This study examined the stability of internalizing and externalizing problems from age 1.5 to 6 years, while taking into account developmental changes in the presentation of problems. The study comprised a population-based cohort of 7,206 children (50.4 % boys). At ages 1.5, 3, and 6 years, mothers reported on problem behavior using the Child Behavior Checklist/1.5-5 (CBCL/1.5-5). At each age we performed latent profile analysis on the CBCL/1.5-5 scales. Latent transition analysis (LTA) was applied to study the stability of problem behavior. Profiles of problem behavior varied across ages. At each age, 82–87 % of the children did not have problems whereas approximately 2 % showed a profile of co-occurring internalizing and externalizing problems. This profile was more severe (with higher scores) at 6 years than at earlier ages. A predominantly internalizing profile only emerged at 6 years, while a profile with externalizing problems and emotional reactivity was present at each age. LTA showed that, based on profiles at 1.5 and 3 years, it was difficult to predict the type of profile at 6 years. Children with a profile of co-occurring internalizing and externalizing problems early in life were most likely to show problem behavior at 6 years. This study shows that the presentation of problem behavior changes across the preschool period and that heterotypic continuity of problems is very common among preschoolers. Children with co-occurring internalizing and externalizing problems were most likely to show persisting problems. The use of evidence-based treatment for these young children may prevent psychiatric problems across the life course.Electronic supplementary materialThe online version of this article (doi:10.1007/s10802-015-9993-y) contains supplementary material, which is available to authorized users.

Objective Children with co-occurring internalizing and externalizing problems have higher levels of impairment and worse outcomes later in life, but it is unclear whether these children can be distinguished validly from children who have problems in a single domain. We used a person-centered statistical approach to examine whether a group of children with co-occurring internalizing and externalizing problems can be identified in a general-population sample of young children. Method This study included a population-based sample of 6,131 children, aged 5 to 7 years. Mothers (92.6%) reported emotional and behavioral problems using the Child Behavior Checklist/1.5–5 (CBCL). A latent profile analysis was performed on the CBCL syndrome scales. Identified classes were compared on early socioeconomic and parental risk factors using multinomial logistic regression. Results We identified 4 classes: 1) a class scoring high on all internalizing and externalizing scales (1.8%), 2) a class with internalizing problems (5.3%), 3) a class with externalizing problems and emotional reactivity (7.3%), and 4) a class without problems (85.6%). The first class, with co-occurring problems, was associated with higher levels of maternal and paternal affective symptoms and hostility than the other 3 classes. Conclusions The class with co-occurring internalizing and externalizing problems appears to be highly similar to the CBCL Dysregulation Profile described in older children. This empirically-based dysregulation profile offers a promise to the study of the development of poor self-regulation.

Background: Omega 3 (n-3) and 6 (n-6) long-chain polyunsaturated fatty acids (LC-PUFAs) and the n-3:n-6 ratio are important for brain development. Whether maternal LC-PUFA status during pregnancy affects risk of problem behavior in later childhood is unclear. Methods: Within a population-based cohort, we measured maternal plasma docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), and arachidonic acid (AA) concentrations and n-3:n-6-ratio in mid-pregnancy. Child emotional and behavioral problems at 6 y of age were assessed by parents (child behavior checklist), teachers (teacher report form), and combined parent/teacher report. results: Higher maternal DHA and n-3:n-6 ratio were associated with fewer child emotional problems using parent (odds ratio (OR) DHA = 0.82; 95% confidence interval (CI): 0.70, 0.96; P = 0.02 and OR n-3:n-6 = 0.83; 95% CI: 0.71, 0.96; P = 0.01; n = 5,307) and combined parent/teacher scores (OR DHA = 0.79; 95% CI: 0.66, 0.95; P = 0.01 and OR n-3:n-6 = 0.77; 95% CI: 0.65, 0.92; P < 0.01; n = 2,828). Higher AA was associated with more child behavioral problems using teacher (OR = 1.10; 95% CI: 1.00, 1.20; P = 0.04; n = 3,365) and combined parent/teacher scores (OR = 1.12; 95% CI: 1.02, 1.22; P = 0.02; n = 2,827). Maternal EPA was not associated with child problem behavior. conclusion: Indications of associations of maternal LC-PUFA status with child emotional and behavioral problems were found. Future research is needed to identify LC-PUFAsensitive periods of fetal brain development by including multiple assessments of prenatal LC-PUFA status. t wo families of polyunsaturated fatty acids (PUFAs), the omega 3 (n-3) and 6 (n-6) fatty acids (FAs), are nutrients that play a major role in brain development and functioning. They affect numerous processes, including membrane fluidity, neurotransmission, and gene expression (1). The long-chain PUFAs (LC-PUFAs), eicosapentaenoic acid (EPA; C20:5n-3), docosahexaenoic acid (DHA; C22:6n-3), and arachidonic acid (AA; C20:4n-6) are the main FAs that are metabolically active.In addition, the ratio between n-3 and n-6 FAs is important for optimal brain functioning. During the last century, however, the Western diet has provided a lower n-3 and higher n-6 intake than that in previous generations, diminishing the n-3:n-6 ratio (2).Because of their role in brain function and development, maternal LC-PUFAs during fetal development have been hypothesized to affect child problem behavior. Approximately half of the dry weight of the brain is lipid, of which 35% are PUFA, most of which is LC-PUFA (1). Increase in AA and DHA content of brain tissue starts during the third trimester of pregnancy (3), indicating that the fetal period possibly is a sensitive period. Moreover, the fetus mostly depends on maternal LC-PUFA supply for its development, because fetal LC-PUFA synthesis is limited (4).Research in this field is however scarce, and results are conflicting. Two studies on maternal fish intake, a major source of DHA, during pregnancy and offspring problem beha...

MSM follow different trajectories of changing sexual risk behaviour over time. Early identification of MSM following a trajectory of falling or rising high-risk behaviour and adequate timing of individual-based preventive interventions may reduce HIV transmission.