BackgroundClinical guidelines recommend psychosocial interventions for cocaine and/or amphetamine addiction as first-line treatment, but it is still unclear which intervention, if any, should be offered first. We aimed to estimate the comparative effectiveness of all available psychosocial interventions (alone or in combination) for the short- and long-term treatment of people with cocaine and/or amphetamine addiction.Methods and findingsWe searched published and unpublished randomised controlled trials (RCTs) comparing any structured psychosocial intervention against an active control or treatment as usual (TAU) for the treatment of cocaine and/or amphetamine addiction in adults. Primary outcome measures were efficacy (proportion of patients in abstinence, assessed by urinalysis) and acceptability (proportion of patients who dropped out due to any cause) at the end of treatment, but we also measured the acute (12 weeks) and long-term (longest duration of study follow-up) effects of the interventions and the longest duration of abstinence. Odds ratios (ORs) and standardised mean differences were estimated using pairwise and network meta-analysis with random effects. The risk of bias of the included studies was assessed with the Cochrane tool, and the strength of evidence with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. We followed the PRISMA for Network Meta-Analyses (PRISMA-NMA) guidelines, and the protocol was registered in PROSPERO (CRD 42017042900). We included 50 RCTs evaluating 12 psychosocial interventions or TAU in 6,942 participants. The strength of evidence ranged from high to very low. Compared to TAU, contingency management (CM) plus community reinforcement approach was the only intervention that increased the number of abstinent patients at the end of treatment (OR 2.84, 95% CI 1.24–6.51, P = 0.013), and also at 12 weeks (OR 7.60, 95% CI 2.03–28.37, P = 0.002) and at longest follow-up (OR 3.08, 95% CI 1.33–7.17, P = 0.008). At the end of treatment, CM plus community reinforcement approach had the highest number of statistically significant results in head-to-head comparisons, being more efficacious than cognitive behavioural therapy (CBT) (OR 2.44, 95% CI 1.02–5.88, P = 0.045), non-contingent rewards (OR 3.31, 95% CI 1.32–8.28, P = 0.010), and 12-step programme plus non-contingent rewards (OR 4.07, 95% CI 1.13–14.69, P = 0.031). CM plus community reinforcement approach was also associated with fewer dropouts than TAU, both at 12 weeks and the end of treatment (OR 3.92, P < 0.001, and 3.63, P < 0.001, respectively). At the longest follow-up, community reinforcement approach was more effective than non-contingent rewards, supportive-expressive psychodynamic therapy, TAU, and 12-step programme (OR ranging between 2.71, P = 0.026, and 4.58, P = 0.001), but the combination of community reinforcement approach with CM was superior also to CBT alone, CM alone, CM plus CBT, and 12-step programme plus non-contingent rewards (ORs between 2.50, P = 0.039, and 5.22, P < ...

Introduction: The objective of the current study was to design and pilot-test a nonverbal intelligence test for children and adolescents with visual impairment (i.e., blindness and low vision) aged 10 to 16 years. Method: A three-dimensional haptic matrix test of nonverbal cognitive abilities (3-DHMT-CA), initially developed for adults with visual impairment, was adapted and administered to 25 juveniles with severe low vision or blindness and 25 sighted peers. The test consisted of 22 tactual matrices with a missing element, and juveniles were asked to understand the logical scheme underlying each matrix and to complete it. Convergent validity was assessed in the sighted group with the Standard Progressive Matrices. Divergent validity was measured with the Verbal Comprehension Index (VCI) and the Working Memory Index (WMI) of the Italian version of the Wechsler Intelligence Scale for Children–Fourth Edition. Between-group differences were analyzed with Student’s t-test and ANOVA. Results: Results show a high correlation with the convergent measure (with the Standard Progressive Matrices), and the moderate correlations with divergent measures (VCI and WMI). Between-group differences showed significantly higher scores for sighted peers than juveniles with visual impairment at 3-DHMT-CA, and non-significant differences at VCI and WMI. Discussion: This haptic nonverbal cognitive test showed good psychometric properties, but it needs to be validated in a larger sample with a qualitative analysis of solution strategies because juveniles with visual impairment seem to use different verbal and working memory strategies. Implications for Practitioners: The 3-DHMT-CA and the haptic two-hands modality seem to be suitable to test nonverbal cognitive abilities in juveniles with visual impairment. Practitioners should focus on empowering verbal and working memory abilities, since they may affect nonverbal cognitive abilities as well.