What causes VCD? - VCD Swimmer

Vocal cord dysfunction seems to have many different triggers. The list is long:

Strenuous exercise
Allergies
Reflux
Strong chemical smells
Psychological causes
Puberty and hormones and other physiological causes (almost no one who has not hit puberty has VCD, except for infants with reflux)
Anything that irritates the vocal cords
Many other possible causes that I am not going to talk about on this blog, as these are the triggers that seem to affect my Kidlet the most.

Type A personalities, high achievers (R Cogwell Anderson 2004)
Driven by coaches or parents or self to succeed in sport or school or both (Katherine R. Newsham 2002)
Over-exaggerate importance placed on performance by parents, coaches (Katherine R. Newsham 2002)
Feeling of being outsider on the team (Katherine R. Newsham 2002)
Having anxiety or being anxious ( Ross 2009)
90% or more have insomnia or sleep disorders (ADHD more prone to delayed sleep phase disorder) (VA Varney, J Evans et al. 2009)

Typically diagnosed as adolescent females (Ibrahim, Gheriani et al. 2007)
Worse right before menstrual cycle due to vocal cord edema (Rasor 2009, Sameep Kadakia 2013)
GERD — Infants with reflux have VCD, ruling out psychological causes, and up to 95% of children with VCD have Laryngeal Pharyngeal Reflux (LPR) (Sandage and Zelazny 2004, Ibrahim, Gheriani et al. 2007)
Vagal Nerve Stimulation — People with elliptic seizures disorders being treated with vagal nerve stimulators develop VCD (vagal nerve affected by GERD)(Ibrahim, Gheriani et al. 2007)
Allergies — allergens and post-nasal drip irritate larynx (Ibrahim, Gheriani et al. 2007)
Mouth Breathing — Dries out larynx, “laryngeal hyper-responsiveness initiated by inflammatory insult results in altered autonomic balance which may become persistent. Subsequent stimuli (stress, cold air, exercise) will induce local parasynaptic reflexes causing airway narrowing.” (Ibrahim, Gheriani et al. 2007)