How Early Is Too Early? Identification of Elevated, Persistent Problem Behavior in Childhood

  • Megan Bears AugustynEmail author
  • Thomas Loughran
  • Pilar Larroulet Philippi
  • Terence P. Thornberry
  • Kimberly L. Henry


We inquire how early in childhood children most at risk for problematic patterns of internalizing and externalizing behaviors can be accurately classified. Yearly measures of anxiety/depressive symptoms and aggressive behaviors (ages 6–13; n = 334), respectively, are used to identify behavioral trajectories. We then assess the degree to which limited spans of yearly information allow for the correct classification into the elevated, persistent pattern of the problem behavior, identified theoretically and empirically as high-risk and most in need of intervention. The true positive rate (sensitivity) is below 70% for anxiety/depressive symptoms and aggressive behaviors using behavioral information through ages 6 and 7. Conversely, by age 9, over 90% of the high-risk individuals are correctly classified (i.e., sensitivity) for anxiety/depressive symptoms, but this threshold is not met until age 12 for aggressive behaviors. Notably, the false positive rate of classification for both high-risk problem behaviors is consistently low using each limited age span of data (< 5%). These results suggest that correct classification into highest risk groups of childhood problem behavior is limited using behavioral information observed at early ages. Prevention programming targeting those who will display persistent, elevated levels of problem behavior should be cognizant of the degree of misclassification and how this varies with the accumulation of behavioral information. Continuous assessment of problem behaviors is needed throughout childhood in order to continually identify high-risk individuals most in need of intervention as behavior patterns are sufficiently realized.


Aggression Anxiety Depressive symptoms Trajectory analysis Prevention science Classification 


Funding Information

Support for RYDS and RIGS has been provided by the National Institute on Drug Abuse (R01DA020195, R01DA005512), the Office of Juvenile Justice and Delinquency Prevention (86-JN-CX-0007, 96-MU-FX-0014, 2004-MU-FX-0062), the National Science Foundation (SBR-9123299), and the National Institute of Mental Health (R01MH56486, R01MH63386). Technical assistance for RYDS/RIGS was provided by an NICHD grant (R24HD044943) to The Center for Social and Demographic Analysis at the University at Albany.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


The content is solely the responsibility of the authors and does not represent the official views of any of the funding agencies.

Supplementary material

11121_2019_1060_MOESM1_ESM.docx (15 kb)
ESM 1 (DOCX 15 kb)


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Copyright information

© Society for Prevention Research 2019

Authors and Affiliations

  1. 1.The University of Texas at San AntonioSan AntonioUSA
  2. 2.Pennsylvania State UniversityPennsylvaniaUSA
  3. 3.Pontifica Universidad Catolica de ChileSantiagoChile
  4. 4.The University of MarylandCollege ParkUSA
  5. 5.Colorado State UniversityFort CollinsUSA

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