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A systematic review of the relationships between family functioning, pubertal timing and adolescent substance use


Correspondence to: Marianne B. M. van den Bree, Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4YS, UK. E-mail:



Experiences linked to poor family functioning and pubertal timing have each been associated with increased risk of substance misuse in adolescence. However, it remains unclear to what extent family functioning and pubertal timing combine to put adolescents at particular risk.


A systematic review was planned, undertaken and reported according to the 27 items of the PRISMA statement. Databases World of Knowledge, PsycINFO and PubMed were searched. Fifty-eight papers were retained and are discussed in this review after screening titles, abstracts and full papers against pre-established exclusion criteria.


The combination of off-time pubertal timing and poor parent–adolescent relationship quality has been related to higher levels of substance use. However, this is an under-studied area of research and the evidence is less strong for boys than girls.


Adolescents experiencing both poor parent–adolescent relationship quality and off-time pubertal timing may represent a high-risk group that can benefit from approaches aimed at reducing risk of substance misuse.