Exploring perfectionism in youth with Vocal Cord Dyskinesia

Pediatric Vocal Cord Dyskinesia (VCD) is frequently diagnosed in high-achieving youth. However, perfectionism traits in this population remain unquantified.

We sought to determine if our VCD population demonstrates high levels of perfectionism and to examine the relationship between perfectionism and clinical and demographic variables.

Setting, and Participants: Prospective observational cohort study conducted from January 2022 to July 2025 at a tertiary care multidisciplinary pediatric VCD clinic. Participants included 40 consecutive patients diagnosed with VCD.

Perfectionism was measured using the Child and Adolescent Perfectionism Scale (CAPS), with domains of self-oriented perfectionism (SOP) and socially prescribed perfectionism (SPP). Z-scores were generated using age- and gender-matched normative data and considered elevated if Z ≥ 1 standard deviation above normative means. Secondary measures included demographics and clinical and diagnostic characteristics.

Subjects had a mean age of 13.8 years (SD = 2.9), and 75% were female. The median SOP Z-score was 0.88 (interquartile range [IQR] 0.06 to 1.69), and the median SPP Z-score was -0.54 (IQR -1.16 to 0.37). Elevated SOP (Z ≥ 1) was present in 50% of patients, and 7.5% demonstrated elevated SPP. Overall, 52.5% of patients exhibited elevation in at least one perfectionism domain. Elevated SOP was associated with diagnostic delays and lower emergency room utilization (p < .05).

This pediatric VCD cohort demonstrated a distinct perfectionism profile, with over half of subjects exhibiting clinically elevated perfectionism compared to age- and gender-matched normative data. These findings support the use of psychometric profiling to guide individualized treatment strategies, with attention to underlying perfectionistic traits and suggest a potential shift in management toward addressing internal cognitive frameworks alongside external stressors to improve long-term outcomes.