Jared Lee Loughner Now Understands Gabrielle Giffords Is Alive

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Bill Robles / AP

In this courtroom sketch, from left, Attorney Judy Clark sits with her client, Jared Lee Loughner as U.S. District Judge Larry Burns listens from the bench to testimony from Dr. Christina PIetz, far right, in federal court Wednesday, Sept. 28, 2011 in Tucson, Ariz.

Jared Loughner, the man accused of the deadly Tuscon, Ariz. shooting rampage earlier this year, is likely to be mentally  fit to stand trial, a district court ruled Wednesday.

Loughner, who pleaded not guilty to 49 charges related to the Jan. 8 shootings, remained mostly quiet for a hearing on his mental health. His behavior marked a significant change from his last court appearance in May when federal marshals removed him for an outburst. The haunting smirk that hung from Loughner’s face during previous hearings was also missing. U.S. District Judge Larry Burns noted his change in demeanor.

(MORE: Loughner Returns to Ariz. for Court Hearing)

“I’ve watched Mr. Loughner today and his demeanor is distinctly different,” Burns said. “His smirk is gone. He appears to be paying attention.” After the outburst in May, Loughner was sent to the Federal Medical Center in Springfield, Mo., where he continues to receive treatment to restore his competency. Burns’ ruling will mean pending progress, Loughner can stand trial on the charges of killing six people and wounding 13, including Rep. Gabrielle Giffords, who was critically injured and is still in recovery from the attack last January.

A key testimony in the hearing came from Loughner’s psychologist, Dr. Christina Pietz, who confirmed Loughner’s improved condition may allow prosecution to continue. Pietz explained that upon arrival, Loughner was convinced Giffords was dead, and when shown footage of the shooting, told her the video had been edited.

“He is less obsessed with that,” Pietz said of Loughner, who now recognizes Giffords is alive. “He understands that he has murdered people. He talks about it. He talks about how remorseful he is.” Loughner is suffering from years of untreated schizophrenia, Pietz said, and has been forcibly treated with an anti-psychotic, anti-depressant and a sedative for the past two months.

Though Burns acknowledged the progress made, he ruled to extend Loughner’s stay at the facility for an additional four months, and will allow officials to continue giving Loughner involuntary medication on the grounds that he’s a danger to himself, the Associated Press reports.¬†

If doctors can later determine Loughner’s competency of the case against him, prosecutors can proceed with the trial. The court can may also choose extend his treatment at the Missouri facility if progress is not made or, if medical experts find they cannot restore his mental capability, the judge can dismiss the charges.

MORE: What Motivated Giffords’ Shooter?