to direct gory films including “Snakes on a Plane“, has been found dead in a Johannesburg hotel.

Ellis, 60, was last seen alive in a restaurant on Saturday. His body was discovered in a bathroom by a hotel manager at the weekend. There was no indication of foul play or robbery, police said in a statement on Tuesday.

“It is unknown what was the cause of death,” South African police said.

Ellis was in South Africa shooting a movie.

His 2006 film “Snakes on a Plane” about reptiles slithering through a jet inflicting gruesome deaths on passengers spawned numerous parodies, massive internet hoopla and was one of the most heavily hyped films of the North American summer season.

The film’s star, Samuel L. Jackson, threatened to quit when the studio considered changing the title, saying he had taken the job based on the name.

“So talented, so kind, such a Good Friend. He’ll be missed. Gone too soon!” Jackson tweeted on Tuesday.

Ellis also directed other B-list thrillers including “Shark Night” and “Cellular”.

(Reporting by Jon Herskovitz, editing by Paul Casciato)

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Gaps Seen in Therapy for Suicidal Teenagers

Most adolescents who plan or attempt suicide have already gotten at least some mental health treatment, raising questions about the effectiveness of current approaches to helping troubled teenagers, according to the largest in-depth analysis to date of suicidal behaviors in American teenagers.

The study in the journal JAMA Psychiatry found that 55 percent of suicidal teenagers had received some therapy before they thought about suicide, planned it or tried to kill themselves, contradicting the widely held belief that suicide is due in part to a lack of access to treatment.

The findings, based on interviews with a nationwide sample of more than 6,000 teenagers and at least one parent of each, linked suicidal behavior to complex combinations of mood disorders like depression and behavior problems that include attention-deficit and eating disorders, as well as alcohol and drug abuse.

The study found that about one in eight teenagers had persistent suicidal thoughts at some point, and about a third of them had made a suicide attempt, usually within a year of having the idea.

Previous studies have had similar findings, based on smaller, regional samples. But the new study is the first to suggest, in a large nationwide sample, that access to treatment does not make a big difference.

The study suggests that effective treatment for severely suicidal teenagers must address not just mood disorders, but also behavior problems that can lead to impulsive acts, experts said. According to the Centers for Disease Control and Prevention, 1,386 people between the ages of 13 and 18 committed suicide in 2010, the latest year for which numbers are available.

“I think one of the take-aways here is that treatment for depression may be necessary but not sufficient to prevent kids from attempting suicide,” said Dr. David Brent, a professor of psychiatry at the University of Pittsburgh, who was not involved in the study. “We simply do not have empirically validated treatments for recurrent suicidal behavior.”

The report said nothing about whether the therapies given were state of the art, or carefully done, said Matt Nock, a professor of psychology at Harvard and the lead author; and it is possible that some of the treatments prevented suicide attempts. “But it’s telling us we’ve got a long way to go to do this right,” Dr. Nock said. His co-authors included Ronald C. Kessler of Harvard, and researchers from Boston University and Children’s Hospital Boston.

Margaret McConnell, a consultant in Alexandria, Va., said that her daughter Alice, who killed herself in 2006, at the age of 17, was getting treatment at the time. “I think there might have been some carelessness in the way the treatment was done,” Ms. McConnell said, “and I was trusting a 17-year-old to manage her own medication; we found out after we lost her that she wasn’t taking it regularly.”

In the study, researchers surveyed 6,483 adolescents from the ages of 13 to 18 and found that 9 percent of male teenagers and 15 percent of female teenagers experienced some stretch of having persistent suicidal thoughts. Among girls, 5 percent made suicide plans and 6 percent made at least one attempt (some were unplanned).

Among boys, 3 percent made plans and 2 percent carried out attempts – which tended to be more lethal than girls’ attempts.

(Suicidal thinking or behavior was virtually unheard-of before age 10.)

Over all, about one-third of teenagers with persistent suicidal thoughts went on to make an attempt to take their own lives.

Almost all of the suicidal adolescents in the study qualified for some psychiatric diagnosis, whether depression, phobias, or generalized anxiety disorder. Those with an added behavior problem – attention-deficit disorder, substance abuse, explosive anger – were more likely to act on thoughts of self-harm, the study found.

Doctors have tested a range of therapies to prevent or reduce recurrent suicidal behaviors, with mixed success. Medications can ease depression, but in some cases can increase suicidal thinking. Talk therapy can contain some behavior problems, but not all.

One approach, called dialectical behavior therapy, has proved effective in reducing hospitalizations and attempts in people with so-called borderline personality disorder, who are highly prone to self-harm, among others.

But suicidal teenagers who have a mixture of mood and behavior issues are difficult to reach. In one 2011 study, researchers at George Mason University reduced suicide attempts, hospitalizations, drinking and drug use among suicidal adolescent substance abusers. The study found that a combination of intensive treatments – talk therapy for mood problems, family-based therapy for behavior issues and patient-led reduction in drug use – was more effective that regular therapies.

“But that’s just one study, and it’s small,” Dr. Brent said. “We can treat components of the overall problem, but that’s about all.”

Ms. McConnell said that her daughter’s depression seemed mild and that there was no warning that she would take her life. “I think therapy does help a lot of people, if it’s handled right,” she said.

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Shares Fall Again as Investors Remain Wary

Stocks fell Tuesday, retreating further from last week’s rally after the federal budget deal, as companies started to report quarterly results.

In the wake of a 4.3 percent increase in the two sessions around the close of the budget negotiations, the benchmark Standard & Poor’s 500-stock index has fallen, with investors finding few catalysts to extend the rally that took the index to five-year highs.

“We had a brief respite, courtesy of what happened on the fiscal cliff deal and the flip of the calendar with new money coming into the market,” said Bucky Hellwig, senior vice president at BB&T Wealth Management in Birmingham, Ala.

Stock in AT&T fell 1.7 percent to $34.35, making it one of the biggest drags on the S.& P. 500, after the company said it sold more than 10 million smartphones in the quarter.

The figure beat the same quarter in 2011, but meant increased costs for AT&T. Wireless service providers like AT&T pay large subsidies to handset makers so that they can offer discounts to customers who commit to two-year contracts.

Fourth-quarter profits are expected to beat the previous quarter’s lackluster results, but analysts’ estimates are down sharply from October. Quarterly earnings are expected to grow by 2.7 percent from a year ago, according to Thomson Reuters data.

The Dow dropped 55.44 points, or 0.41 percent, to close at 13,328.85. The S.& P. 500 fell 4.74 points, or 0.32 percent, to 1,457.15. The Nasdaq composite index lost 7.01 points, or 0.23 percent, to 3,091.81.

“The stark reality of uncertainty with regard to earnings, plus the negotiations on the debt ceiling, are there, and that doesn’t give investors a lot of reason to take bets on the long side,” Mr. Hellwig said.

With AT&T’s fall, the S.& P. telecom services index was the worst performer of the 10 major S.& P. sectors, down 2.7 percent.

Stock in Sears Holdings fell 6.4 percent to $40.16 a day after the company said the chairman, Edward Lampert, would become chief executive after Louis D’Ambrosio steps down because of a relative’s health. Markets declined as some of the first earnings to be reported were weak.

The Treasury’s benchmark 10-year note rose 11/32, to 97 28/32, and the yield fell to 1.86 percent from 1.90 percent late Monday.

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