In planning interventions it is essential to understand how adverse risk factors in early childhood are associated with child mental health problems, whether some types of problems can be better explained by the specific risk factors, and whether early risk factors are differently related to different types of child behavior problems. A community sample of 692 1.5-3.5-year-old children from Northern Russia was assessed by means of maternal reports. The study compared two models for the development of internalizing (withdrawn, anxious/depressed) and externalizing (aggressive, destructive) behavior problems in relation to the same early risk factors using structural equation modeling. Findings suggested that the development of these problems is related to maternal psychological problems and alcohol use during pregnancy, and mediated by the continuing maternal and family dysfunction and compromised postnatal condition of the child. Results indicated good model fit for both internalizing and externalizing problems, and neither of the models fit significantly better than the other. Findings are discussed in terms of understanding developmental risk and informing intervention and prevention efforts.