title: Stress moderates the relationship between problematic Internet use by parents and problematic Internet use by adolescents.
abstract: OBJECTIVE
  Based on the theoretical framework of Problem Behavior and Stress Reduction theories for problematic Internet use (PIU), this study aimed to investigate the relationship between parental PIU and the PIU among adolescents taking into consideration the stress levels of young people.
  
  
  METHODS
  This was a population-based parent and adolescent dyad health survey utilizing a random sampling technique. PIU for both parents and adolescents was measured by the Internet addiction test designed by Young. The stress level of adolescents was assessed using the stress subscale of the Depression Anxiety Stress Scale (DASS). Data were analyzed using logistic regression modeling techniques with adjustment for potential confounding factors with analysis on the modification effect of stress levels on the relationship between parent and adolescent PIU.
  
  
  RESULTS
  Of the total 1,098 parent and adolescent dyads with usable information, 263 adolescents (24.0%) and 62 parents (5.7%) could be classified as moderate and severe problematic users of the Internet. About 14% (n = 157) of adolescents could be classified with moderate-to-severe stress. Regression analysis results suggested a significant interaction between parental PIU and adolescents' stress levels on adolescent PIU. Stratified regression analyses by stress level resulted in a significant parent and adolescent PIU relationship in the low stress group (odds ratio, 3.18; 95% confidence interval 1.65-6.14). However, the association between parent and adolescent PIU in the high stress group became insignificant.
  
  
  CONCLUSIONS
  There was a significant parent and adolescent PIU relationship; however, this relationship is differentially affected by the stress status of the adolescent. The direct implication of the results is that parental Internet use should also be assessed and included as part of the treatment regime for adolescents.
authors.affiliation: Discipline of Paediatrics and Child Health, The Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia; Department of Health and Physical Education, The Hong Kong Institute of Education, Hong Kong SAR, China. Electronic address: ltlam@ied.edu.hk.
authors.forename: Lawrence T
authors.initials: LT
authors.lastname: Lam
authors.affiliation: Department of Health and Physical Education, The Hong Kong Institute of Education, Hong Kong SAR, China.
authors.forename: Emmy M Y
authors.initials: EM
authors.lastname: Wong
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000328:Adult; D016739:Behavior, Addictive / Q000453:epidemiology* / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D020407:Internet / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D018570:Risk Assessment; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000453:epidemiology*; D011795:Surveys and Questionnaires
keywords: Adolescents; Dyad study; Internet addiction; Parent; Problematic Internet use; Stress