Gaming engagement spans a continuum from non-problematic play to gaming disorder (GD). Although emotion regulation, motivations and mental health are established correlates of problematic gaming, less is known about how these factors co-occur within individuals and their influence on developmental trajectories. Using a large international sample of gamers (men, women, non-binary), across three waves over a 12-month period (T1: N = 5255; T2: N = 1926; T3: N = 2317), this study examined the stability of four psychological gamer profiles: Avoidant, Engaged, Relational, and Dysregulated, based on emotion regulation and motivational factors. Latent transition analysis was used to examine profile stability and transitions over time, incorporating time-varying covariates (gaming time and psychological distress). Regression analyses tested whether baseline profile membership predicted GD symptom severity one year later, beyond initial symptoms. Profiles showed high longitudinal stability, supporting their interpretation. Avoidant and Engaged profiles reflected adaptive patterns that differed primarily in motivational intensity. However, transitions from the Relational to the Dysregulated profiles were significantly predicted by higher psychological distress, while gaming time showed only modest associations with profile change. Importantly, baseline Relational and Dysregulated profiles predicted higher GD symptom severity at follow-up, independent of initial GD symptoms. These findings highlight the public mental health relevance of emotionally informed, person-centred approaches. Profilebased identification may support more accurate population screening, inform prevention strategies that avoid over-pathologizing high engagement, and guide stepped interventions aligned with ICD-11 criteria.