Based on the general assumption that even problematic behaviours are associated with an inherently health-promoting motivation to cope with unpleasant or unsatisfying life situations, the compensatory model of media use focuses on how psychosocial vulnerabilities moderate links between media behaviours and adverse outcomes. The present paper means to further develop this approach by exploring the moderating role of state- and trait-level factors (state: perceived stress; trait: social interaction anxiety and loneliness) on the relation between video game consumption (i.e. playing duration and habitual gaming), motivations (i.e. achievement, social, immersion), and engagement (harmonious and obsessive engagement) within a large-scale sample of mostly heavy gamers. Overall, results provided further evidence for the compensatory approach, with perceived stress emerging as a critical psychosocial factor that intensified positive and negative relations between several gaming behaviours and harmful outcomes. Moreover, our results reiterated the heuristic importance of intra- and interpersonally pressured (i.e. obsessive) engagement to explain adverse gaming outcomes as well as self-determined (i.e. harmonious) engagement as a potentially fruitful gateway toward more healthy gaming. These findings constitute solid empirical groundwork that may contribute to effective prevention and intervention methods against problematic gaming.