Noteworthy News Articles on Mental Health Topics, December 11- , 2005

To understand the difference between good stress and bad stress, said neuroscientist Robert Sapolsky, consider the fact that a roller coaster ride lasts for three minutes, not three days. "There's a reason that we'll pay money to go on a roller coaster and be terrified" for a brief period, said the Stanford University professor. This kind of stressful episode can be invigorating and empowering, he said. Blood circulates better, senses are heightened, memory sharpens, energy peaks and chemicals producing pleasure increase in the brain. But if that same stress continues for an extended period, Sapolsky said, the body continues straight downhill.
      His Stanford laboratory was among the first to document the way sustained stress can damage the hippocampus, a region of the brain central to learning and memory. Under continued stress, neurons shrivel in another part of the brain, the prefrontal cortex, the center of emotion and executive function. Meanwhile, the amygdala, which processes fear and anxiety, grows neurons, essentially trapping us in a state of fear. The body stops its repair work, compromising the immune system, and constant pressure on the cardiovascular system eventually leads to high blood pressure and heart disease, Sapolsky said. Sapolsky, recipient of a MacArthur Foundation "genius" grant for studying stress in groups of baboons, presented his conclusions at a Mind and Life Institute conference in Washington last month, where scientists reported on leading-edge brain research and the effects of meditation on healing and health.
     When it comes to stress, Sapolsky said, many of us have it all wrong. "It's easy to say, 'Aha! The answer is having no stress in my life!' " But the idea that we should -- or could -- live without it, he said, is "nonsense."
     The body's reaction to stress can become chronic and pernicious. This doesn't happen because a physical threat to safety continues for a long time, but because humans -- endowed with imagination, memory and language -- have the ability to create psychological stress, even when no physical or emotional threat is present. Sapolsky, author of the book "Why Zebras Don't Get Ulcers," calls this "adventitious suffering -- the pain of what was, what will be, what could be or what someone else is experiencing." The body makes no distinction between immediate, in-your-face stressors and chronic, in-your-imagination ones, Sapolsky said. Faced with either kind of threat, the body reacts, and when the threat is sustained psychologically, the physically destructive stress response continues. An individual's personality or the frame of mind in which one encounters stress also can determine its health effects.
     Ronald Glaser, a viral immunologist at Ohio State University (OSU), studies the physical changes induced by everyday stress. He and his wife, Jan Kiecolt-Glaser, a clinical psychologist and researcher at OSU, were among the first to test the effects of stress on the immune system. In 1991, they took a sampling of college students on the last day of a series of academic exams and inoculated them with the hepatitis B vaccine. They then monitored the antibody response in each. The students had been followed a year and a half before the inoculations. Those who had the least stress in their everyday lives, or who had greater social support, had more-robust immune system reactions to the vaccine than the others. The lesson: Those who encounter stress from a position of psychological strength and social alliances withstand stress better.
     According to Sheldon Cohen, a psychology professor at Carnegie Mellon University, the medical literature demonstrates a link between chronic stress and depression, upper respiratory infections, cardiovascular disease and HIV progression. But understanding why these deleterious reactions occur, explained Glaser, is "big-time complexity" involving the central nervous, endocrine and immune systems and how they "talk" to each other. Researchers don't completely understand it yet. What is known is that stress hormones -- cortisol, ACTH, prolactin, growth hormone, epinephrine and norepinephrine -- increase when a person is under stress. They bind to receptors in blood cells and change what the cells do in the body, Glaser says.
     To explain how different people respond to chronic stress, Sapolsky used the analogy of living in New York: For someone with good mental health and a strong social support system, he said, the city offers an exciting life and an intense, beneficial sensory experience -- good stress. But if you are someone who has developed a lot of scar tissue putting up with what the city can throw at you, or you live in a place with no running water and drug dealers on the corner, the city and its stressors can be "one more nail in your coffin."
     Letting adventitious suffering get the better of you can do the same. It's important to realize that while it feels real and has real effects, it is a creation of humans' ability to empathize and worry. Simply recognizing that may make it easier to turn stress that results from adventitious suffering into productive stimulation, Sapolsky said.
     Meditation, Sapolsky said, can focus the mind and bring the roots of your stress into awareness. For some, merely taking stock can do the same. Or you might follow the simple advice of Barrie Cassileth, who heads integrative medicine services at Memorial Sloan-Kettering Cancer Center in New York. "Close your eyes for a minute, take a deep breath, think about people dying in other parts of the world. Refocus, and get back to work."



Online Poker Drove Student to Rob Bank, Lawyer Says
Matt Assad, The Morning Call- 12/14/2005

ALLENTOWN, Pa. — Somewhere in a hectic schedule that included being president of his Lehigh University sophomore class, playing second-chair cello in the university orchestra and working at the chaplain's office, Greg Hogan developed a secret habit. For 14 months the polite, energetic finance and accounting double major from an affluent Ohio suburb used online poker to blow off steam. But the hobby quickly became an addiction that led Hogan to lose about $5,000.
     It was that addiction that led him last week into a Wachovia bank in Allentown, where he handed a teller a note and calmly walked out with $2,871 that wasn't his, says his lawyer, John J. Waldron. Allentown police said Hogan confessed to the robbery. Now the 19-year-old son of a Baptist minister faces up to 20 years in prison on bank robbery charges, and his lawyer says the nationwide poker craze is partly to blame. "This is one of the nicest kids I've ever met, but his gambling addiction led him to make a terrible, terrible mistake," Waldron said. "There's so much good in this kid. It easily outweighs this one bad mistake." District Judge Carl L. Balliet will get a chance to consider that Jan. 31, when Hogan has a preliminary hearing on felony charges of robbery, theft and receiving stolen property.
     According to Allentown police, Hogan went into the bank Friday, handed the teller a note saying he had a gun and walked out with the money. He hopped into a waiting sport utility vehicle and rode away with two members of his fraternity. The two men in the vehicle with Hogan said he told them he was cashing a check, and both told police they knew nothing of Hogan's plans. Neither has been charged and both declined to comment Tuesday, as did the bank teller. A witness wrote down the SUV's plate number and police arrested Hogan at his fraternity house.
     The arrest shocked Hogan's classmates. "There are some students here that you just wouldn't be surprised to see arrested," said Pat Thornton, one of Hogan's friends. "But Greg wasn't one of them. Greg's just a friendly, energetic guy. You'd have trouble finding anyone who didn't like him." At Lehigh, students liked him enough to elect him sophomore class president. He showed enough skill on the cello to be named second chair and he worked part time in the university chaplain's office, Waldron said. Hogan is a graduate of a private high school in Shaker Heights, a suburb of Cleveland. His father, Gregory Sr., is a minister at the First Baptist Church of Barberton, Ohio, and his mother, Karen, holds a doctorate in nursing.
     Hogan's parents and grandparents met with Waldron for 90 minutes Sunday and talked about the addiction Hogan had been keeping a secret. Waldron said he had hired a forensic psychologist to evaluate Hogan. "That's the million-dollar question," Waldron said. "Why would such a good kid with so much promise do this? We know he had a gambling addiction, but why didn't he seek other options? That has everyone scratching their heads."
     William N. Thompson, professor of public policy at the University of Nevada, Las Vegas, isn't among them. Thompson said the poker craze had arrived and Hogan was another of its victims. What used to be played by middle-age men in smoky backrooms is being played by college and high school students. If players can't find a live game, online poker is a mouse click away, and they need only a computer and a credit card whose credit limit hasn't been maxed out. "It's everywhere and now it's even on the Internet, where there is almost no controls," Thompson said. "You can expect it to get worse, and you can expect to see more and more college students fall into it."



Video Violence Numbing
Amy Witesall, Ann Arbor News- 12/14/2005

If video games like "Mercenaries'' or "Grand Theft Auto: San Andreas'' are on your kids' Christmas list -- or on your own -- consider this: A recent study suggests that playing violent video games actually changes brain function and desensitizes chronic players to real-life violence. "When people become used to violence, it reduces their inhibitions against behaving aggressively,'' said University of Michigan psychology and communication studies professor Brad Bushman, who co-authored the study along with researchers at the University of Missouri and the University of North Carolina. "I've had people say, 'I play violent video games and I've never killed anyone.' Well, very few people have ever killed anyone, but I want to know how do you treat your parents? How do you treat your siblings? How do you treat your teachers at school?'' The study will be published in a coming edition of the Journal of Experimental Psychology.
      Researchers asked 39 male undergraduates how often they played their favorite video games and how violent those games were. Then they assessed the subjects' irritability and aggressiveness based on how strongly they identified with statements like "I easily fly off the handle with those who don't listen or understand.'' Next, participants were fitted with electrode caps to measure a type of brain wave associated with how people evaluate stimuli. Researchers measured their brain waves while showing them neutral images, like a man riding a bicycle, violent ones, like a man holding a gun to another man's head, and negative but nonviolent images, like a dead dog. The participants who routinely played violent video games had less reaction to the violent images compared to the neutral and negative, nonviolent ones.
     Finally, researchers told subjects they were competing in a reaction-time contest with a person in another room to see who could press a button faster after hearing a tone. They were told the slower person would get a blast of sound through a pair of earphones, with the intensity and length of the sound determined beforehand by the previous round's winner. Actually, there was no partner, but the tendency to give long, loud blasts of noise was used to measure aggression. The smaller the participant's brain response to the violent images, the more likely he was to blast his "partner'' in the reaction-time test with loud, unpleasant noise.
     The connection between violent media and aggressive behavior is nothing new, but this latest study takes that knowledge to a new level, linking exposure to violent games with a diminished reaction to violent images for the first time. "A lot of people complain that these are short-term effects, but we're finding effects at the cortical level.'' said Bushman. "At the level of the brain you can distinguish between violent video game players and non-violent video game players.''

Dr. Eric J. Topol, a cardiologist, has been perhaps the most public face of the prestigious Cleveland Clinic Foundation, a prominent medical center regarded as one of the nation's best. Not shy in the media spotlight, Dr. Topol has cultivated the persona of a Naderesque crusader against drugs he deems dangerous, as well as their makers. Some of his most impassioned criticism has been aimed at Merck and its drug Vioxx, the painkiller the company withdrew from the market over questions about its safety. But he has also been outspoken recently about other drugs. Now, Dr. Topol's bluntness -- refreshing to his admirers, startlingly unscientific to his targets and his critics -- has drawn a bright spotlight to his own conduct and that of the Cleveland Clinic. In the last month, he has been demoted and the clinic's image has been tarnished in what has become an unusually public dispute pitting him against the clinic's chief executive, Dr. Delos Cosgrove.
     Dr. Topol, who retains the position of chairman of cardiovascular medicine at the clinic, suggested in a Webcast on Thursday (www.theheart.org) that his unabashed willingness to take on Merck was a principal reason for his removal this month as head of the clinic's medical college. In what Merck lawyers have suggested is a vendetta, he described the company's behavior as "appalling" in recent testimony in a Vioxx lawsuit. But his demotion has drawn attention to the mounting tensions between the clinic's research mission and its deep ties to the businesses that finance that research. Both Dr. Topol and Dr. Cosgrove refused to comment for this article, but associates say Dr. Topol may decide to leave the clinic.
     The dispute at the Cleveland Clinic goes far beyond a simple power struggle between strong-willed men who competed for the clinic's top job. Dr. Topol severed his ties to industry after being embarrassed last December by an article in Fortune magazine. But the continued controversy has focused attention on the many longstanding corporate ties at the clinic. Those business links involve not only staff doctors and researchers, but also Dr. Cosgrove and the clinic's board.
     The Cleveland Clinic is emblematic of the way the drug and medical device industries and the investment community work closely with medical researchers and doctors to develop and promote new medicines and technologies. Almost inevitably, such relationships raise concerns about possible conflicts of interest that could lead doctors to favor some treatments over others or to bias the results of medical research. "It's not just the Cleveland Clinic," said Les Funtleyder, a health care strategist at the investment company Miller Tabak & Company in New York. He says other high-profile academic medical centers also have numerous financial ties that raise the potential for conflicts of interest. Dr. Jerome P. Kassirer, a former editor in chief for The New England Journal of Medicine, describes the potential conflicts at the clinic "as extremely serious ones" but notes that the Cleveland Clinic is "not unique at all."
     It was Dr. Topol's criticism of Merck that indirectly brought the clinic's conflicts to the fore. After the drug was withdrawn in September 2004 by Merck, Dr. Topol, who in journal articles had questioned the drug's cardiovascular safety, criticized the company's conduct. Dr. Topol soon found himself under attack. He was the subject of the Fortune magazine article, which contended he had a conflict of interest. A hedge fund that listed Dr. Topol on its advisory panel had been a short seller of Merck's stock before the Vioxx withdrawal. Dr. Topol said he had nothing to do with the fund's action, which was a financial bet that the share price would fall.
     Dr. Topol also found himself under fire at the clinic, where he would later claim that the chairman of the trustees, Malachi Mixon, had been contacted by Merck's chief executive at the time, Raymond V. Gilmartin. In any event, the clinic investigated Dr. Topol's business dealings, according to people briefed on the inquiry. Dr. Topol suggested in his Webcast that the clinic's pique might be related to the relationship between Mr. Gilmartin and Mr. Mixon, who attended Harvard Business School together. Mr. Mixon, in an interview, would not discuss any conversations he had with Mr. Gilmartin on the subject. A Merck spokeswoman, however, denied that Mr. Gilmartin had ever contacted the Cleveland Clinic.
     After the Fortune article, Dr. Topol publicly announced that he would cut all ties to industry, which included relationships with Eli Lilly, deCode Genetics and the Medicines Company -- despite the fact that many doctors at the clinic and elsewhere had similar consulting deals. "I think there's a real problem in academics today," he told The New York Times in January. "There's a very close-knit relationship with industry, and it's too close when any individual can derive a profit from that relationship." The Cleveland Clinic itself was at the time finishing a set of ethical guidelines in which physicians and researchers were encouraged to continue working with industry, but were told that their ties would require reviews.
     When his contract came up for renewal at the clinic at the end of last year, the clinic put Dr. Topol on a form of probation, giving him a six-month contract rather than the usual yearlong agreement, according to associates. It was a largely symbolic move, but associates said it angered Dr. Topol, who in 15 years at the clinic had been responsible for establishing the clinic's medical school and elevating the reputation of its cardiovascular medicine unit. On the Webcast, Dr. Topol said the conflict-of-interest committee, on which he served, had looked into the financial arrangements of other doctors, including Dr. Cosgrove, as well as the fact that clinic patients were being used in tests of medical devices made by companies in which the clinic had financial interests.
     Some of the clinic's perceived conflicts begin at the very top. Mr. Mixon, for example, is chief executive of Invacare, a major health care supply company. The company not only conducts about $200,000 a year in business with the clinic, but several people with clinic ties are on the Invacare board. They include Dr. Bernadine Healy, the former head of the Red Cross who is married to Dr. Floyd D. Loop, the cardiac surgeon who led the clinic until he retired last year and was replaced by Dr. Cosgrove. Dr. Healy, who could not be reached for comment, owns options for 41,570 shares of stock in Invacare, according to a securities filing from earlier this year. Mr. Mixon, who would not address other issues in this article, said his company's business dealings with the clinic constituted "peanuts" in the context of his company's overall annual revenue of about $1.5 billion. A clinic spokeswoman, Eileen Sheil, said the clinic would not respond to questions about Mr. Mixon's company or Invacare's other board members. Nor would the clinic address questions involving a number of Dr. Cosgrove's financial arrangements, although Ms. Sheil said he had severed those ties. In a statement, the clinic said it had begun an independent review of conflicts, to be conducted by an outside group.
     Dr. Cosgrove, a well-regarded cardiac surgeon, is intimately familiar with the role physicians play in industry. His inventions include the Cosgrove-Edwards heart device, marketed by Edwards Lifesciences. The devices are used at the Cleveland Clinic, although the clinic would not discuss how or whether patients are informed of Dr. Cosgrove's connection when they are used. Dr. Cosgrove also spearheaded the clinic's entrepreneurial efforts through a venture capital fund.
     In an article last January, The New York Times described various companies in which the clinic had a financial interest, including AtriCure, the maker of a heart device. The Wall Street Journal featured AtriCure in a front-page article about the Cleveland Clinic this week. All of this attention threatens to tarnish the clinic's image as an institution conducting world-class medical research. "All of these pieces of information coming out bit by bit are potentially damaging to the clinic's reputation," said Dr. Mildred K. Cho, a medical ethicist at Stanford University.
     The clinic says its board of trustees has appointed an independent group to review the clinic's conflicts. But, in the meantime, Dr. Topol has been removed from the conflict-of-interest committee, a position he held by virtue of his leadership role at the medical college. The publicity may prompt change, said Dr. Kassirer, the former medical journal editor. "The only question is whether it will really embarrass anyone. The clinic is so powerful, it has so much clout."  Click here for a corresponding NYT 1/25/2005 article.

ITHACA, N.Y. -- Janie Cisneros was having a crisis, and she needed to talk to a counselor. But there would be no embarrassing or intimidating visit to the campus clinic.

Instead, Sigrid Frandsen-Pechenik took Cisneros to the mall, where they had coffee and talked in English and in Spanish.

It was not the usual approach to mental health counseling. But as campuses become more diverse, colleges are finding that the old ways do not always work.

There are language barriers, as well as cultural stigmas, that equate mental health problems with being weak or crazy. There are the pressures of immigrant families who send their children to college, and who do not expect to see them fail. And since Sept. 11, there are pressures over visas, homeland security, and privacy.

Many students choose not to ask for help, counselors say.

So Frandsen-Pechenik, who is the assistant director of counseling and psychological services at Cornell University, is part of a national effort to take counseling out of the office and to bring it closer to students.

The idea is to break from the traditional model of trips to the counseling center, scheduled appointments, and 50-minute sessions, which have their own built-in stresses.

Counselors at the Cornell, an Ivy League university in Ithaca, hold group talks such as ''The Joys and Challenges of Being Other Than Caucasian at Cornell," and they also have drop-in sessions at the international student center, the engineering school, and at various other spots.

''There's a lot of shame" in going to the counseling center, said Cinthia Tejada, a senior from New York. ''But with outreach, it's not like you're singling yourself out."

A report this year by the American Council on Education found more diverse campuses from 1991 to 2001. Hispanic enrollment rose 75 percent; that of Asian-Americans increased 54 percent; that of blacks grew 37 percent.

In a lecture this spring, a counselor, Wai Kwong Wong, said Asian and Asian-American students accounted for 50 percent of suicides in the past decade at Cornell. At present, Asians and Asian-Americans make up just 17 percent of enrollment.

Richard Kadison, chief of mental health services at Harvard University, said minorities and foreigners have a particularly tough time in college.

''I've worked with many Asian students who have had a hard time finding a language to talk about mental health concerns, and it is something that just isn't discussed in their families," he said.

At Cornell, the outreach includes multilingual sessions and culture-specific marketing. Cornell literature promotes Frandsen-Pechenik as the school's ''very own Latina psychologist."

The effort is taking hold around the country.

This year, the University of Florida recruited a psychiatrist who speaks several Chinese dialects to join a staff that includes a Spanish speaker.

The Massachusetts Institute of Technology's counseling center offers monthly Chinese Tea Time group sessions. And an online ''Ask Dr. Xi" service will begin next semester for Asian and other international students.

Last month, black colleges and universities met in Baltimore to discuss marketing campaigns to help black students overcome a stigma attached to counseling.

And in New Jersey, Rutgers University's counseling center sponsored an Asian film series, with discussions afterward. ''We thought it would be a nonthreatening approach," said David Chandler, a counseling director at Rutgers University in New Brunswick.

Weeks before, Justin had hooked up a Web camera to his computer, hoping to use it to meet other teenagers online. Instead, he heard only from men who chatted with him by instant message as they watched his image on the Internet. To Justin, they seemed just like friends, ready with compliments and always offering gifts.

Now, on an afternoon in 2000, one member of his audience sent a proposal: he would pay Justin $50 to sit bare-chested in front of his Webcam for three minutes. The man explained that Justin could receive the money instantly and helped him open an account on PayPal.com, an online payment system.

"I figured, I took off my shirt at the pool for nothing," he said recently. "So, I was kind of like, what's the difference?"

Justin removed his T-shirt. The men watching him oozed compliments.

So began the secret life of a teenager who was lured into selling images of his body on the Internet over the course of five years. From the seduction that began that day, this soccer-playing honor roll student was drawn into performing in front of the Webcam - undressing, showering, masturbating and even having sex - for an audience of more than 1,500 people who paid him, over the years, hundreds of thousands of dollars.

Justin's dark coming-of-age story is a collateral effect of recent technological advances. Minors, often under the online tutelage of adults, are opening for-pay pornography sites featuring their own images sent onto the Internet by inexpensive Webcams. And they perform from the privacy of home, while parents are nearby, beyond their children's closed bedroom doors.

The business has created youthful Internet pornography stars - with nicknames like Riotboyy, Miss Honey and Gigglez - whose images are traded online long after their sites have vanished. In this world, adolescents announce schedules of their next masturbation for customers who pay fees for the performance or monthly subscription charges. Eager customers can even buy "private shows," in which teenagers sexually perform while following real-time instructions.

A six-month investigation by The New York Times into this corner of the Internet found that such sites had emerged largely without attracting the attention of law enforcement or youth protection organizations. While experts with these groups said they had witnessed a recent deluge of illicit, self-generated Webcam images, they had not known of the evolution of sites where minors sold images of themselves for money.

"We've been aware of the use of the Webcam and its potential use by exploiters," said Ernest E. Allen, chief executive of the National Center for Missing and Exploited Children, a private group. "But this is a variation on a theme that we haven't seen. It's unbelievable."

Minors who run these sites find their anonymity amusing, joking that their customers may be the only adults who know of their activities. It is, in the words of one teenage site operator, the "Webcam Matrix," a reference to the movie in which a computerized world exists without the knowledge of most of humanity.

In this virtual universe, adults hunt for minors on legitimate sites used by Webcam owners who post contact information in hopes of attracting friends. If children respond to messages, adults spend time "grooming" them - with praise, attention and gifts - before seeking to persuade them to film themselves pornographically.

The lure is the prospect of easy money. Many teenagers solicit "donations," request gifts through sites like Amazon.com or negotiate payments, while a smaller number charge monthly fees. But there are other beneficiaries, including businesses, some witting and some unwitting, that provide services to the sites like Web hosting and payment processing.

Not all victims profit, with some children ending up as pornographic commodities inadvertently, even unknowingly. Adolescents have appeared naked on their Webcams as a joke, or as presents for boyfriends or girlfriends, only to have their images posted on for-pay pornography sites. One Web site proclaims that it features 140,000 images of "adolescents in cute panties exposing themselves on their teen Webcams."

Entry into this side of cyberspace is simplicity itself. Webcams cost as little as $20, and the number of them being used has mushroomed to 15 million, according to IDC, an industry consulting group. At the same time, instant messaging programs have become ubiquitous, and high-speed connections, allowing for rapid image transmission, are common.

The scale of Webcam child pornography is unknown, because it is new and extremely secretive. One online portal that advertises for-pay Webcam sites, many of them pornographic, lists at least 585 sites created by teenagers, internal site records show. At one computer bulletin board for adults attracted to adolescents, a review of postings over the course of a week revealed Webcam image postings of at least 98 minors.

The Times inquiry has already resulted in a large-scale criminal investigation. In June, The Times located Justin Berry, then 18. In interviews, Justin revealed the existence of a group of more than 1,500 men who paid for his online images, as well as evidence that other identifiable children as young as 13 were being actively exploited.

In a series of meetings, The Times persuaded Justin to abandon his business and, to protect other children at risk, assisted him in contacting the Justice Department. Arrests and indictments of adults he identified as pornography producers and traffickers began in September. Investigators are also focusing on businesses, including credit card processors that have aided illegal sites. Anyone who has created, distributed, marketed, possessed or paid to view such pornography is open to a criminal charge.

"The fact that we are getting so many potential targets, people who knowingly bought into a child pornographic Web site, could lead to hundreds of other subjects and potentially save hundreds of other kids that we are not aware of yet," said Monique Winkis, a special agent with the Federal Bureau of Investigation who is working the case.

Law enforcement officials also said that, with the cooperation of Justin, they had obtained a rare guide into this secluded online world whose story illuminates the exploitation that takes place there.

"I didn't want these people to hurt any more kids," Justin said recently of his decision to become a federal witness. "I didn't want anyone else to live the life I lived."

A High-Tech Transformation
Not long ago, the distribution of child pornography in America was a smallish trade, relegated to back rooms and corners where even the proprietors of X-rated bookstores refused to loiter.

By the mid-1980's, however, technology had transformed the business, with pedophiles going online to communicate anonymously and post images through rudimentary bulletin board systems. As Internet use boomed in the 1990's, these adults honed their computer skills, finding advanced ways to meet online and swap illegal photos; images once hard to obtain were suddenly available with the click of a mouse.

As the decade drew to a close, according to experts and records of online conversations, these adults began openly fantasizing of the day they would be able to reach out to children directly, through instant messaging and live video, to obtain the pornography they desired.

Their dream was realized with the Web camera, which transformed online pornography the way the automobile changed transportation. At first, the cameras, some priced at more than $100, offered little more than grainy snapshots, "refreshed" a few times per minute. But it was not long before easy-to-use $20 Webcams could transmit high-quality continuous color video across the globe instantly.

By 2000, things had worked out exactly the way the pedophiles hoped. Webcams were the rage among computer-savvy minors, creating a bountiful selection of potential targets.

Among them was Justin Berry. That year, he was a gangly 13-year-old with saucer eyes and brown hair that he often dyed blond. He lived with his mother, stepfather and younger sister in Bakersfield, Calif., a midsize city about 90 miles north of Los Angeles. Already he was so adept at the computer that he had registered his own small Web site development business, which he ran from the desk where he did his schoolwork.

So Justin was fascinated when a friend showed off the free Webcam he had received for joining Earthlink, an Internet service provider. The device was simple and elegant. As Justin remembers it, he quickly signed up, too, eager for his own Webcam.

"I didn't really have a lot of friends," he recalled, "and I thought having a Webcam might help me make some new ones online, maybe even meet some girls my age."

As soon as Justin hooked the camera to his bedroom computer and loaded the software, his picture was automatically posted on spotlife.com, an Internet directory of Webcam users, along with his contact information. Then he waited to hear from other teenagers.

No one Justin's age ever contacted him from that listing. But within minutes he heard from his first online predator. That man was soon followed by another, then another.

Justin remembers his earliest communications with these men as nonthreatening, pleasant encounters. There were some oddities - men who pretended to be teenage girls, only to slip up and reveal the truth later - but Justin enjoyed his online community.

His new friends were generous. One explained how to put together a "wish list" on Amazon.com, where Justin could ask for anything, including computer equipment, toys, music CD's or movies. Anyone who knew his wish-list name - Justin Camboy - could buy him a gift. Amazon delivered the presents without revealing his address to the buyers.

The men also filled an emotional void in Justin's life. His relationship with his father, Knute Berry, was troubled. His parents divorced when he was young; afterward, police records show, there were instances of reported abuse. On one occasion Mr. Berry was arrested and charged with slamming Justin's head into a wall, causing an injury that required seven staples in his scalp. Although Justin testified against him, Mr. Berry said the injury was an accident and was acquitted. He declined to comment in a telephone interview.

The emotional turmoil left Justin longing for paternal affection, family members said. And the adult males he met online offered just that. "They complimented me all the time," Justin said. "They told me I was smart, they told me I was handsome."

In that, experts said, the eighth-grade boy's experience reflected the standard methods used by predatory adults to insinuate themselves into the lives of minors they meet online.

"In these cases, there are problems in their own lives that make them predisposed to" manipulation by adults, Lawrence Likar, a former F.B.I. supervisor, said of children persuaded to pose for pornography. "The predators know that and are able to tap into these problems and offer what appear to be solutions."

Justin's mother, Karen Page, said she sensed nothing out of the ordinary. Her son seemed to be just a boy talented with computers who enjoyed speaking to friends online. The Webcam, as she saw it, was just another device that would improve her son's computer skills, and maybe even help him on his Web site development business.

"Everything I ever heard was that children should be exposed to computers and given every opportunity to learn from them," Ms. Page said in an interview.

She never guessed that one of her son's first lessons after turning on his Webcam was that adults would eagerly pay him just to disrobe a little.

The Instant Audience
It was as if the news shot around the Web. By appearing on camera bare-chested, Justin sent an important message: here was a boy who would do things for money.

Gradually the requests became bolder, the cash offers larger: More than $100 for Justin to pose in his underwear. Even more if the boxers came down. The latest request was always just slightly beyond the last, so that each new step never struck him as considerably different. How could adults be so organized at manipulating young people with Webcams?

Unknown to Justin, they honed their persuasive skills by discussing strategy online, sharing advice on how to induce their young targets to go further at each stage.

Moreover, these adults are often people adept at manipulating teenagers. In its investigation, The Times obtained the names and credit card information for the 1,500 people who paid Justin to perform on camera, and analyzed the backgrounds of 300 of them nationwide. A majority of the sample consisted of doctors and lawyers, businessmen and teachers, many of whom work with children on a daily basis.

Not long ago, adults sexually attracted to children were largely isolated from one another. But the Internet has created a virtual community where they can readily communicate and reinforce their feelings, experts said. Indeed, the messages they send among themselves provide not only self-justification, but also often blame minors with Webcam sites for offering temptation.

"These kids are the ones being manipulative," wrote an adult who called himself Upandc in a posting this year to a bulletin board for adults attracted to children.

Or, as an adult who called himself DLW wrote: "Did a sexual predator MAKE them make a site? No. Did they decide to do it for themselves? Yes."

Tempting as it may be for some in society to hold the adolescent Webcam operators responsible, experts in the field say that is misguided, because it fails to recognize the control that adults exercise over highly impressionable minors.

"The world will want to blame the kids, but the reality is, they are victims here," said Mr. Allen of the National Center for Missing and Exploited Children.

But there is no doubt that the minors cash in on their own exploitation. With Justin, for example, the road to cyberporn stardom was paved with cool new equipment. When his growing legion of fans complained about the quality of his Webcam, he put top-rated cameras and computer gear on his Amazon wish list, and his fans rushed to buy him all of it.

A $35 Asante four-port hub, which allowed for the use of multiple cameras, was bought by someone calling himself Wesley Taylor, Amazon receipts show. For $45, a fan nicknamed tuckertheboy bought a Viking memory upgrade to speed up Justin's broadcast. And then there were cameras - a $60 color Webcam by Hawking Technologies from banjo000; a $60 Intel Deluxe USB camera from boyking12; and a $150 Hewlett-Packard camera from eplayernine.

Justin's desk became a high-tech playhouse. To avoid suspicions, he hid the Webcams behind his desk until nighttime. Whenever his mother asked about his new technology and money, Justin told her they were fruits of his Web site development business. In a way, it was true; with one fan's help, he had by then opened his own pornographic Web site, called justinscam.com.

His mother saw little evidence of a boy in trouble. Justin's grades stayed good - mostly A's and B's, although his school attendance declined as he faked illness to spend time with his Webcam.

As he grew familiar with the online underground, Justin learned he was not alone in the business. Other teenagers were doing the same things, taking advantage of an Internet infrastructure of support that was perfectly suited to illicit business.

As a result, while it helped to have Justin's computer skills, even minors who fumbled with technology could operate successful pornography businesses. Yahoo, America Online and MSN were starting to offer free instant message services that contained embedded ability to transmit video, with no expertise required. The programs were offered online, without parental controls. No telltale credit card numbers or other identifying information was necessary. In minutes, any adolescent could have a video and text system up and running, without anyone knowing, a fact that concerns some law enforcement officials.

There were also credit card processing services that handled payments without requiring tax identification numbers. There were companies that helped stream live video onto the Internet - including one in Indiana that offered the service at no charge if the company president could watch free. And there were sites - portals, in the Web vernacular - that took paid advertising from teenage Webcam addresses and allowed fans to vote for their favorites.

Teenagers, hungry for praise, compete for rankings on the portals as desperately as contestants on TV reality shows, offering special performances in exchange for votes. "Everyone please vote me a 10 on my cam site," a girl nicknamed Thunderrockracin told her subscribers in 2002, "and I will have a live sleep cam!"

In other words, she would let members watch her sleep if they boosted her up the rankings.

Fearing the Fans
Justin began to feel he belonged to something important, a broad community of teenagers with their own businesses. Some he knew by their real names, others by the screen names they used for their sites - Strider, Stoner, Kitty, Calvin, Emily, Seth and so on. But collectively, they were known by a name now commonplace in this Internet subculture:

They call themselves "camwhores."

Justin chatted with the boys online, and sometimes persuaded the girls to masturbate on camera while he did the same. Often, he heard himself compared to Riotboyy, another young-looking teenager whose site had experienced as many as 6,400 hits in a single week.

In conversations with Justin, other minors with for-pay sites admitted to being scared of certain fans. Some adults wrote things like "It wants to possess you." They had special wardrobe requests for the adolescents: in jeans with a belt, without a belt, with a lacy bra, showing legs, showing feet, wearing boxers with an erection, and others.

One 16-year-old who called himself hot boyy 23 finally found the entreaties too much. "Hey guys," he wrote when he shut down his site, "I'm sorry, there are just too many freaks out there for me. I need to live a more normal life, too. I might be back someday and I might not. I'm sorry I had to ruin all the fun."

It was not only the minors operating Webcam sites for pay who faced frightening adults. Earlier this year, a teenage girl in Alabama posed seminude on her Webcam in a sexually charged conversation with someone she thought was another teenage girl. But her new confidant, it turned out, was an adult named Julio Bardales from Napa, Calif., law enforcement officials said. And when the girl stopped complying, she received an e-mail message from Mr. Bardales containing a montage of her images. Across them was a threat in red letters that the images would be revealed unless she showed a frontal nude shot over the Webcam. Mr. Bardales was subsequently arrested. The police said he possessed images of more under-age girls on Webcams, including other montages with the same threat.

Justin says that he did not fully understand the dangers his fans posed, and before he turned 14, he was first lured from the relative safety of his home. A man he met online hosted Justin's Web site from Ann Arbor, Mich., and invited him there to attend a computer camp. Justin's mother allowed him to go, thinking the camp sounded worthwhile.

Another time, the man enticed Justin to Michigan by promising to arrange for him to have sex with a girl. Both times, Justin said, the man molested him. Transcripts of their subsequent conversations online support the accusations, and a video viewed by The Times shows that the man, who appears for a short time in the recording, also taped pornography of Justin.

From then on, Justin's personality took on a harder edge, evident in the numerous instant messages he made available to The Times. He became an aggressive negotiator of prices for his performances. Emboldened by a growing contempt for his audience, he would sometimes leave their questions unanswered for hours, just to prove to himself that they would wait for him.

"These people had no lives," Justin said. "They would never get mad."

Unnerved by menacing messages from a fan of his first site, Justin opened a new one called jfwy.com, an online acronym that loosely translates into "just messing with you." This time, following an idea suggested by one of his fans, he charged subscribers $45 a month. In addition, he could command large individual payments for private shows, sometimes $300 for an hourlong performance.

"What's in the hour?" inquired a subscriber named Gran0Stan in one typical exchange in 2002. "What do you do?"

"I'll do everything, if you know what I mean," Justin replied.

Gran0Stan was eager to watch, and said the price was fine. "When?" he asked.

"Tonight," Justin said. "After my mom goes to sleep."

As his obsession with the business grew, Justin became a ferocious competitor. When another under-age site operator called Strider ranked higher on a popular portal, Justin sent him anonymous e-mail messages, threatening to pass along images from Strider's site to the boy's father. The site disappeared.

"I was vicious," Justin said. "But I guess I really did Strider a favor. Looking back, I wish someone had done that to me."

By then, fans had begun offering Justin cash to meet. Gilo Tunno, a former Intel employee, gave him thousands of dollars to visit him in a Las Vegas hotel, according to financial records and other documents. There, Justin said, Mr. Tunno began a series of molestings. At least one assault was videotaped and the recording e-mailed to Justin, who has since turned it over to the F.B.I.

Mr. Tunno played another critical role in Justin's business, the records show. When he was 15, Justin worried that his mother might discover what he was doing. So he asked Mr. Tunno to sign an apartment lease for him and pay rent. Justin promised to raise money to pay a share. "I'll whore," he explained in a message to Mr. Tunno.

Mr. Tunno agreed, signing a lease for $410 a month for an apartment just down the street from Justin's house. From then on, Justin would tell his mother he was visiting friends, then head to the apartment for his next performance. Mr. Tunno, who remains under investigation in the case, is serving an eight-year federal sentence on an unrelated sexual abuse charge involving a child and could not be reached for comment.

The rental symbolized a problem that Justin had not foreseen: his adult fans would do almost anything to ensure that his performances continued. At its worst, they would stand between him and the people in his offline life whom they saw as a threat to his Webcam appearances.

For example, when a girlfriend of Justin's tried to convince him to shut down his site in December 2002, a customer heaped scorn on her.

"She actually gets mad at you for buying her things with the money you make from the cam?" messaged the customer, a man using the nickname Angelaa. "Just try and remember, Justin, that she may not love you, but most of us in your chat room, your friends, love you very much."

A Life Falls Apart
In early 2003, Justin's offline life began to unravel. A former classmate found pornographic videos on the Internet from Justin's Web site, made copies and handed them out around town, including to students at his school. Justin was taunted and beaten.

Feeling embarrassed and unable to continue at school, Justin begged his mother to allow him to be home-schooled through an online program. Knowing he was having trouble with classmates, but in the dark about the reasons why, she agreed.

Then, in February, came another traumatic event. Justin had begun speaking with his father, hoping to repair their relationship. But that month, Mr. Berry, who had been charged with insurance fraud related to massage clinics he ran, disappeared without a word.

Despairing, Justin turned to his online fans. "My dad left. I guess he doesn't love me," he wrote. "Why did I let him back in my life? Let me die, just let me die."

His father did not disappear for long. Soon, Mr. Berry called his son from Mazatlán, Mexico; Justin begged to join him, and his father agreed.

In Mexico, Justin freely spent his cash, leading his father to ask where the money had come from. Justin said that he confessed the details of his lucrative Webcam business, and that the reunion soon became a collaboration. Justin created a new Web site, calling it mexicofriends, his most ambitious ever. It featured Justin having live sex with prostitutes. During some of Justin's sexual encounters, a traffic tracker on his site showed hundreds watching. It rapidly became a wildly popular Webcam pornography site, making Justin one of the Internet's most sought after under-age pornography stars.

For this site, Justin, then 16, used a pricing model favored by legitimate businesses. For standard subscribers, the cost was $35, billed monthly. But discounts were available for three-month, six-month and annual memberships. Justin used the cash to support a growing cocaine and marijuana habit.

Money from the business, Justin said, was shared with his father, an accusation supported by transcripts of their later instant message conversations. In exchange, Justin told prosecutors and The Times, his father helped procure prostitutes. One video obtained by the F.B.I. shows Mr. Berry sitting with Justin as the camera is turned on, then making the bed before a prostitute arrives to engage in intercourse with his teenage son. Asked about Justin's accusations, Mr. Berry said, "Obviously, I am not going to comment on anything."

In the fall of 2003, Justin's life took a new turn when a subscriber named Greg Mitchel, a 36-year-old fast food restaurant manager from Dublin, Va., struck up an online friendship with the boy and soon asked to visit him. Seeing a chance to generate cash, Justin agreed.

Mr. Mitchel arrived that October, and while in Mexico, molested Justin for what would be the first of many times, according to transcripts of their conversations and other evidence. Mr. Mitchel, who is in jail awaiting trial on six child pornography charges stemming from this case, could not be reached for comment.

Over the following year, Justin tried repeatedly to break free of this life. He roamed the United States. He contemplated suicide. For a time he sought solace in a return to his boyhood Christianity. At one point he dismantled his site, loading it instead with Biblical teachings - and taking delight in knowing the surprise his subscribers would experience when they logged on to watch him have sex.

But his drug craving, and the need for money to satisfy it, was always there. Soon, Mr. Mitchel beckoned, urging Justin to return to pornography and offering to be his business partner. With Mr. Mitchel, records and interviews show, Justin created a new Web site, justinsfriends.com, featuring performances by him and other boys he helped recruit. But as videos featuring other minors appeared on his site, Justin felt torn, knowing that these adolescents were on the path that had hurt him so badly. Justin was now 18, a legal adult. He had crossed the line from under-age victim to adult perpetrator.

A Look Behind the Secrecy
In June, Justin began communicating online with someone who had never messaged him before. The conversations involved many questions, and Justin feared his new contact might be an F.B.I. agent. Still, when a meeting was suggested, Justin agreed. He says part of him hoped he would be arrested, putting an end to the life he was leading.

They met in Los Angeles, and Justin learned that the man was this reporter, who wanted to discuss the world of Webcam pornography with him. After some hesitation, Justin agreed. At one point, asked what he wanted to accomplish in his life, Justin pondered for a moment and replied that he wanted to make his mother and grandmother proud of him.

The next day, Justin began showing the inner workings of his online world. Using a laptop computer, he signed on to the Internet and was quickly bombarded with messages from men urging him to turn on his Webcam and strip.

One man described, without prompting, what he remembered seeing of Justin's genitals during a show. Another asked Justin to recount the furthest distance he had ever ejaculated. Still another offered an unsolicited description of the sexual acts he would perform on Justin if they met.

"This guy is really a pervert," Justin said. "He kind of scares me."

As the sexual pleadings continued, Justin's hands trembled. His pale face dampened with perspiration. For a moment he tried to seem tough, but the protective facade did not last. He turned off the computer without a final word to his online audience.

In the days that followed, Justin agreed in discussions with this reporter to abandon the drugs and his pornography business. He cut himself off from his illicit life. He destroyed his cellphone, stopped using his online screen name and fled to a part of the country where no one would find him.

As he sobered up, Justin disclosed more of what he knew about the Webcam world; within a week, he revealed the names and locations of children who were being actively molested or exploited by adults with Webcam sites. After confirming his revelations, The Times urged him to give his information to prosecutors, and he agreed.

Justin contacted Steven M. Ryan, a former federal prosecutor and partner with Manatt, Phelps & Phillips in Washington. Mr. Ryan had learned of Justin's story during an interview with The Times about a related legal question, and offered to represent him.

On July 14, Mr. Ryan contacted the Child Exploitation and Obscenity Section of the Justice Department, informing prosecutors that he had a client with evidence that could implicate potentially hundreds of people. By then, Mr. Ryan had learned that some of Justin's old associates, disturbed by his disappearance, were hunting for him and had begun removing records from the Internet. Mr. Ryan informed prosecutors of the dangers to Justin and the potential destruction of evidence. Two weeks passed with little response.

Finally, in late July, Justin met in Washington with the F.B.I. and prosecutors. He identified children who he believed were in the hands of adult predators. He listed the marketers, credit card processors and others who supported Webcam child pornography. He also described the voluminous documentary evidence he had retained on his hard drives: financial information, conversation transcripts with his members, and other records. But that evidence would not be turned over, Mr. Ryan said, until Justin received immunity.

The meeting ended, followed by weeks of silence. Word came back that prosecutors were wrestling with Justin's dual role as a victim and a perpetrator. Justin told associates that he was willing to plead guilty if the government would save the children he had identified; Mr. Ryan dissuaded him.

By September, almost 50 days had passed since the first contact with the government, with no visible progress. Frustrated, Mr. Ryan informed prosecutors that he would have to go elsewhere, and contacted the California attorney general.

That proved unnecessary. Prodded by the F.B.I. and others in the Justice Department, on Sept. 7, prosecutors informed Mr. Ryan that his client would be granted immunity. A little more than four weeks after his 19th birthday, Justin became a federal witness.

A Final Online Confrontation
Five days later, on the third floor of a lakeside house in Dublin, Va., Greg Mitchel - Justin's 38-year-old business partner on his pornography Web site - rested on his bed as he chatted online with others in his illicit business.

Ever since Justin's disappearance weeks before, things had been tense for Mr. Mitchel. Some in the business already suspected that Justin might be talking to law enforcement. One associate had already declared to Mr. Mitchel that, if Justin was revealing their secrets, he would kill the boy.

But this night, Sept. 12, the news on Mr. Mitchel's computer screen was particularly disquieting. An associate in Tennessee sent word that the F.B.I. had just raided a Los Angeles computer server used by an affiliated Webcam site. Then, to Mr. Mitchel's surprise, Justin himself appeared online under a new screen name and sent a greeting.

Mr. Mitchel pleaded with Justin to come out of hiding, inviting the teenager on an all-expense-paid trip to Las Vegas with him and a 15-year-old boy also involved in Webcam pornography. But Justin demurred.

"You act like you're in witness protection," Mr. Mitchel typed. "Are you?"

"Haha," Justin replied. Did Mr. Mitchel think he would be on the Internet if he was a federal witness? he asked. Justin changed the subject, later asking the whereabouts of others who lived with Mr. Mitchel, including two adolescents; Mr. Mitchel replied that everyone was home that night.

In a location in the Southwest, Justin glanced from his computer screen to a speakerphone. On the line was a team of F.B.I. agents who at that moment were pulling several cars into Mr. Mitchel's driveway, preparing to arrest him.

"The kids are in the house!" Justin shouted into the phone, answering a question posed by one of the agents.

As agents approached the house, Justin knew he had little time left. He decided to confront the man who had hurt him for so long.

"Do you even remember how many times you stuck your hand down my pants?" he typed.

Mr. Mitchel responded that many bad things had happened, but he wanted to regain Justin's trust.

"You molested me," Justin replied. "Don't apologize for what you can't admit."

There was no response. "Peekaboo?" Justin typed.

On the screen, a message appeared that Mr. Mitchel had signed off. The arrest was over.

Justin thrust his hands into the air. "Yes!" he shouted.

In the weeks since the first arrest, F.B.I. agents and prosecutors have focused on numerous other potential defendants. For example, Tim Richards, identified by Justin as a marketer and principal of justinsfriends.com, was arrested in Nashville last month and arraigned on child pornography charges. According to law enforcement officials, Mr. Richards was stopped in a moving van in his driveway, accompanied by a young teenage boy featured by Mr. Richards on his own Webcam site. Mr. Richards has pleaded not guilty.

Hundreds of thousands of computer files, including e-mail containing a vast array of illegal images sent among adults, have been seized from around the country. Information about Justin's members has been downloaded by the F.B.I. from Neova.net, the company that processed the credit cards; Neova and its owner, Aaron Brown, are targets of the investigation, according to court records and government officials. And Justin has begun assisting agents with Immigration and Customs Enforcement, who hope to use his evidence to bring new charges against an imprisoned child rapist.

Justin himself has found a measure of control over his life. He revealed the details of his secret life to his family, telling them of all the times in the past that he had lied to them. He has sought counseling, kept off drugs, resumed his connection with his church and plans to attend college beginning in January.

In recent weeks, Justin returned to his mother's home in California, fearing that - once his story was public - he might not be able to do so easily. On their final day together, Justin's mother drove him to the airport. Hugging him as they said goodbye, she said that the son she once knew had finally returned.

Then, as tears welled in her eyes, Justin's mother told him that she and his grandmother were proud of him.