Schema Modes and Addiction Relapse in Methadone-Treated Individuals: The Mediating Roles of Quality of Life and Rumination

Objective: This study aimed to develop a structural model of addiction relapse based on schema modes, with quality of life and rumination as mediating variables among individuals receiving methadone treatment. Methods and Materials: This descriptive-correlational study was conducted using structural equation modeling. The study population included clients undergoing methadone treatment in addiction treatment centers in Qazvin, Iran, in 2025. A total of 310 participants were selected through convenience sampling. Data were collected using the Addiction Relapse Questionnaire, Schema Mode Questionnaire, World Health Organization Quality of Life Questionnaire, and Rumination Questionnaire. Data were analyzed using SPSS version 26 and AMOS. The proposed model was evaluated using structural equation modeling and model fit indices. Findings: The structural model showed acceptable fit indices, including χ²/df = 2.10, RMSEA = .05, CFI = .94, NFI = .91, GFI = .96, and AGFI = .94. Schema modes had a significant positive direct effect on addiction relapse (β = .40, p < .001) and rumination (β = .41, p < .001), while quality of life had a significant negative direct effect on relapse (β = −.34, p < .001). Schema modes also significantly predicted quality of life negatively (β = −.53, p < .001). Indirect effects of schema modes on relapse through rumination (β = .20, p < .001) and quality of life (β = .18, p < .001) were significant. Conclusion: Schema modes, rumination, and quality of life are important psychological factors associated with addiction relapse among individuals receiving methadone treatment. Interventions targeting maladaptive schemas, rumination reduction, and quality-of-life improvement may support relapse prevention.