Introduction: The prevalence of high-risk behaviors in women with substance abuse disorders is high due to their high vulnerability to this disorder. This study aimed to investigate the mediating role of resilience in the relationship between metacognitive beliefs and attachment style with high-risk addictive behaviors in women undergoing methadone maintenance treatment.
Methods: The method of the present study was descriptive-correlational with a structural equation approach. The statistical population was women undergoing methadone maintenance treatment at Special Counseling Centers No. 1 and 2 in Kermanshah city in the first half of 2024, of which 240 were selected using convenience sampling. Data collection tools included the Moeini and Ahmadi Risk Behavior Questionnaire (2014), Wells Metacognitive Beliefs (2004), Collins and Reed Attachment Style (1990), and Connor and Davidson Resilience (2003). Data were analyzed using the Pearson correlation coefficient, regression and structural equation modeling with SPSS-28 and Smart PLS-3 software.
Results: The results showed a direct and significant relationship between metacognitive beliefs and attachment style with risky behaviors (P<0.01). Also, resilience has a mediating role between metacognitive beliefs and attachment styles with risky addictive behaviors (P<0.01).
Conclusion: It can be said that negative metacognitive beliefs and insecure attachment styles increase the background for the occurrence of risky behaviors in women with substance abuse disorder. However, high resilience can lead to a decrease in risky behaviors in this group. All mental health professionals are advised to provide the basis for the  prevention and reduction of risky behaviors in women with substance abuse disorder by increasing resilience.