Adolescent depression: Significant issues in diagnosis and treatment of constricted adolescents

This article examines depression in those adolescents who are constricted emotionally. Specific elements of ego organization are discussed with particular emphasis on loss, grieving, identification, and ego ideal. The authors examine characteristics of such adolescents from a socio-developmental-psychological perspective, utilizing data from the cases of two patients who presented remarkably differing profiles. In terms of treatment, differences in therapeutic style are illustrated to reflect the distinct levels of personality organization achieved by each of the patients. Constricted youth are distinguished from those youngsters who are depressed but are more typically oppositional and negativistic, and reveal a long standing history of chronic acting out.