The protective role of parent-adolescent communication in the relationship between internet addiction and adolescent mental health.
 
 Xiao Zhang, Jocelyn Gutierrez, Mikaela Rojas, Christopher Rogers, Myriam Forster
 
Background: Internet addiction (IA) is characterized by excessive use that a person is unable to regulate despite negative consequences, such as failing to meet responsibilities and diminished quality of relationships. Currently, nearly all US teens (96%) use the Internet every day, and nearly half (46%) report being online ‘almost constantly. ‘Considerable evidence suggests that IA has negative effects on students’ academic performance, peer relationships, and mental health. However, almost no research has investigated whether parent-adolescent communication can offset the risk of IA for depression and anxiety after accounting for early life adversity and neighborhood characteristics.
 
 Methods: Data are survey responses (N=2,824) of high school students participating in the SHARE project across three states. Ordered logistic regression models tested the hypothesized relationships between IA (Internet Addiction Test) and depression (CESD) and anxiety (GAD-7), adjusting for age, sex, ethnicity, adverse childhood experiences, neighborhood disadvantage, and urbanicity. We also assessed whether parent- adolescent communication (PACS) moderated the relationship between IA and depression and anxiety.
 
 Results: On average, students were 15.6 (SD=2.0) years old, 48% were male, and 31%
identified as non-Hispanic White, followed by African American (28%), Hispanic (17%),
Multiethnic (17%), and Asian (7%). About 1 in 3 students (27%) reported moderate to severe IA, and over half (51%) screened positive for moderate to severe depression, and 35% for moderate to severe anxiety. IA was associated with higher odds of moderate to severe depression (AOR:3.5, 95%CI:2.80, 4.32) and moderate to severe anxiety (AOR:3.1, 95%CI:2.57, 3.78), while higher parent-adolescent communication scores were associated with lower odds of depression (AOR:0.9, 95%CI:0.93, 0.96) and anxiety (AOR:0.9, 95%CI:0.93, 0.96). Importantly, higher parent-adolescent communication offset the negative effects of IA for depression (p<0.05) but not anxiety.
 
Discussion: Our results provide compelling evidence that symptoms of
compulsive Internet use increase risk for depression and anxiety, although meaningful and positive communication between parents and adolescents can act as a potent protective factor. Community and school-based programs that foster parent-child communication and teach active  listening to family members may be promising approaches to reduce both high levels of IA and
mental health symptoms.