The widespread use of video games among adolescents has raised concerns about their impact on psychological and social development. This study aimed to assess the effects of different types of parental mediation on adolescents' tendency to use video games to avoid negative emotions and determine the relationship between adolescents' interpersonal skills and their reliance on online video games for escapism. Participants were 452 adolescents from 15 middle and high schools. Data on sociodemographic information, gaming habits, parental control of online gaming, interpersonal skills, and reasons for playing online games were also collected. Hierarchical multiple regression was used to analyze the data, with online video game escapism as the dependent variable. Results supported the study's hypothesis that both parental mediation and adolescent interpersonal skills significantly predict the use of online video games for escapism. Higher levels of parental monitoring were associated with a lower tendency of adolescents to use video games to escape negative emotions, while parental mediation supporting autonomy showed a similar but weaker protective effect. At the same time, parental monitoring was also found to be associated with lower interpersonal skills, notably higher impulsivity, narcissism, and stress in social situations. In addition, adolescents with higher levels of impulsivity were more likely to use video games for escapism. These findings highlight the importance of balanced parental involvement and the development of adolescents' social skills to mitigate the risks of problematic online gaming. Interventions should promote effective parental mediation strategies and enhance adolescents' interpersonal skills to reduce their tendency to use video games as a coping mechanism for real-life challenges. Effective parental mediation and improved interpersonal skills are critical for promoting healthier gaming habits and reducing adolescent escapism.