ABSTRACT Aim This study aimed to evaluate the relationship between metacognition, difficulties in emotion regulation, and level of addiction severity in individuals with substance use disorder. Methods This cross-sectional study was carried out with 121 participants at the Alcohol and Drug Addicts Treatment and Research Center between February and June 2023. The data were collected using the Metacognition Questionnaire-30 (MTQ-30), Difficulties in Emotion Regulation Scale-Brief Form (DERS-16), and Addiction Profile Index (API). Results All the participants were male and polysubstance users; the age of the onset of substance use was 16.43 ± 5.95; they had been receiving treatment for addiction for an average of 1.79 ± 2.16 years. There was a strong positive significant correlation between the mean total MTQ-30 score and the mean total DERS-16 and API scores (r = .704, p < .001; r = .776, p < .001) and a moderate positive significant correlation between the mean total DERS-16 score and the mean total API score (r = .628, p < .001). It was determined that metacognition had an effect at a rate of 60.3% and difficulty in emotion regulation had an effect at a rate of 39.5% on the addiction severity of individuals. Conclusion Addiction severity was found to increase as the levels of metacognitive impairment and difficulty in emotion regulation increased.
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