Gambling-like gaming, offline leisure, and help-seeking in problematic gaming among Flemish adolescents: a three-wave longitudinal study

Introduction Problematic gaming among adolescents has received growing attention, yet longitudinal evidence that can inform harm-reduction responses remains limited, particularly regarding gambling-like gaming features, offline leisure, and help-seeking. Methods This study examined the prevalence, course, and prospective correlates of problematic gaming in a three-wave annual cohort of Flemish adolescent gamers. Secondary school students who reported gaming at least occasionally completed surveys at baseline (T1: N = 1,863), one-year follow-up (T2: N = 1,807), and two-year follow-up (T3: N = 1,748). Problematic gaming was assessed with the Gaming Disorder Scale for Adolescents. Baseline predictors included engagement with gambling-like gaming features, microtransactions, extracurricular hobby participation, and perceived competence in extracurricular domains; help-seeking knowledge and behavior were assessed at T3. Results Problematic gaming was uncommon across waves (1.5–1.9%) and among adolescents who participated at all three waves, none met the cut-off at every assessment. After adjustment for baseline symptoms and sociodemographic covariates, greater engagement with gambling-like gaming features predicted higher problematic gaming symptoms over 1 year, but not over 2 years. Microtransaction engagement was positively correlated with problematic gaming but did not independently predict later symptom change. Neither extracurricular hobby participation nor perceived competence in extracurricular domains were associated with subsequent changes in problematic gaming symptoms. At T3, 53.4% of adolescents reported knowing where they could seek help for gaming-related problems, whereas only 3.5% reported having sought help, and baseline problematic gaming did not prospectively predict later help-seeking. Discussion Overall, problematic gaming in this community sample was relatively uncommon and showed limited categorical stability over time. The findings identify gambling-like gaming features as a relevant prospective target for harm-reduction-oriented prevention, whereas the baseline offline leisure indicators did not prospectively predict symptom change. They also point to a gap between perceived access to support and actual help-seeking.