This study examined the adjustment of a sample of adolescent girls and young women (N = 228) who were in compulsory care in Sweden between 1999 and 2000. Using person-oriented analyses, participants’ responses to the Adolescent Drug Abuse Diagnosis Instrument (Friedman & Utada, 1989; ADAD) at intake yielded five externalizing problem configurations. The main analyses focused on examining whether problem configuration at intake was important to participants’ adjustment at a four-year follow-up. Overall, results indicated that problem configuration can be important to later adjustment (less life satisfaction, more drug use, and problems controlling violent behavior), particularly if the problem configuration involves multiple problems at elevated levels and/or drug use. The implications of the study results are discussed in light of efforts to improve the tailoring of care and treatment for diverse youth who experience multiple problems.