Kirstin Greaves-Lord

• PhD
• Professor at Erasmus University Rotterdam

Previous studies showed an impact of autism on the child’s quality of life and societal costs, although little is known about changes from pre- to post-diagnosis. Therefore, our study explored the utilization of health-related services and associated costs in a group of 36 clinically referred Dutch children with autism (aged 2–10 years), pre- and p...

The purpose of this study was to investigate whether face-to-face and therapist-assisted online (i.e., blended) behavioral parent training are effective on reducing disruptive behaviors in children with autism spectrum disorder (ASD) in routine mental health care. Ninety-seven children with ASD (4–13 years; 76 boys) were randomized to face-to-face...

People with an autism spectrum disorder (ASD) regularly struggle with issues in sensory processing, interoception, and self-regulation. This can contribute to the development of anxiety, depression, and burnout. Moreover, there is an overlap in the symptomatology of ASD and post-traumatic stress disorder (PTSD) (Stavropoulos et al., 2018). This is...

We evaluated the collaboration between autistic people, their relatives/proxies, care-/educational professionals and researchers within the project groups of the Academic Workplace Autism 2.0 through participatory action research combined with thematic analyses. We identified six themes that are of importance for successful collaboration with exper...

In this study, we investigated 1) from which sources adolescents (with and without ASD) received information regarding sex, 2) to what extend parents and adolescents differed in how they reported about the received information on sex and from which sources, and 3) whether there were differences between adolescent with and without ASD. From the resu...

This study aims to compare the experiences of women and men of different age groups with regard to their first autism spectrum disorder (ASD) diagnosis, symptoms, treatment, and gender roles to inform our understanding in clinical practice of differences as well as similarities. Semi-structured interviews were conducted amongst 22 women (n = 12) an...

We developed a Dutch questionnaire called the Autistic Women’s Experience (AWE) and compared its psychometric properties to the Autism Spectrum Quotient (AQ). Whilst attenuated gender differences on the AQ have been widely replicated, this instrument may not fully capture the unique experience of autistic women. The AWE was co-developed with autist...

The goal of this study was to translate and adapt the original 9-item of the Contextual Assessment of Social Skills (CASS) to a Dutch version and assess its psychometric qualities. Autistic adolescents aged 12 to 18 years (n = 99) took part in a randomized controlled trial. In this study, pre-intervention data were utilized. The original CASS was a...

Psychosexual functioning is an important aspect of human development and relationships. A previous study investigated psychosexual functioning of autistic adolescents using the Teen Transition Inventory (TTI), but there is a lack of comprehensive measurement of psychosexual functioning among autistic and non-autistic (NA) adults. To address this ga...

To explore associations between autism traits and family functioning over time, we studied longitudinal data of a mixed group of 168 clinically referred autistic and non-autistic children. Cross-lagged models showed a significant association between fewer autism traits at the diagnostic assessment and better family functioning 1 year later for the...

The current study evaluated a brief, informant-based autism interview: the Developmental, Dimensional and Diagnostic Interview – Adult Version (3Di-Adult). Feasibility, reliability and validity of the Dutch 3Di-Adult was tested amongst autistic participants (n = 62) and a non-autistic comparison group (n = 30) in the Netherlands. The 3Di-Adult cons...

There is an ongoing debate as to whether autism spectrum disorder (ASD) is expressed differently in women than men. It is unclear whether differences found are specific to autism or merely reflecting normative development. In this study, we compared sex differences in developmental trajectories of autistic and co-occurring psychopathological sympto...

Problems with identity development probably aff ect wellbeing in autistic people through camouflaging behavior and associations with self-concept, self-acceptance and meaning of life. To improve our understanding of the process of identity development within autistic people, interviews were conducted with n=14 participants. Participants narrated ab...

Background Young people with a psychotic disorder have the same social goals as their healthy peers, but their social networks are smaller, they participate less often in leisure activities and are less successful in work and education. Causes of these problems are multifaceted, but culminate in difficulties with interacting in daily life social si...

Despite the established need for sexuality and relationship programming for autistic adults, there are extremely limited curricula for this population. This pilot study used an evidence-based sexuality and relationship education program for autistic adolescents (Tackling Teenage Training) as the basis for an adult-focused virtual psychoeducational...

Background This article aims to explain and elaborate upon the recently released ICD-11 criteria for Autism Spectrum Disorder (ASD, World Health Organization), which endorse a medical model. Method We integrate insights from several disciplines (e.g., psychology, linguistics, sociology and lived experiences) to reflect the scientific and ethical i...

Ideal friend and romantic partner characteristics related to self-perceived characteristics have been investigated in typically developing (TD) individuals, but not in individuals with autism spectrum disorder (ASD). Considering the autistic symptoms and challenges, investigating these concepts in autistic individuals is relevant. Given the lack of...

Background Social cognitive difficulties in Autism Spectrum Disorder (ASD) can affect the daily lives of people with ASD profoundly, impacting the development and maintenance of meaningful social relations. Social cognition training (SCT) is commonly used for improving social functioning, but lacks ecological validity and the ability to effectively...

Background Children with Autism Spectrum Disorder (ASD) and Attention‐Deficit/Hyperactivity Disorder (ADHD) have an increased obesity risk. Although these conditions commonly co‐occur, shared factors relating to obesity risk are unknown. Objectives To examine the shared and unique associations of ADHD and autistic traits with eating behaviours and...

Objective The etiology of autism spectrum disorder (ASD) remains unclear, due to genetic heterogeneity and heterogeneity in symptoms across individuals. This study compares ASD symptomatology between monogenetic syndromes with a high ASD prevalence, in order to reveal syndrome specific vulnerabilities and to clarify how genetic variations affect AS...

Background This study examines the effectiveness of the culturally adapted Dutch version of The Program for the Education and Enrichment of Relational Skills (PEERS®), utilizing a randomized control trial (RCT) with an active treatment control condition. Methods 106 adolescents with ASD, aged 12–18 years, were randomly assigned to one of two group...

Background & Aims: Disorganized speech (DS) refers to the failure to communicate coherently. Children with autism spectrum disorder (ASD) show disorganized speech, such as abrupt topic changes. Disorganized speech can be explained by 1) social pragmatic communication difficulties (SPCD) or 2) social cognition problems (SCP). Methods: We tested whet...

This study investigates the relationship between the perceived stress of parents with a child with (characteristics of) an autism spectrum disorder (ASD) and the degree of ASD characteristics within parents. Data from 222 children (mean age 7.8 years) and their primary caregivers, previously collected as part of the Social Spectrum Study, were anal...

This study investigated the association of child, caregiver, and caregiving measurements with the quality of life (QoL) in 81 caregivers (mostly parents) of clinically referred children with autism spectrum disorder (ASD). We used the EuroQol five-dimensional (EQ-5D) questionnaire and the care-related QoL questionnaire (CarerQol) to respectively as...

Background: Social skills interventions are commonly deployed for adolescents with autism spectrum disorder (ASD). Because effective and appropriate social skills are determined by cultural factors that differ throughout the world, the effectiveness of these interventions relies on a good cultural fit. Therefore, the ACCEPT study examines the effec...

The content of interventions targeting social behavior is sensitive to cultural differences in etiquette and societal customs. Here we describe (1) the process of linguistic and cultural adaptation of the PEERS® social skills program to the Dutch language and culture, and (2) the results from a preliminary adaptation test among 32 adolescents (12–1...

We compared the presence of autistic and comorbid psychopathology and functional impairments in young adults who received a clinical diagnosis of Pervasive Developmental Disorders Not Otherwise Specified or Asperger’s Disorder during childhood to that of a referred comparison group. While the Autism Spectrum Disorder group on average scored higher...

Background: Social skills interventions are commonly deployed for adolescents with autism spectrum disorder (ASD). Because effective and appropriate social skills are determined by cultural factors that differ throughout the world, the effectiveness of these interventions relies on a good cultural fit. Therefore, the ACCEPT study examines the effe...

Growing up in an urban area has been associated with an increased chance of mental health problems in adults, but less is known about this association in adolescents. We examined whether current urbanicity was associated with mental health problems directly and indirectly via biological stress system functioning. Participants (n = 323) were adolesc...

Background: Urbanization is steadily increasing worldwide. Previous research indicated a higher incidence of mental health problems in more urban areas, however, very little is known regarding potential mechanisms underlying this association. We examined whether urbanicity was associated with mental health problems in children directly, and indire...

This study investigated health-related QoL (HRQoL) and care-related quality of life (CarerQol) in clinically referred children with an autism spectrum disorder (ASD), and their primary and secondary caregivers. The EuroQol five-dimensional (EQ-5D) and the CarerQol questionnaires were used to respectively measure health-related QoL and care-related...

The private nature of psychosexual functioning leads adolescents and their parents to have different perspectives, which highlights studying parent–child informant discrepancies in this domain. We investigated informant discrepancy in psychosexual functioning, using the self‐report and parent report versions of the Teen Transition Inventory (TTI),...

Dysregulated physiological stress reactivity has been suggested to impact the development of children and adolescents with important health consequences throughout the life span. Both environmental adversity and genetic predispositions can lead to physiological imbalances in stress systems, which in turn lead to developmental differences. We invest...

Background: Although a bidirectional relationship between autism spectrum disorder (ASD) and anxiety symptoms is assumed, few studies have investigated this. Moreover, little is known about potential differential relationships of the two core symptom domains of ASD - social communication impairment and restricted, repetitive behavior - with anxiet...

To gain further insight into psychosexual functioning, including behaviors, intrapersonal and interpersonal aspects, in adolescents with Autism Spectrum Disorder (ASD), comprehensive, multi-informant measures are needed. This study describes (1) the development of a new measure of psychosexual functioning in both parent- and self-reports (Teen Tran...

Background Inappropriate sexual behaviour, sexual problems and sexual victimization in adolescents with autism spectrum disorders (ASD) is regularly reported in previous research, but little is known about factors associated with these problems, nor about factors associated with a healthy sexuality development in adolescents with ASD. Investigating...

Background: Previous research underscores the importance of psychosexual guidance for adolescents with autism spectrum disorder (ASD). Such guidance is provided in the Tackling Teenage Training (TTT) program, in which adolescents with ASD receive psycho-education and practice communicative skills regarding topics related to puberty, sexuality, and...

This paper provides an overview of the design and cohort characteristics of the Social Spectrum Study: a clinical cohort study that used a two-phase sampling design to identify children at risk for ASD. After screening 1281 children aged 2.5–10 years who had been consecutively referred to one of six mental health services in the Netherlands, childr...

In order to shed more light on why referred girls are less likely to be diagnosed with autism spectrum disorder than boys, this study examined whether behavioral characteristics influence the probability of an autism spectrum disorder diagnosis differently in girls versus boys derived from a multicenter sample of consecutively referred children age...

The Developmental Diagnostic Dimensional Interview-short version (3Di-sv) provides a brief standardized parental interview for diagnosing autism spectrum disorder (ASD). This study explored its validity, and compatibility with DSM-5 ASD. 3Di-sv classifications showed good sensitivity but low specificity when compared to ADOS-2-confirmed clinical di...

Background: Exposure to elevated levels of inflammatory markers during pregnancy has been suggested as possible aetiologic factor in the occurrence of autism spectrum disorder (ASD). In this study, we investigated the prospective relation between maternal C-reactive protein (CRP) during early pregnancy and children's autistic traits in the general...

Objective: Youth who report risky substance use and who have a familial history of substance use disorders (SUDs) are at increased risk for developing SUDs themselves later in life. Physiological stress reactivity may be a potential biological mechanism underlying this increased risk. In the current study, we examined (a) whether physiological str...

Background: In order to shed more light on the frequent co-occurrence of Autism Spectrum Disorder (ASD) and anxiety in children, the aims of the study were (a) to examine whether ASD and anxiety share familial transmission indicated by cross-symptom associations between parental and children's symptoms (e.g., parental anxiety predicting children's...

The current 7-year follow-up study investigated: (1) the stability of ASD severity, and (2) associations of ASD severity in adolescence with (a) childhood and concurrent psychiatric comorbidity, and (b) concurrent societal functioning. The Autism Diagnostic Observation Schedule (ADOS) and the Diagnostic Interview Schedule for Children were administ...

The current study was a 7-year follow-up of 74 6-12 year old children with Pervasive Developmental Disorder-Not Otherwise Specified. We examined the rates and 7 year stability of comorbid psychiatric diagnoses as ascertained with the Diagnostic Interview Schedule for Children: Parent version at ages 6-12 and again at ages 12-20. Also, we examined c...

Background: Previous research shows that adolescents with autism spectrum disorder (ASD) run several risks in their psychosexual development and that these adolescents can have limited access to reliable information on puberty and sexuality, emphasizing the need for specific guidance of adolescents with ASD in their psychosexual development. Few s...

Individuals with autistic traits are considered to be prone to develop psychosexual problems due to their limited social skills and insight. This study investigated the longitudinal relation between autistic traits in childhood (T1; age 10-12 years) and parent-reported psychosexual problems in early adolescence (T2; age 12-15 years). In a general p...

Children of parents with a substance use disorder (CPSUD) are at increased risk for developing problematic substance use later in life. Endophenotypes may help to clarify the mechanism behind this increased risk. However, substance use and externalizing symptoms may confound the relation between dysregulated physiological stress responding and fami...

Previous research suggests that individuals with autism spectrum disorder (ASD) show a detail-focused cognitive style. The aim of the current longitudinal study was to investigate whether this detail-focused cognitive style in childhood predicted a higher symptom severity of repetitive and restrictive behaviors and interests (RRBI) in adolescence....

Limited accuracy and speed in facial recognition (FR) and in the identification of facial emotions (IFE) have been shown in autism spectrum disorders (ASD). This study aimed at evaluating the predictive value of atypicalities in FR and IFE for future symptom severity in children with ASD. Therefore we performed a seven-year follow-up study in 87 ch...

The screening accuracy of the parent and teacher-reported Social Responsiveness Scale (SRS) was compared with an autism spectrum disorder (ASD) classification according to (1) the Developmental, Dimensional, and Diagnostic Interview (3Di), (2) the Autism Diagnostic Observation Schedule (ADOS), (3) both the 3Di and ADOS, in 186 children referred to...

Previous studies have shown that psychosexual functioning in adolescents with autism spectrum disorder (ASD) is hampered and emphasize the need for a specialized training program tailored to their needs. Therefore, an individual training program was developed; the Tackling Teenage Training (TTT) program. The current pilot study systematically evalu...

Background: Information on psychosexual functioning in adolescents with autism spectrum disorder (ASD) is scarce, especially when considering self-reported information. Moreover, the assessment of psychosexual functioning is complex, since psychosexual functioning is a multi-facet concept, not only covering sexual behaviours, but also knowledge, i...

Formal thought disorder (FTD) is a disruption in the flow of thought, which is inferred from disorganisation of spoken language. FTD in autism spectrum disorders (ASD) might be a precursor of psychotic disorders or a manifestation of ASD symptom severity. The current longitudinal study is a seven-year follow-up of 91 individuals aged 5-12 years wit...

It remains unclear why individuals with autism spectrum disorder (ASD) tend to respond in an atypical manner in social situations. Investigating autonomic and subjective responses to social vs. nonsocial stimuli may help to reveal underlying mechanisms of these atypical responses. This study examined autonomic responses (skin conductance level and...

Although P300 amplitude reductions constitute a persistent finding in children of addicted parents, relatively little is known about the specificity of this finding. The major aim of this study was to investigate the association between parental rearing, adverse life events, stress-reactivity, substance use and psychopathology on the one hand, and...

Limited quality of social relations, milder symptom severity and higher intelligence were shown to account for higher anxiety levels in autism spectrum disorders. The current study replicated and extended earlier findings by combining these three determinants of anxiety in autism spectrum disorders in one study. The sample consisted of 134 school-a...

Risky decision making, a hallmark phenotype of substance use disorders (SUD), is thought to be associated with deficient feedback processing. Whether these aberrations are present prior to SUD onset or reflect merely a consequence of chronic substance use on the brain remains unclear. The present study investigated whether blunted feedback processi...

This study evaluated the ability of the Child Behavior Checklist and the Teacher’s Report Form to identify children with autism spectrum disorders (ASD), using a sample of children with ASD (n = 458), referred children without ASD (n = 1109) and children from the general population (n = 999). A ten items ASD scale was constructed using half of the...

It has been suggested that atypical eye contact of individuals with autism spectrum disorders (ASDs) arises from an unusually high level of autonomic activity elicited by another person's gaze. The present study investigated visual fixation duration and autonomic reactivity (heart rate, skin conductance response) simultaneously, while adolescents l...

Samenvatting Met de komst van de DSM-5, is de aanwezigheid van repetitief gedrag volgens minimaal twee criteria voorwaarde voor de diagnose autismespectrumstoornis (ASS). Onder clinici en ouders leven daarom zorgen dat door deze verandering, met name mensen met stoornis van Asperger of pervasieve ontwikkelingsstoornis – niet anderszins omschreven (...

Background: Children of parents with a substance use disorder (CPSUDs) are at increased risk for the development of substance use disorders later in life, and therefore may manifest vulnerability markers for these disorders at a higher level than children from the general population. Our aim was to examine hypothalamic-pituitary-adrenal (HPA) axis...

The present study examined the role of parental rearing behavior in adolescents' risky decision-making and the brain's feedback processing mechanisms. Healthy adolescent participants (n = 110) completed the EMBU-C, a self-report questionnaire on perceived parental rearing behaviors between 2006 and 2008 (T1). Subsequently, after an average of 3.5 y...

Abnormal physiological stress reactivity is increasingly investigated as a vulnerability marker for various physical and psychological health problems. However, studies are inconsistent in taking into account potential covariates that may influence the developing stress system. We systematically tested determinants (individual, developmental, envir...

The Child Behavior Checklist Dysregulation Profile (DP) in youth has been shown to be a predictor of psychopathology later in life. We examined the activity of the Hypothalamic Pituitary Adrenal (HPA) axis in youth with remitted, new, persistent, and no DP. Data from 489 youth (47% boys) participating in a Dutch longitudinal general population stud...

This study aimed to contribute to the Diagnostic and Statistical Manual (DSM) debates on the conceptualization of autism by investigating (1) whether empirically based distinct phenotypic profiles could be distinguished within a sample of mainly cognitively able children with pervasive developmental disorder (PDD), and (2) how profiles related to d...

Evidence suggests that some developmental disorders, such as autism spectrum disorders (ASDs), are caused by errors in brain plasticity. Given the important role of matrix metalloproteinases (MMPs) and neurotrophins (NTs) in neuroplasticity, amniotic fluid samples for 331 ASD cases and 698 frequency-matched controls were analyzed for levels of MMP-...

One of the core features of individuals with a substance-use disorder (SUD) is the reduced ability to successfully process errors and monitor performance, as reflected by diminished error-related negativities (ERN). However, whether these error-related brain abnormalities are caused by chronic substance use or rather predates it remains unclear. Th...

Objective: To examine levels of 3 neurotrophic factors (NTFs): Brain derived neurotrophic factor (BDNF), Neurotrophin-4 (NT-4), and transforming growth factor-β (TGF-β) in dried blood spot samples of neonates diagnosed with autism spectrum disorders (ASD) later in life and frequency-matched controls. Method: Biologic samples were retrieved from...

Background: Few studies have investigated physiological stress (re)activity in relation to substance use, especially in adolescents. Using substances is one way to stimulate physiological arousal, therefore inherent hypo-arousal may be associated with substance use in adolescents. The purpose of this study was to examine the relation of autonomic...

Background: In concert with many neuropathological findings and accumulating lines of research suggesting that synaptic pathways are disrupted in some cases of autism spectrum disorders (ASD), abnormal formation of neuronal connections or elimination of inappropriate connections have been postulated to play a crucial role in the onset of ASD. Mat...

Adolescence is a critical developmental period regarding exposure to substances. Therefore, it is important to be able to identify those adolescents who are most vulnerable to substance abuse in the (near) future. The JOiN study was specifically designed to examine two endophenotypes of adolescent substance use in a normal risk (NR) and high risk (...

Aims HPA axis activity may prove a viable biomarker for identifying those susceptible to alcohol use disorders. The purpose of this study was to examine the relation of the age at which adolescents begin drinking with diurnal and stress cortisol. Design Adolescents’ diurnal cortisol levels on a normal day and cortisol levels during a stress procedu...

Endophenotypes are intermediate phenotypes on the putative causal pathway from genotype to phenotype and can aid in discovering the genetic etiology of a disorder. There are currently very few suitable endophenotypes available for substance use disorders (SUD). The amplitude of the P300 event-related brain potential is a possible candidate. The pre...

Hypothalamic-pituitary-adrenal (HPA) axis activity may prove a viable biomarker for identifying those susceptible to alcohol use disorders. The purpose of this study was to examine the relation of the age at which adolescents begin drinking with diurnal and stress cortisol. Adolescents' diurnal cortisol levels on a normal day and cortisol levels du...

The aim was to identify risk indicators from preadolescence (age period 10-12) that significantly predict unfavorable deviations from normal anxiety development throughout adolescence (age period 10-17 years). Anxiety symptoms were assessed in a community sample of 2,220 boys and girls at three time-points across a 5-year interval. Risk indicators...

To investigate the relationship of life-time and repeated cannabis use with hypothalamic-pituitary-adrenal (HPA) axis reactivity to social stress in a general population sample of adolescents. Adolescents who reported life-time or repeated cannabis use, life-time or repeated tobacco use and never use of either cannabis or tobacco were compared with...

No abstract available.

The present study investigated whether autonomic flexibility predicted future anxiety levels in adolescent boys and girls. This study is part of the TRacking Adolescents' Individual Lives Survey (TRAILS), a prospective cohort study of Dutch adolescents. The current study included a subsample of 965 individuals. Measures of autonomic flexibility, i....

We examined within a prospective longitudinal study whether cortisol levels were associated with smoking or drinking behaviours, taking parental substance use into account. The influence of parental substance use on cortisol levels of their adolescent offspring at age 10-12 years was examined. Next, cortisol levels of adolescents who initiated smok...

This study investigated whether baseline cortisol measures predicted future anxiety, and compared cortisol values of groups with different developmental pathways of anxiety. Cortisol levels were assessed in 1768 individuals (10-12 years). Anxiety levels were assessed at the same age and 2 years later. Cortisol measures did not predict future anxiet...