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Multiple self-images held by 58 adolescents were studied using a specially developed Q-sort technique. A perceptual-cognitive process, psychological differentiation, was also followed. Results suggest that "realms" of self-image are selectively influenced by psychopathology, age, and sex. Patient-adolescents perceived greater discrepancy between all idealized views of themselves and their current self-images (lower correlations). But temporal self-images and peer self-images differentiated only between sex and age groups. A further sex difference finding was on the psychological differentiation measure. Findings are discussed in terms of psychoanalytic theories of adolescent development, particularly with reference to ego ideal. It is also argued that a psychoanalytic framework alone cannot account for the sex differences, which may be reflecting important cultural trends. Finally, the finding that patients have a lower overall integration of self-images is discussed in terms of "identity diffusion."