Parallel Change Processes in Envy and the Patient–Therapist Relationship During Psychodynamic Group Psychotherapy

Parallel Change Processes in Envy and the Patient–Therapist Relationship During Psychodynamic Group Psychotherapy | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Parallel Change Processes in Envy and the Patient–Therapist Relationship During Psychodynamic Group Psychotherapy Aleksandra Ściegienny-Lemler, Michał Mielimąka, Patrycja Jęda-Mielimąka, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9332763/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 5 You are reading this latest preprint version Abstract Objectives The study focuses on envy as a complex interpersonal affect. It examines variability in patients’ levels of personality organisation, envy, and the therapist-patient relationship in psychodynamic group process. Design : Conducted between 2022 and 2024, the study included a sample of 164 patients treated in 3 half-opened therapeutic groups, the majority of whom were diagnosed with personality or anxiety disorders. Methods The following instruments were used: the Inventory of Personality Organisation (IPO-PL), the Neurotic Personality Questionnaire (NPQ), and the Scale to Assess Therapeutic Relationship (STAR). Results Linear mixed-effects analyses (LMM) were conducted. Regarding personality organisation there were no statistically significant differences across the three therapeutic groups. In all therapy groups the leader–member therapeutic relationship strengthened, and envy levels declined significantly, with modest differences in change trajectories between groups. Conclusions The findings suggest parallel and partially independent change processes, which is of considerable clinical relevance. group psychotherapy envy personality organisation leader–member relationship psychodynamic therapy 1. Introduction 1.1 The therapist-patient relationship change across psychotherapy process Meta-analytic evidence indicates that the therapist-patient relationship is a significant predictor of outcomes in group psychotherapy, although its impact appears to be somewhat weaker than that of group cohesion (Alldredge et al., 2021 ). The stage of group development, along with the overall group climate, significantly influences the nature of ruptures and their repair in the psychotherapy process. In the initial phase of the group, participants tend to prioritise psychological safety and approach interactions with caution (Yalom & Leszcz, 2020 ). Such a phenomenon can also be observed in semi-open therapeutic groups, where there is a phase of getting to know one another and building interactions during the rotation of patients. Ruptures at this stage are often linked to problems with adherence to group rules, challenges to authority, and misunderstanding the group process. Observing the rupture-repair dynamics during the whole treatment - both among group members and in relationships outside the group - can help foster increased self-compassion, deeper relationship satisfaction, and greater empathy (Marmarosh, 2021 ). Alliance ruptures can be understood as breakdowns in the therapeutic process involving difficulties in meeting fundamental needs for autonomy and connection (Muran & Eubanks, 2020 ). Contemporary interpersonal psychotherapy models frame these needs along the orthogonal dimensions of dominance and warmth (Wright et al., 2021 ). Thus, confrontation ruptures are more likely to involve cold and dominant behaviours, whereas withdrawal ruptures tend to manifest through cold and submissive interpersonal strategies. These phenomena, related to personality-based interpersonal dynamics, represent central mechanisms of therapeutic change (Zilcha-Mano & Muran, 2024 ). According to Marmarosh ( 2021 ), analysing ruptures within the transference–countertransference dynamic provides valuable insight into how early childhood experiences shape an individual’s psychological development and patients capacity for change. The way in which relationships are formed with other group members will mirror the manner in which they are formed with the therapist (Castonguay & Beutler, 2006 ; Constantino et al., 2018 ). Taken together, these findings indicate that the therapist-patient relationship is not a static characteristic of treatment but a dynamic process that evolves during the phases of group psychotherapy. This temporal variability suggests longitudinal changes in not only the leader–member relationship, but also in rupture–repair processes. 1.2. Envy as a factor of change Envy is commonly defined as a negative emotional response, encompassing psychological, cognitive, motivational, and behavioural states (Scherer & Moors, 2019 ), and is triggered when individuals perceive themselves as lacking a valued attribute possessed by someone else (Miceli & Castelfranchi, 2007 ; Smith & Kim, 2007 ). These psychological emotional states are particularly pronounced when the envied individual is perceived as similar to the self, heightening the sense of personal relevance and comparison (Henniger & Harris, 2015 ). Envy is not merely a fleeting emotion; it can persist over time, grow in complexity (Hoogland, Thielke, & Smith, 2017 ), and evolve into other emotional states (Lange, Weidman & Crusius, 2018 : Smith, 2004 ). A recent longitudinal study (Erz & Rentzsch, 2024 ) demonstrated that both global and domain-specific dispositional envy is relatively stable across a six-year period. Within a psychodynamic approach, permanent low self-esteem reflects deficits in ego integration and internal object relations, resulting in an increase in envy. Consistent with this perspective, longitudinal evidence indicates that lower self-esteem prospectively predicts an increase in dispositional envy over time (Erz & Rentzsch, 2024 ). This change suggests that structural depreciation in personality organisation predisposes individuals to develop envy as a defensive and relational affect. Although dispositional envy shows relative temporal stability, longitudinal and clinical evidence suggests that it may be altered by specific relational and intrapsychic conditions. Psychotherapy group contexts may create conditions under which envy-related affects can be transformed. Thus, changes in the level and quality of dispositional envy may be expected to occur over the course of group psychotherapy. 1.3. Personality organisation and psychotherapy outcomes The meta-analysis by Bucher et al. ( 2019 ) emphasises the clinical importance of personality evaluation for case conceptualization and treatment planning. It suggests that personality traits are related to psychotherapy outcomes, for example agreeableness can be positively associated with therapeutic alliance. Shir and Tishby (2024) maintain that in short-term dynamic therapy, similarity between the leader–member therapeutic relationship in personality traits such as neuroticism and conscientiousness, or in attachment style, contributes to better relational matching and more favourable therapeutic outcomes. Contemporary research conceptualizes levels of personality organisation according to differences in identity integration versus identity diffusion, the predominance of primitive defence mechanisms, and the integrity of reality testing. At the borderline (Kernberg & Michels, 2009 ; Leichsenring, 2023) or psychotic organisation level (Kernberg,2019), identity becomes more fragmented and dominated by primitive defences, while reality testing becomes increasingly impaired. At the neurotic or healthy organisation level, identity is integrated, defences are more mature, and reality testing remains stable (Csáky-Pallavicini et al., 2025 ). Patients diagnosed with borderline personality disorder may demonstrate weaker early therapeutic alliances compared to those with other personality disorders (Prusiński,2023). These findings suggest that certain personality disorders may pose greater challenges in establishing a strong therapeutic bond and achieving agreement on goals. While personality organisation represents a relatively enduring structural characteristic, contemporary psychodynamic perspectives in Transference-Focused Psychotherapy posit that core aspects of identity integration, defensive functioning, and affect regulation can improve through sustained therapeutic engagement. Through repeated interactions, participants can test their perceptions of self and others against the reactions of multiple group members, creating opportunities for reality testing and corrective emotional experiences that challenge maladaptive internal models (Yalom & Leszcz, 2020 ). These considerations justify the expectation that measurable changes in personality organisation can occur across different phases of group psychotherapy treatment. This study aimed to examine direct longitudinal changes in dispositional envy, and the leader–member therapeutic relationship across three time points (pre-, mid-, and post-treatment) in group psychotherapy as well as analyse variation in personality organisation across three different psychotherapy groups. Hypothesis 1 Levels of personality organisation will differ across treatment conditions. Hypothesis 2 The level of envy will decrease over the course of treatment. Hypothesis 3 The leader–member therapeutic relationship will strengthen over the course of treatment. 2. Methods 2.1. Participants This study was conducted between 2022 and 2024 at the Day Treatment Unit. Participants engaged in semi-open therapeutic groups, each comprising 10 members. All patients underwent a 12-week treatment program, which included 72 hours of group psychotherapy, where two therapists co-leading the group alternately, 12 hours of individual therapy, and up to 48 hours of optional workshop-based sessions. The therapeutic approach was mostly psychodynamic. Patients were referred to group therapy by clinical psychologists and psychiatrists. During the screening and qualification process, individuals diagnosed with psychotic disorders, active substance use disorders, or neurological impairments impacting cognitive function were excluded. Out of 231 patients who agreed to participate, 67 were disqualified due to discontinuation of treatment or incomplete assessment data, leaving a final sample of 164 individuals: 96 women (58.5%) and 68 men (41.5%). The majority were Polish nationals, aged between 18 and 60 years (M = 35.5, SD = 10.5). Most participants had completed higher education, either a bachelor’s or master’s degree (n = 98), or secondary education (n = 61), while 3.5% (n = 4) had primary education, and one participant held a doctoral degree. Alongside psychotherapy, the majority of patients (n = 101) also received pharmacological treatment, mainly antidepressants and anxiolytics, including SSRIs (Selective Serotonin Reuptake Inhibitors), SNRIs (Serotonin–Norepinephrine Reuptake Inhibitors), and mood stabilizers. Most of these patients were prescribed more than one medication. Hydroxyzine was the most frequently used drug (n = 14), followed by venlafaxine (n = 13) and sertraline (n = 12). Pregabalin and escitalopram were each taken by 11 patients, trazodone by 8, and lamotrigine by 4. Fluoxetine was used by 3 patients, bupropion by 2, and several medications were taken by only one patient each, including tianeptine, citalopram, vortioxetine (antidepressants), propranolol (anxiolytic), valproic acid, methylphenidate, atomoxetine (ADHD treatments), chlorprothixene, quetiapine (low-dose anxiolytic), and levetiracetam (antiepileptic). The therapeutic methods employed were consistent with standard care practices for patients with neurotic and/or personality disorders. These practices, as described by Mielimąka et al. ( 2015 ), involve treating patients with psychotherapy using methods such as clarification, confrontation, and both present-focused and genetic interpretations, with the therapist's intervention limited to a minimum. Pharmacotherapy, mainly targeting anxiety and mood symptoms, is used on the ward when necessary, and doses are reduced whenever possible. The study was approved by the Bioethics Committee (approval no. 1072.6120.244.2022, issued on November 16, 2022). The dataset used in this study has been partially reported elsewhere; however, the current analyses address different research questions and employ a longitudinal process-oriented approach. Each patient participated in a semi-open psychotherapy group for approximately sixty working days. Only individuals who provided written informed consent were included in the study, and all participants were informed of their right to withdraw at any time. To ensure anonymity, participants were assigned unique, randomly generated codes for confidential completion of the test battery. At the beginning of treatment, participants completed the IPO-PL, and at the beginning, in the middle and at the end NPQ, and STAR-P questionnaires. 2.2. Data collection The questionnaires described below were administered during treatment to test the study hypothesis. The Inventory of Personality Organisation IPO questionnaire comprises 83 items and incorporates three clinical scales - reality testing ability (Reality Testing, 20 items), defense mechanisms used (Primitive Defenses, 16 items), and degree of identity integration (Identity Diffusion, 21 items) - as well as two additional scales: the aggression scale (18 items), and the moral values scale (11 items). The clinical scales help diagnose the level of personality organisation, while the additional scales characterise superego pathology or different forms of aggression, including initiating aggression toward others, aggressive responses to provocation from others, and self-directed aggression. All items are rated on a 5-point Likert scale (1 – never true, 5 – always true). In the Polish adaptation for IPO, Cronbach's alpha for the scales range from 0.78 to 0.91 (Izdebska and Pastwa-Wojciechowska, 2013 ). The Neurotic Personality Questionnaire (NPQ) includes 243 items, each requiring a clear "yes"/"no" response. Of these, 240 items contribute to 24 different scales, ranging in length from 8 to 20 items, with most scales (20 out of 24) containing at least 11 items. Some items are included in multiple scales, with diagnostic value varying according to response direction (either "yes" or "no"). Specifically, 4 items appear on four different scales, 15 on three scales, and 46 on two scales. Internal consistency, as measured by Cronbach’s alpha, ranges from 0.65 to 0.88 (Aleksandrowicz et al., 2006). In the present study, all items from the ‘envy’ scale from NPQ were used to operationalise the level of envy. Envy was characterized by questionnaire scales feelings of frustration in response to other people’s achievements and by a tendency to devalue others. The ‘envy’ scale consists of 14 items, and demonstrates acceptable psychometric properties, with a Cronbach’s alpha of 0.749, a test–retest reliability coefficient of 0.776, and a Guttman split-half coefficient of 0.720 (Klasa et al.,2022). The Scale to Assess Therapeutic Relationship (STAR) questionnaire contains 12 statements rated on a five-point scale (1 = never, 5 = always), with higher results indicating a stronger therapeutic relationship. For the patient version, reliability was r = 0.76, p < 0.05, with Cronbach’s alpha coefficients of 0.897 for the patient version and 0.645 for the clinician version (Sosnowska et al., 2011; McGuire-Snieckus et al. 2007 ). 3 Statistical analysis 3.1 Linear mixed-effects analyses Linear mixed-effects models (LMMs) were used to test the study hypotheses across outcome variables by examining pre-, mid-, and post-treatment changes in the level of envy and the leader–member therapeutic relationship as a function of treatment condition, based on data from three therapy groups ( Table 2 ) . Personality organisation was assessed only once and was therefore analysed as a function of treatment condition only.For personality organisation, no statistically significant differences were found across the three therapy groups (p = .27). The estimated mean level of personality organisation was 20.78 (95% CI [17.77, 23.80]), indicating a moderate level of personality pathology in the sample. Thus, group membership was not associated with differences in levels of personality organisation at assessment.Time had a statistically significant effect on the level of envy, with scores decreasing over the course of treatment (B = − 0.30, p < .001). This decline was of moderate magnitude, suggesting a clinically meaningful reduction in envious tendencies across participants. Although the overall effect of treatment condition was not significant (p = .17), the time × condition interaction was statistically significant (B = − 0.15, p = .034), indicating that the rate of improvement differed modestly across therapy groups. Specifically, some groups showed a smaller reduction in envy than others, although these between-group differences were small in size. The therapist-patient relationship showed a significant positive change over time (B = 0.28, p < .001), reflecting a strengthening across treatment. The size of the change was moderate to large, indicating a robust improvement in perceived alliance. Neither the main effect of treatment condition (p = .14) nor the interaction between time and condition (p = .32) was statistically significant, suggesting that the increase was comparable across all three therapy groups. The estimated baseline level of the therapist-patient relationship was 6.44 (95% CI [5.33, 7.56]). Overall, model-fit indices indicated an adequate, though not optimal, fit. The fixed effects and the combined fixed and random effects accounted for only a limited proportion of variance in the outcomes, suggesting that substantial individual differences in change trajectories remained unexplained. Covariance and correlation matrices for fixed and random effects showed no problematic dependencies among estimated parameters; residual correlations were consistent with expectations from independent outcome models. Table 2 Linear Mixed-Effects Model Parameters for Personality and Interpersonal Functioning (N = 164) Outcome Fixed Effect B SE T p Personality organisation Intercept (95% CI [17.77, 23.80], df = 161) 20.78 1.53 13.60 < .001 Condition** 0.10 0.09 1.11 .27 Level of envy Intercept (95% CI [3.90, 5.91], df = 562) 4.90 0.51 9.55 < .001 Time* −0.30 0.06 −5.00 < .001 Condition** 0.11 0.08 1.38 .17 Time × Condition** −0.15 0.07 −2.14 .034 Therapist-patient relationship Intercept (95% CI [5.33, 7.56], df = 526) 6.44 0.57 11.36 < .001 Time* 0.28 0.05 5.60 < .001 Condition** 0.09 0.06 1.50 .14 Time × Condition** 0.06 0.06 1.00 .32 Note. *Time = pre-, mid-, and post-treatment assessments.* Condition = three therapy groups. B = unstandardized fixed-effect estimate; SE = standard error of the estimate; t = t value for the fixed effect; p = two-tailed significance level. Personality organisation was assessed only once; therefore, only intercept and condition effects are reported for this outcome. 4. Discussion By jointly modelling longitudinal change in personality organisation, envy, and the therapist-patient relationship, the present study extends prior research that has typically examined these constructs in isolation or within cross-sectional designs. This integrative and process-oriented perspective contributes to a more dynamic understanding of affective and relational change mechanisms in psychodynamic group psychotherapy. The study analysed whether longitudinal changes occur in dispositional envy and the therapist-patient relationship across the group psychotherapy process, in conjunction with variation in personality organisation throughout different psychotherapy groups. To test the hypotheses linear mixed-effects analyses were conducted, allowing for the examination of within-person change over time and thereby providing a more nuanced picture of therapeutic processes than cross-sectional approaches. For levels of envy, time emerged as a significant predictor with the rate of improvement varying slightly across therapeutic groups. Moreover, improvements in the patient-therapist relationship were observed over time during group psychotherapy. From a psychodynamic perspective, envy is conceptualized as a deeply rooted affect linked to early object relations and unconscious rivalry dynamics. Therefore, its modification may require prolonged exposure to corrective relational experiences and repeated interpretive work within the group context, taking into account the relationship between patients treated in a group setting and the therapist Consequently, dealing with envy-related issues is a long-term process, and improvements in this domain require time. In contrast, the comparatively rapid strengthening of the therapist- patient relationship may reflect early gains in perceived safety, structure, and emotional attunement, which emerge relatively early in treatment and serve as preconditions for deeper intrapsychic. Difficulty in establishing the described therapeutic relationship may account for the high rate of patient dropout from the study or treatment. More risk factors for therapy non-completion have been described in Sobański et al. ( 2013 ).Therefore, the first hypothesis (Levels of personality organisation will differ across treatment conditions ) was not supported, whereas the second ( The level of envy will decrease over the course of treatment ) and third hypotheses ( The leader–member therapeutic relationship will strengthen over the course of treatment ) were fully confirmed. The substantial interindividual variability observed across trajectories further supports contemporary process-based models of psychotherapy, which emphasise nonlinear, idiographic change patterns rather than uniform treatment effects. Prior research has highlighted the importance of group climate, personality traits, and group cohesion as factors influencing the therapist-patient relationship (Lorentzen & Høglend, 2008 ; Ogrodniczuk, 2003). In the present study exploring similar issues, we focused on group psychotherapy, mostly adopting the psychodynamic approach. This focus is supported by recent evidence: a meta-analysis by Leichsenring et al. ( 2023 ) showed that psychodynamic therapy is among the most strongly recommended options for treating depressive, anxiety, personality and somatic symptom disorders. In addition, a multilevel meta-analysis by Flückiger et al. ( 2024 ) indicated a strong positive association between negative affectivity and anxiety symptoms. Building on these findings, the present study, specifically examines outcomes related to the patient-therapist relationship in psychodynamic group psychotherapy. This emphasis is further supported by findings from an extensive meta-analysis by Constantino et al.(2018), examining the relationship between patients’ initial perceptions of treatment credibility and their perceived outcomes after therapy across diverse psychotherapeutic approaches and clinical settings. Similarly, a meta-analysis by Flückiger et al. ( 2020 ), consistent with earlier findings, indicated that the therapist- patient relationship significantly predicted post-treatment outcome. Therapy outcomes indicate that alliance strengthening over time is associated with symptom change, in line with findings from previous meta-analyses. Another meta-analysis (Alldredge et al., 2021 ), indicated that the therapeutic alliance between group members and the leader, as well as the overall cohesion among group participants, are similarly associated with treatment outcomes. Differences in the therapist-patiemt relationship as reported in the meta-analysis by Flückiger et al. ( 2018 ), may reflect differences in relation to other patients’ perspectives inherent in psychotherapy groups. Importantly, these disparities do not necessarily indicate negative outcomes; rather, they represent clinically meaningful signals that warrant therapeutic attention. Moreover, addressing ruptures and promoting repair in any relational area appears to be an evidence-based strategy for enhancing therapeutic effectiveness. Within this approach, reductions in dispositional envy may be conceptualised as downstream effects of progressive alliance consolidation, insofar as secure therapeutic bonds may reduce defensive social comparison and perceived relational threat. This is consistent with findings from a meta-analysis of group psychotherapy outcomes ( et al., 2021Rosendahl), which demonstrated the overall effectiveness of group treatments across diagnostic categories, alongside substantial variability in effect sizes. Taken together, these meta-analytic findings converge with the present results, highlighting the therapeutic alliance as a robust, transdiagnostic mechanism of change operating both at the individual dyadic level and within the broader group relational matrix. Overall, the present findings support a differentiated, process-oriented model of psychodynamic group psychotherapy in which affective, relational, and structural dimensions of change are recognised and addressed. For future research, it is important to consider recent discussions on bridging the gap between research and clinical practice, particularly with regard to the assessment of personality pathology and its potentially detrimental impact. Studies should also integrate dynamic systems modelling and session-level process measures to examine whether changes in envy temporally lag behind alliance consolidation and whether this sequence predicts long-term structural personality change. Limitations Several limitations should be acknowledged. First, reliance on self-report measures may have reduced sensitivity to unconscious affective processes such as envy. Second, the generalizability of findings may be constrained by the specific clinical setting and psychodynamic treatment orientation. Third, a limitation of the present study is the lack of a control group, which makes it difficult to determine whether the observed changes can be attributed specifically to group psychotherapy. Conclusions The synthesis of our research results indicates that time emerged as a significant predictor of envy levels, and a strengthening of the patient-therapist relationship was also observed. In summary, the findings suggest that reductions in envy may represent an affective marker of therapeutic change occurring alongside the strengthening of the therapeutic relationship. Declarations Funding The authors received no financial support for the research, authorship, and/or publication of this article. Author Contribution A.Ś.-L. designed the study, conducted the literature review, and wrote the main body of the manuscript.M.M. contributed to data analysis and interpretation of the results.P.J. prepared the section on pharmacotherapy.K.K. performed the substantive (content-related) revision of the article.K.S. assisted in data collection.D.D. provided overall scientific supervision and served as the principal supervisor.J.A.S. contributed to the study concept and supported the interpretation of the results.All authors reviewed and approved the final version of the manuscript. Data Availability The data that support the findings of this study are not publicly available but are available from the authors upon reasonable request. Access to the data may be obtained by contacting the authors via email, subject to any applicable ethical or confidentiality considerations. References Aleksandrowicz, J. W., Klasa, K., Sobański, J. A., & Stolarska, D. (2009). KON-2006 neurotic personality questionnaire. Archives of Psychiatry and Psychotherapy , 11 (1), 21–29. Alldredge, C. T., Burlingame, G. M., Yang, C., & Rosendahl, J. (2021). Alliance in group therapy: A meta-analysis. Group Dynamics: Theory Research and Practice , 25 (1), 13–28. https://doi.org/10.1037/gdn0000135 Bucher, M. A., Suzuki, T., & Samuel, D. B. (2019). A meta-analytic review of personality traits and their associations with mental health treatment outcomes. Clinical Psychology Review , 70 , 51–63. https://doi.org/10.1016/j.cpr.2019.04.002 Castonguay, L. G., & Beutler, L. E. (2006). Principles of therapeutic change: A task force on participants, relationships, and technique factors. Journal of Clinical Psychology , 62 (6), 631–638. https://doi.org/10.1002/jclp.20264 Constantino, M. J., Coyne, A. E., Boswell, J. F., Iles, B. R., & Vîslă, A. (2018). A meta-analysis of the association between patients’ early perception of treatment credibility and their posttreatment outcomes. Psychotherapy , 55 (4), 486–495. https://doi.org/10.1037/pst0000168 Constantino, M. J., Vîslă, A., Coyne, A. E., & Boswell, J. F. (2018). A meta-analysis of the association between patients’ early treatment outcome expectation and their posttreatment outcomes. Psychotherapy , 55 (4), 473–485. https://doi.org/10.1037/pst0000114 Csáky-Pallavicini, K., Horváth, Z., Unoka, Z., Kun, B., & Demetrovics, Z. (2025). Personality organisation and anxiety symptoms: Investigating the mediation of perfectionism. Comprehensive Psychiatry , 138 , 152582. https://doi.org/10.1016/j.comppsych.2025.152582 Erz, E., & Rentzsch, K. (2024). Does insecurity lead to envy? The longitudinal interplay between dispositional envy and self-esteem. Journal of Research in Personality , 113 , 104543. https://doi.org/10.1016/j.jrp.2024.104543 Erz, E., & Rentzsch, K. (2024). Stability and change in dispositional envy: Longitudinal evidence on envy as a stable trait. European Journal of Personality , 38 (1), 67–84. https://doi.org/10.1177/08902070221128137 Flückiger, C., Del Re, A. C., Wampold, B. E., & Horvath, A. O. (2018). The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy , 55 (4), 316–340. https://doi.org/10.1037/pst0000130 Flückiger, C., Mahlke, F., John, G., Daus, P., & Zinbarg, R. E. (2024). How strongly are trait positive and negative affectivity associated with anxiety symptoms? A multilevel meta-analysis. Journal of Anxiety Disorders , 102956. https://doi.org/10.1016/j.janxdis.2024.102956 Flückiger, C., Rubel, J., Del Re, A. C., Horvath, A. O., Wampold, B. E., Crits-Christoph, P., Atzil-Slonim, D., Compare, A., Falkenström, F., Ekeblad, A., & Barber, J. P. (2020). The reciprocal relationship between alliance and early treatment symptoms: A two-stage individual participant data meta-analysis. Journal of Consulting and Clinical Psychology , 88 (9), 829–843. https://doi.org/10.1037/ccp0000594 Henniger, N. E., & Harris, C. R. (2015). Envy across adulthood: The what and the who. Basic and Applied Social Psychology , 37 (6), 303–318. https://doi.org/10.1080/01973533.2015.1088440 Hoogland, C. E., Thielke, S., & Smith, R. H. (2017). Envy as an evolving episode. In Envy at work and in organizations: Research, theory, and applications (pp. 111–142). Emerald Group Publishing. https://doi.org/10.1108/S1746-979120170000007005 Hopwood, C. J., Pincus, A. L., & Wright, A. G. C. (2021). Six assumptions of contemporary integrative interpersonal theory of personality and psychopathology. Current Opinion in Psychology , 41 , 65–70. https://doi.org/10.1016/j.copsyc.2021.03.007 Izdebska, A., & Pastwa-Wojciechowska, B. (2013). Organizacja osobowości i jej pomiar – polska adaptacja kwestionariusza IPO Kernberga i współpracowników. Czas Psychologiczny , 19 , 17–34. Kernberg, O. F. (2019 Winter;47(4):353–372). Psychotic Personality Structure. Psychodyn Psychiatry. 10.1521/pdps.2019.47.4.353 . PMID: 31913791. Kernberg, O. F., & Michels, R. (2009). Borderline personality disorder. American Journal of Psychiatry , 166 (5), 505–508. Lange, J., Weidman, A. C., & Crusius, J. (2018). The painful duality of envy: Evidence for an integrative theory and a meta-analysis on the relation of envy and schadenfreude. Journal of Personality and Social Psychology , 114 (4), 572–598. https://doi.org/10.1037/pspi0000118 Leichsenring, F., Abbass, A., Heim, N., Keefe, J. R., Kisely, S., Luyten, P., & Steinert, C. (2023). The status of psychodynamic psychotherapy as an empirically supported treatment for common mental disorders–an umbrella review based on updated criteria. World Psychiatry , 22 (2), 286–304. https://doi.org/10.1002/wps.21104 Leichsenring, F., Heim, N., Leweke, F., Spitzer, C., Steinert, C., & Kernberg, O. F. (2023). Borderline personality disorder: A review. Journal Of The American Medical Association , 329 (8), 670–679. https://doi.org/10.1001/jama.2023.0589 Lorentzen, S., & Høglend, P. A. (2008). Moderators of the effects of treatment length in long-term psychodynamic group psychotherapy. Psychotherapy and Psychosomatics , 77 (5), 321–322. https://doi.org/10.1159/000147946 Marmarosh, C. L. (2021). Ruptures and repairs in group psychotherapy: From theory to practice. International Journal of Group Psychotherapy , 71 (2), 205–223. https://doi.org/10.1080/00207284.2020.1855893 McGuire-Snieckus, R., McCabe, R., Catty, J., Hansson, L., & Priebe, S. (2007). A new scale to assess the therapeutic relationship in community mental health care: STAR. Psychological Medicine , 37 (1), 85–95. Epub 2006 Nov 9. PMID: 17094819. Miceli, M., & Castelfranchi, C. (2007). The envious mind. Cognition and Emotion , 21 (3), 449–479. https://doi.org/10.1080/02699930600814735 Mielimąka, M., Rutkowski, K., Cyranka, K., Sobański, J. A., Müldner-Nieckowski, Ł., Dembińska, E., Smiatek-Mazgaj, B., & Klasa, K. (2015). Effectiveness of intensive group psychotherapy in treatment of neurotic and personality disorders. Psychiatria Polska , 49 (1), 29–48. https://doi.org/10.12740/PP/26093 Muran, J. C., & Eubanks, C. F. (2020). Therapist performance under pressure: Negotiating emotion, difference, and rupture . American Psychological Association. https://doi.org/10.1037/0000182-000 Ogrodniczuk, J. S., Piper, W. E., Joyce, A. S., Weideman, R., McCallum, M., Azim, H. F., & Rosie, J. S. (2003). Differentiating symptoms of complicated grief and depression among psychiatric outpatients. Can J Psychiatry. ;48(2):87–93. doi: 10.1177/070674370304800204. PMID: 12655905. Prusiński, T. (2023). Personality disorder type only sometimes matters: An exploration of patients’ personality disorder as a source of variance in early therapeutic alliance. Clinical Psychology & Psychotherapy , 30 (3). Article 2943. https://doi.org/10.1002/cpp.2943 Rosendahl, J., Alldredge, C. T., Burlingame, G. M., & Strauss, B. (2021). Recent developments in group psychotherapy research. American Journal of Psychotherapy , 74 (2), 52–59. https://doi.org/10.1176/appi.psychotherapy.20200031 Scherer, K. R., & Moors, A. (2019). The emotion process: Event appraisal and component differentiation. Annual Review of Psychology , 70 (1), 719–745. https://doi.org/10.1146/annurev-psych-122216-011854 Smith, R. H. (2004). Envy and its transmutations. In L. Z. Tiedens, & C. W. Leach (Eds.), The social life of emotions (pp. 43–63). Cambridge University Press. https://doi.org/10.1017/CBO9780511819568.004 Smith, R. H., & Kim, S. H. (2007). Comprehending envy. Psychological Bulletin , 133 (1), 46–64. https://doi.org/10.1037/0033-2909.133.1.46 Sobański, J. A., Klasa, K., Rutkowski, K., Dembińska, E., & Muldner-Nieckowski, Ł. (2013). Symptom profile of patients who dropped out of complex psychotherapy at a day hospital for neurotic disorders: A retrospective analysis. Psychiatria i Psychoterapia , 9 (4), 14–38. Sosnowska, M., Prot, K., Murawiec, S., Kos-Maszaro, I., Kamela, D., Lech, K., Czerwińska, M., Grudowska, B., Skiba, J., Augustyn, A., Krzysztoszek, B., & Twardowska, H. (2012). Trudności emocjonalne terapeutów i szybsze rozpoczynanie leczenia w ramach opieki środowiskowej — porównanie leczenia środowiskowego z leczeniem ambulatoryjnym. Psychoterapia , 3 (162), 55–63. Klasa, K., Sobański, J. A., Konop, M., Dembińska, E., Mielimąka, M., Citkowska-Kisielewska, A., Jęda, P., Pelc, M., & Rutkowski, K. (2022). Complaints of dyspnea and their associations with personality traits in patients referred to psychotherapy in a day hospital. Journal Of Psychosomatic Research , 157 , 110786. Epub 2022 Mar 18. PMID: 35364372. Wright, A. G. C., Hopwood, C. J., & Pincus, A. L. (2021). The interpersonal situation: Contemporary perspectives on interpersonal theory and assessment. Current Opinion in Psychology , 41 , 106–111. https://doi.org/10.1016/j.copsyc.2021.04.004 Yalom, I. D., & Leszcz, M. (2020). The theory and practice of group psychotherapy. Hachette UK. Zilcha-Mano, S., & Muran, J. C. (2024). Thinking transtheoretically about alliance and rupture: Implications for practice and training. Clinical Psychology in Europe , 6 . https://doi.org/10.32872/cpe.12439 . Special Issue), Article e12439. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 15 May, 2026 Reviewers invited by journal 08 Apr, 2026 Editor assigned by journal 08 Apr, 2026 Submission checks completed at journal 08 Apr, 2026 First submitted to journal 06 Apr, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9332763","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":622516286,"identity":"5500dde3-04ae-4a6e-8331-f58f9c38067f","order_by":0,"name":"Aleksandra Ściegienny-Lemler","email":"data:image/png;base64,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","orcid":"","institution":"Jagiellonian University","correspondingAuthor":true,"prefix":"","firstName":"Aleksandra","middleName":"","lastName":"Ściegienny-Lemler","suffix":""},{"id":622516293,"identity":"985d2698-9632-43ad-b58d-62260c31f125","order_by":1,"name":"Michał Mielimąka","email":"","orcid":"","institution":"Jagiellonian University","correspondingAuthor":false,"prefix":"","firstName":"Michał","middleName":"","lastName":"Mielimąka","suffix":""},{"id":622516295,"identity":"3fd2beb8-b9ba-43cb-8870-a29b689f7621","order_by":2,"name":"Patrycja Jęda-Mielimąka","email":"","orcid":"","institution":"Jagiellonian University","correspondingAuthor":false,"prefix":"","firstName":"Patrycja","middleName":"","lastName":"Jęda-Mielimąka","suffix":""},{"id":622516297,"identity":"f4d70c7b-7781-4400-b11c-eaa707cc03ba","order_by":3,"name":"Katarzyna Klasa","email":"","orcid":"","institution":"Jagiellonian University","correspondingAuthor":false,"prefix":"","firstName":"Katarzyna","middleName":"","lastName":"Klasa","suffix":""},{"id":622516298,"identity":"7a55059c-8701-425e-9b8d-9aebf124c527","order_by":4,"name":"Skrobol Karolina","email":"","orcid":"","institution":"Jagiellonian University","correspondingAuthor":false,"prefix":"","firstName":"Skrobol","middleName":"","lastName":"Karolina","suffix":""},{"id":622516300,"identity":"369cd7ef-9b10-48a5-89cd-647a0edc7302","order_by":5,"name":"Dominika Dudek","email":"","orcid":"","institution":"Jagiellonian University","correspondingAuthor":false,"prefix":"","firstName":"Dominika","middleName":"","lastName":"Dudek","suffix":""},{"id":622516301,"identity":"f58ada36-fb0a-4583-aac6-6079b98488ab","order_by":6,"name":"Jerzy A. Sobański","email":"","orcid":"","institution":"Jagiellonian University","correspondingAuthor":false,"prefix":"","firstName":"Jerzy","middleName":"A.","lastName":"Sobański","suffix":""}],"badges":[],"createdAt":"2026-04-06 10:25:12","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9332763/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9332763/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":107705313,"identity":"f32ae14b-7bbd-43da-ab89-ad61006a5a03","added_by":"auto","created_at":"2026-04-24 09:11:19","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":285894,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9332763/v1/b41d5ed8-e2fe-4552-b5e6-9801085fb6b0.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Parallel Change Processes in Envy and the Patient–Therapist Relationship During Psychodynamic Group Psychotherapy","fulltext":[{"header":"1. Introduction","content":"\u003cdiv id=\"Sec2\" class=\"Section2\"\u003e \u003ch2\u003e1.1 The therapist-patient relationship change across psychotherapy process\u003c/h2\u003e \u003cp\u003eMeta-analytic evidence indicates that the therapist-patient relationship is a significant predictor of outcomes in group psychotherapy, although its impact appears to be somewhat weaker than that of group cohesion (Alldredge et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). The stage of group development, along with the overall group climate, significantly influences the nature of ruptures and their repair in the psychotherapy process. In the initial phase of the group, participants tend to prioritise psychological safety and approach interactions with caution (Yalom \u0026amp; Leszcz, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Such a phenomenon can also be observed in semi-open therapeutic groups, where there is a phase of getting to know one another and building interactions during the rotation of patients. Ruptures at this stage are often linked to problems with adherence to group rules, challenges to authority, and misunderstanding the group process. Observing the rupture-repair dynamics during the whole treatment - both among group members and in relationships outside the group - can help foster increased self-compassion, deeper relationship satisfaction, and greater empathy (Marmarosh, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Alliance ruptures can be understood as breakdowns in the therapeutic process involving difficulties in meeting fundamental needs for autonomy and connection (Muran \u0026amp; Eubanks, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Contemporary interpersonal psychotherapy models frame these needs along the orthogonal dimensions of dominance and warmth (Wright et al., \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Thus, confrontation ruptures are more likely to involve cold and dominant behaviours, whereas withdrawal ruptures tend to manifest through cold and submissive interpersonal strategies. These phenomena, related to personality-based interpersonal dynamics, represent central mechanisms of therapeutic change (Zilcha-Mano \u0026amp; Muran, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). According to Marmarosh (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), analysing ruptures within the transference\u0026ndash;countertransference dynamic provides valuable insight into how early childhood experiences shape an individual\u0026rsquo;s psychological development and patients capacity for change. The way in which relationships are formed with other group members will mirror the manner in which they are formed with the therapist (Castonguay \u0026amp; Beutler, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2006\u003c/span\u003e; Constantino et al., \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Taken together, these findings indicate that the therapist-patient relationship is not a static characteristic of treatment but a dynamic process that evolves during the phases of group psychotherapy. This temporal variability suggests longitudinal changes in not only the leader\u0026ndash;member relationship, but also in rupture\u0026ndash;repair processes.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e1.2. Envy as a factor of change\u003c/h2\u003e \u003cp\u003eEnvy is commonly defined as a negative emotional response, encompassing psychological, cognitive, motivational, and behavioural states (Scherer \u0026amp; Moors, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2019\u003c/span\u003e), and is triggered when individuals perceive themselves as lacking a valued attribute possessed by someone else (Miceli \u0026amp; Castelfranchi, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2007\u003c/span\u003e; Smith \u0026amp; Kim, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2007\u003c/span\u003e). These psychological emotional states are particularly pronounced when the envied individual is perceived as similar to the self, heightening the sense of personal relevance and comparison (Henniger \u0026amp; Harris, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Envy is not merely a fleeting emotion; it can persist over time, grow in complexity (Hoogland, Thielke, \u0026amp; Smith, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2017\u003c/span\u003e), and evolve into other emotional states (Lange, Weidman \u0026amp; Crusius, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2018\u003c/span\u003e: Smith, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2004\u003c/span\u003e). A recent longitudinal study (Erz \u0026amp; Rentzsch, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) demonstrated that both global and domain-specific dispositional envy is relatively stable across a six-year period. Within a psychodynamic approach, permanent low self-esteem reflects deficits in ego integration and internal object relations, resulting in an increase in envy. Consistent with this perspective, longitudinal evidence indicates that lower self-esteem prospectively predicts an increase in dispositional envy over time (Erz \u0026amp; Rentzsch, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). This change suggests that structural depreciation in personality organisation predisposes individuals to develop envy as a defensive and relational affect. Although dispositional envy shows relative temporal stability, longitudinal and clinical evidence suggests that it may be altered by specific relational and intrapsychic conditions. Psychotherapy group contexts may create conditions under which envy-related affects can be transformed. Thus, changes in the level and quality of dispositional envy may be expected to occur over the course of group psychotherapy.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e1.3. Personality organisation and psychotherapy outcomes\u003c/h2\u003e \u003cp\u003eThe meta-analysis by Bucher et al. (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) emphasises the clinical importance of personality evaluation for case conceptualization and treatment planning. It suggests that personality traits are related to psychotherapy outcomes, for example agreeableness can be positively associated with therapeutic alliance. Shir and Tishby (2024) maintain that in short-term dynamic therapy, similarity between the leader\u0026ndash;member therapeutic relationship in personality traits such as neuroticism and conscientiousness, or in attachment style, contributes to better relational matching and more favourable therapeutic outcomes. Contemporary research conceptualizes levels of personality organisation according to differences in identity integration \u003cem\u003eversus\u003c/em\u003e identity diffusion, the predominance of primitive defence mechanisms, and the integrity of reality testing. At the borderline (Kernberg \u0026amp; Michels, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2009\u003c/span\u003e; Leichsenring, 2023) or psychotic organisation level (Kernberg,2019), identity becomes more fragmented and dominated by primitive defences, while reality testing becomes increasingly impaired. At the neurotic or healthy organisation level, identity is integrated, defences are more mature, and reality testing remains stable (Cs\u0026aacute;ky-Pallavicini et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). Patients diagnosed with borderline personality disorder may demonstrate weaker early therapeutic alliances compared to those with other personality disorders (Prusiński,2023). These findings suggest that certain personality disorders may pose greater challenges in establishing a strong therapeutic bond and achieving agreement on goals. While personality organisation represents a relatively enduring structural characteristic, contemporary psychodynamic perspectives in Transference-Focused Psychotherapy posit that core aspects of identity integration, defensive functioning, and affect regulation can improve through sustained therapeutic engagement. Through repeated interactions, participants can test their perceptions of self and others against the reactions of multiple group members, creating opportunities for reality testing and corrective emotional experiences that challenge maladaptive internal models (Yalom \u0026amp; Leszcz, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). These considerations justify the expectation that measurable changes in personality organisation can occur across different phases of group psychotherapy treatment.\u003c/p\u003e \u003cp\u003eThis study aimed to examine direct longitudinal changes in dispositional envy, and the leader\u0026ndash;member therapeutic relationship across three time points (pre-, mid-, and post-treatment) in group psychotherapy as well as analyse variation in personality organisation across three different psychotherapy groups.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eHypothesis 1\u003c/strong\u003e \u003cp\u003eLevels of personality organisation will differ across treatment conditions.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eHypothesis 2\u003c/strong\u003e \u003cp\u003eThe level of envy will decrease over the course of treatment.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eHypothesis 3\u003c/strong\u003e \u003cp\u003eThe leader\u0026ndash;member therapeutic relationship will strengthen over the course of treatment.\u003c/p\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.1. Participants\u003c/h2\u003e \u003cp\u003eThis study was conducted between 2022 and 2024 at the Day Treatment Unit. Participants engaged in semi-open therapeutic groups, each comprising 10 members. All patients underwent a 12-week treatment program, which included 72 hours of group psychotherapy, where two therapists co-leading the group alternately, 12 hours of individual therapy, and up to 48 hours of optional workshop-based sessions. The therapeutic approach was mostly psychodynamic. Patients were referred to group therapy by clinical psychologists and psychiatrists. During the screening and qualification process, individuals diagnosed with psychotic disorders, active substance use disorders, or neurological impairments impacting cognitive function were excluded. Out of 231 patients who agreed to participate, 67 were disqualified due to discontinuation of treatment or incomplete assessment data, leaving a final sample of 164 individuals: 96 women (58.5%) and 68 men (41.5%). The majority were Polish nationals, aged between 18 and 60 years (M\u0026thinsp;=\u0026thinsp;35.5, SD\u0026thinsp;=\u0026thinsp;10.5). Most participants had completed higher education, either a bachelor\u0026rsquo;s or master\u0026rsquo;s degree (n\u0026thinsp;=\u0026thinsp;98), or secondary education (n\u0026thinsp;=\u0026thinsp;61), while 3.5% (n\u0026thinsp;=\u0026thinsp;4) had primary education, and one participant held a doctoral degree. Alongside psychotherapy, the majority of patients (n\u0026thinsp;=\u0026thinsp;101) also received pharmacological treatment, mainly antidepressants and anxiolytics, including SSRIs (Selective Serotonin Reuptake Inhibitors), SNRIs (Serotonin\u0026ndash;Norepinephrine Reuptake Inhibitors), and mood stabilizers. Most of these patients were prescribed more than one medication. Hydroxyzine was the most frequently used drug (n\u0026thinsp;=\u0026thinsp;14), followed by venlafaxine (n\u0026thinsp;=\u0026thinsp;13) and sertraline (n\u0026thinsp;=\u0026thinsp;12). Pregabalin and escitalopram were each taken by 11 patients, trazodone by 8, and lamotrigine by 4. Fluoxetine was used by 3 patients, bupropion by 2, and several medications were taken by only one patient each, including tianeptine, citalopram, vortioxetine (antidepressants), propranolol (anxiolytic), valproic acid, methylphenidate, atomoxetine (ADHD treatments), chlorprothixene, quetiapine (low-dose anxiolytic), and levetiracetam (antiepileptic). The therapeutic methods employed were consistent with standard care practices for patients with neurotic and/or personality disorders. These practices, as described by Mielimąka et al. (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2015\u003c/span\u003e), involve treating patients with psychotherapy using methods such as clarification, confrontation, and both present-focused and genetic interpretations, with the therapist's intervention limited to a minimum. Pharmacotherapy, mainly targeting anxiety and mood symptoms, is used on the ward when necessary, and doses are reduced whenever possible. The study was approved by the Bioethics Committee (approval no. 1072.6120.244.2022, issued on November 16, 2022). The dataset used in this study has been partially reported elsewhere; however, the current analyses address different research questions and employ a longitudinal process-oriented approach. Each patient participated in a semi-open psychotherapy group for approximately sixty working days. Only individuals who provided written informed consent were included in the study, and all participants were informed of their right to withdraw at any time. To ensure anonymity, participants were assigned unique, randomly generated codes for confidential completion of the test battery. At the beginning of treatment, participants completed the IPO-PL, and at the beginning, in the middle and at the end NPQ, and STAR-P questionnaires.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.2. Data collection\u003c/h2\u003e \u003cp\u003eThe questionnaires described below were administered during treatment to test the study hypothesis.\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eThe Inventory of Personality Organisation IPO questionnaire comprises 83 items and incorporates three clinical scales - reality testing ability (Reality Testing, 20 items), defense mechanisms used (Primitive Defenses, 16 items), and degree of identity integration (Identity Diffusion, 21 items) - as well as two additional scales: the aggression scale (18 items), and the moral values scale (11 items). The clinical scales help diagnose the level of personality organisation, while the additional scales characterise superego pathology or different forms of aggression, including initiating aggression toward others, aggressive responses to provocation from others, and self-directed aggression. All items are rated on a 5-point Likert scale (1 \u0026ndash; never true, 5 \u0026ndash; always true). In the Polish adaptation for IPO, Cronbach's alpha for the scales range from 0.78 to 0.91 (Izdebska and Pastwa-Wojciechowska, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2013\u003c/span\u003e).\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eThe Neurotic Personality Questionnaire (NPQ) includes 243 items, each requiring a clear \"yes\"/\"no\" response. Of these, 240 items contribute to 24 different scales, ranging in length from 8 to 20 items, with most scales (20 out of 24) containing at least 11 items. Some items are included in multiple scales, with diagnostic value varying according to response direction (either \"yes\" or \"no\"). Specifically, 4 items appear on four different scales, 15 on three scales, and 46 on two scales. Internal consistency, as measured by Cronbach\u0026rsquo;s alpha, ranges from 0.65 to 0.88 (Aleksandrowicz et al., 2006). In the present study, all items from the \u0026lsquo;envy\u0026rsquo; scale from NPQ were used to operationalise the level of envy. Envy was characterized by questionnaire scales feelings of frustration in response to other people\u0026rsquo;s achievements and by a tendency to devalue others. The \u0026lsquo;envy\u0026rsquo; scale consists of 14 items, and demonstrates acceptable psychometric properties, with a Cronbach\u0026rsquo;s alpha of 0.749, a test\u0026ndash;retest reliability coefficient of 0.776, and a Guttman split-half coefficient of 0.720 (Klasa et al.,2022).\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eThe Scale to Assess Therapeutic Relationship (STAR) questionnaire contains 12 statements rated on a five-point scale (1\u0026thinsp;=\u0026thinsp;never, 5\u0026thinsp;=\u0026thinsp;always), with higher results indicating a stronger therapeutic relationship. For the patient version, reliability was r\u0026thinsp;=\u0026thinsp;0.76, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05, with Cronbach\u0026rsquo;s alpha coefficients of 0.897 for the patient version and 0.645 for the clinician version (Sosnowska et al., 2011; McGuire-Snieckus et al. \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2007\u003c/span\u003e).\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"3 Statistical analysis","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Linear mixed-effects analyses\u003c/h2\u003e \u003cp\u003eLinear mixed-effects models (LMMs) were used to test the study hypotheses across outcome variables by examining pre-, mid-, and post-treatment changes in the level of envy and the leader\u0026ndash;member therapeutic relationship as a function of treatment condition, based on data from three therapy groups \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e. Personality organisation was assessed only once and was therefore analysed as a function of treatment condition only.For personality organisation, no statistically significant differences were found across the three therapy groups (p = .27). The estimated mean level of personality organisation was 20.78 (95% CI [17.77, 23.80]), indicating a moderate level of personality pathology in the sample. Thus, group membership was not associated with differences in levels of personality organisation at assessment.Time had a statistically significant effect on the level of envy, with scores decreasing over the course of treatment (B\u0026thinsp;=\u0026thinsp;\u0026minus;\u0026thinsp;0.30, p \u0026lt; .001). This decline was of moderate magnitude, suggesting a clinically meaningful reduction in envious tendencies across participants. Although the overall effect of treatment condition was not significant (p = .17), the time \u0026times; condition interaction was statistically significant (B\u0026thinsp;=\u0026thinsp;\u0026minus;\u0026thinsp;0.15, p = .034), indicating that the rate of improvement differed modestly across therapy groups. Specifically, some groups showed a smaller reduction in envy than others, although these between-group differences were small in size. The therapist-patient relationship showed a significant positive change over time (B\u0026thinsp;=\u0026thinsp;0.28, p \u0026lt; .001), reflecting a strengthening across treatment. The size of the change was moderate to large, indicating a robust improvement in perceived alliance. Neither the main effect of treatment condition (p = .14) nor the interaction between time and condition (p = .32) was statistically significant, suggesting that the increase was comparable across all three therapy groups. The estimated baseline level of the therapist-patient relationship was 6.44 (95% CI [5.33, 7.56]). Overall, model-fit indices indicated an adequate, though not optimal, fit. The fixed effects and the combined fixed and random effects accounted for only a limited proportion of variance in the outcomes, suggesting that substantial individual differences in change trajectories remained unexplained. Covariance and correlation matrices for fixed and random effects showed no problematic dependencies among estimated parameters; residual correlations were consistent with expectations from independent outcome models.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cem\u003eLinear Mixed-Effects Model Parameters for Personality and Interpersonal Functioning (N\u0026thinsp;=\u0026thinsp;164)\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOutcome\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFixed Effect\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eT\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePersonality organisation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntercept (95% CI [17.77, 23.80], df\u0026thinsp;=\u0026thinsp;161)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e13.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCondition**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.27\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLevel of envy\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntercept (95% CI [3.90, 5.91], df\u0026thinsp;=\u0026thinsp;562)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e9.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTime*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026minus;0.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;5.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCondition**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.17\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTime \u0026times; Condition**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026minus;0.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;2.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.034\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTherapist-patient relationship\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntercept (95% CI [5.33, 7.56], df\u0026thinsp;=\u0026thinsp;526)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTime*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCondition**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.14\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTime \u0026times; Condition**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.32\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003e\u003cb\u003eNote.\u003c/b\u003e*Time\u0026thinsp;=\u0026thinsp;pre-, mid-, and post-treatment assessments.*\u003cem\u003eCondition\u0026thinsp;=\u0026thinsp;three therapy groups.\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003eB\u0026thinsp;=\u0026thinsp;unstandardized fixed-effect estimate; SE\u0026thinsp;=\u0026thinsp;standard error of the estimate; t\u0026thinsp;=\u0026thinsp;t value for the fixed effect; p\u0026thinsp;=\u0026thinsp;two-tailed significance level. Personality organisation was assessed only once; therefore, only intercept and condition effects are reported for this outcome.\u003c/em\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eBy jointly modelling longitudinal change in personality organisation, envy, and the therapist-patient relationship, the present study extends prior research that has typically examined these constructs in isolation or within cross-sectional designs. This integrative and process-oriented perspective contributes to a more dynamic understanding of affective and relational change mechanisms in psychodynamic group psychotherapy. The study analysed whether longitudinal changes occur in dispositional envy and the therapist-patient relationship across the group psychotherapy process, in conjunction with variation in personality organisation throughout different psychotherapy groups. To test the hypotheses linear mixed-effects analyses were conducted, allowing for the examination of within-person change over time and thereby providing a more nuanced picture of therapeutic processes than cross-sectional approaches. For levels of envy, time emerged as a significant predictor with the rate of improvement varying slightly across therapeutic groups. Moreover, improvements in the patient-therapist relationship were observed over time during group psychotherapy. From a psychodynamic perspective, envy is conceptualized as a deeply rooted affect linked to early object relations and unconscious rivalry dynamics. Therefore, its modification may require prolonged exposure to corrective relational experiences and repeated interpretive work within the group context, taking into account the relationship between patients treated in a group setting and the therapist Consequently, dealing with envy-related issues is a long-term process, and improvements in this domain require time. In contrast, the comparatively rapid strengthening of the therapist- patient relationship may reflect early gains in perceived safety, structure, and emotional attunement, which emerge relatively early in treatment and serve as preconditions for deeper intrapsychic. Difficulty in establishing the described therapeutic relationship may account for the high rate of patient dropout from the study or treatment. More risk factors for therapy non-completion have been described in Sobański et al. (\u003cspan class=\"CitationRef\"\u003e2013\u003c/span\u003e).Therefore, the first hypothesis \u003cem\u003e(Levels of personality organisation will differ across treatment conditions\u003c/em\u003e) was not supported, whereas the second (\u003cem\u003eThe level of envy will decrease over the course of treatment\u003c/em\u003e ) and third hypotheses (\u003cem\u003eThe leader–member therapeutic relationship will strengthen over the course of treatment\u003c/em\u003e) were fully confirmed. The substantial interindividual variability observed across trajectories further supports contemporary process-based models of psychotherapy, which emphasise nonlinear, idiographic change patterns rather than uniform treatment effects. Prior research has highlighted the importance of group climate, personality traits, and group cohesion as factors influencing the therapist-patient relationship (Lorentzen \u0026amp; Høglend, \u003cspan class=\"CitationRef\"\u003e2008\u003c/span\u003e; Ogrodniczuk, 2003). In the present study exploring similar issues, we focused on group psychotherapy, mostly adopting the psychodynamic approach. This focus is supported by recent evidence: a meta-analysis by Leichsenring et al. (\u003cspan class=\"CitationRef\"\u003e2023\u003c/span\u003e) showed that psychodynamic therapy is among the most strongly recommended options for treating depressive, anxiety, personality and somatic symptom disorders. In addition, a multilevel meta-analysis by Flückiger et al. (\u003cspan class=\"CitationRef\"\u003e2024\u003c/span\u003e) indicated a strong positive association between negative affectivity and anxiety symptoms. Building on these findings, the present study, specifically examines outcomes related to the patient-therapist relationship in psychodynamic group psychotherapy. This emphasis is further supported by findings from an extensive meta-analysis by Constantino et al.(2018), examining the relationship between patients’ initial perceptions of treatment credibility and their perceived outcomes after therapy across diverse psychotherapeutic approaches and clinical settings. Similarly, a meta-analysis by Flückiger et al. (\u003cspan class=\"CitationRef\"\u003e2020\u003c/span\u003e), consistent with earlier findings, indicated that the therapist- patient relationship significantly predicted post-treatment outcome. Therapy outcomes indicate that alliance strengthening over time is associated with symptom change, in line with findings from previous meta-analyses. Another meta-analysis (Alldredge et al., \u003cspan class=\"CitationRef\"\u003e2021\u003c/span\u003e), indicated that the therapeutic alliance between group members and the leader, as well as the overall cohesion among group participants, are similarly associated with treatment outcomes. Differences in the therapist-patiemt relationship as reported in the meta-analysis by Flückiger et al. (\u003cspan class=\"CitationRef\"\u003e2018\u003c/span\u003e), may reflect differences in relation to other patients’ perspectives inherent in psychotherapy groups. Importantly, these disparities do not necessarily indicate negative outcomes; rather, they represent clinically meaningful signals that warrant therapeutic attention. Moreover, addressing ruptures and promoting repair in any relational area appears to be an evidence-based strategy for enhancing therapeutic effectiveness. Within this approach, reductions in dispositional envy may be conceptualised as downstream effects of progressive alliance consolidation, insofar as secure therapeutic bonds may reduce defensive social comparison and perceived relational threat. This is consistent with findings from a meta-analysis of group psychotherapy outcomes ( et al., 2021Rosendahl), which demonstrated the overall effectiveness of group treatments across diagnostic categories, alongside substantial variability in effect sizes. Taken together, these meta-analytic findings converge with the present results, highlighting the therapeutic alliance as a robust, transdiagnostic mechanism of change operating both at the individual dyadic level and within the broader group relational matrix. Overall, the present findings support a differentiated, process-oriented model of psychodynamic group psychotherapy in which affective, relational, and structural dimensions of change are recognised and addressed. For future research, it is important to consider recent discussions on bridging the gap between research and clinical practice, particularly with regard to the assessment of personality pathology and its potentially detrimental impact. Studies should also integrate dynamic systems modelling and session-level process measures to examine whether changes in envy temporally lag behind alliance consolidation and whether this sequence predicts long-term structural personality change.\u003c/p\u003e "},{"header":"Limitations","content":"\u003cp\u003eSeveral limitations should be acknowledged. First, reliance on self-report measures may have reduced sensitivity to unconscious affective processes such as envy. Second, the generalizability of findings may be constrained by the specific clinical setting and psychodynamic treatment orientation. Third, a limitation of the present study is the lack of a control group, which makes it difficult to determine whether the observed changes can be attributed specifically to group psychotherapy.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThe synthesis of our research results indicates that time emerged as a significant predictor of envy levels, and a strengthening of the patient-therapist relationship was also observed. In summary, the findings suggest that reductions in envy may represent an affective marker of therapeutic change occurring alongside the strengthening of the therapeutic relationship.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eThe authors received no financial support for the research, authorship, and/or publication of this article.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eA.Ś.-L. designed the study, conducted the literature review, and wrote the main body of the manuscript.M.M. contributed to data analysis and interpretation of the results.P.J. prepared the section on pharmacotherapy.K.K. performed the substantive (content-related) revision of the article.K.S. assisted in data collection.D.D. provided overall scientific supervision and served as the principal supervisor.J.A.S. contributed to the study concept and supported the interpretation of the results.All authors reviewed and approved the final version of the manuscript.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe data that support the findings of this study are not publicly available but are available from the authors upon reasonable request. Access to the data may be obtained by contacting the authors via email, subject to any applicable ethical or confidentiality considerations.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAleksandrowicz, J. W., Klasa, K., Sobański, J. A., \u0026amp; Stolarska, D. (2009). KON-2006 neurotic personality questionnaire. \u003cem\u003eArchives of Psychiatry and Psychotherapy\u003c/em\u003e, \u003cem\u003e11\u003c/em\u003e(1), 21\u0026ndash;29.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlldredge, C. T., Burlingame, G. M., Yang, C., \u0026amp; Rosendahl, J. (2021). Alliance in group therapy: A meta-analysis. \u003cem\u003eGroup Dynamics: Theory Research and Practice\u003c/em\u003e, \u003cem\u003e25\u003c/em\u003e(1), 13\u0026ndash;28. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1037/gdn0000135\u003c/span\u003e\u003cspan address=\"10.1037/gdn0000135\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBucher, M. A., Suzuki, T., \u0026amp; Samuel, D. B. (2019). A meta-analytic review of personality traits and their associations with mental health treatment outcomes. \u003cem\u003eClinical Psychology Review\u003c/em\u003e, \u003cem\u003e70\u003c/em\u003e, 51\u0026ndash;63. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.cpr.2019.04.002\u003c/span\u003e\u003cspan address=\"10.1016/j.cpr.2019.04.002\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCastonguay, L. G., \u0026amp; Beutler, L. E. (2006). Principles of therapeutic change: A task force on participants, relationships, and technique factors. \u003cem\u003eJournal of Clinical Psychology\u003c/em\u003e, \u003cem\u003e62\u003c/em\u003e(6), 631\u0026ndash;638. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1002/jclp.20264\u003c/span\u003e\u003cspan address=\"10.1002/jclp.20264\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eConstantino, M. J., Coyne, A. E., Boswell, J. F., Iles, B. R., \u0026amp; V\u0026icirc;slă, A. (2018). A meta-analysis of the association between patients\u0026rsquo; early perception of treatment credibility and their posttreatment outcomes. \u003cem\u003ePsychotherapy\u003c/em\u003e, \u003cem\u003e55\u003c/em\u003e(4), 486\u0026ndash;495. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1037/pst0000168\u003c/span\u003e\u003cspan address=\"10.1037/pst0000168\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eConstantino, M. J., V\u0026icirc;slă, A., Coyne, A. E., \u0026amp; Boswell, J. F. (2018). A meta-analysis of the association between patients\u0026rsquo; early treatment outcome expectation and their posttreatment outcomes. \u003cem\u003ePsychotherapy\u003c/em\u003e, \u003cem\u003e55\u003c/em\u003e(4), 473\u0026ndash;485. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1037/pst0000114\u003c/span\u003e\u003cspan address=\"10.1037/pst0000114\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCs\u0026aacute;ky-Pallavicini, K., Horv\u0026aacute;th, Z., Unoka, Z., Kun, B., \u0026amp; Demetrovics, Z. (2025). Personality organisation and anxiety symptoms: Investigating the mediation of perfectionism. \u003cem\u003eComprehensive Psychiatry\u003c/em\u003e, \u003cem\u003e138\u003c/em\u003e, 152582. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.comppsych.2025.152582\u003c/span\u003e\u003cspan address=\"10.1016/j.comppsych.2025.152582\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eErz, E., \u0026amp; Rentzsch, K. (2024). Does insecurity lead to envy? The longitudinal interplay between dispositional envy and self-esteem. \u003cem\u003eJournal of Research in Personality\u003c/em\u003e, \u003cem\u003e113\u003c/em\u003e, 104543. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.jrp.2024.104543\u003c/span\u003e\u003cspan address=\"10.1016/j.jrp.2024.104543\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eErz, E., \u0026amp; Rentzsch, K. (2024). Stability and change in dispositional envy: Longitudinal evidence on envy as a stable trait. \u003cem\u003eEuropean Journal of Personality\u003c/em\u003e, \u003cem\u003e38\u003c/em\u003e(1), 67\u0026ndash;84. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1177/08902070221128137\u003c/span\u003e\u003cspan address=\"10.1177/08902070221128137\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFl\u0026uuml;ckiger, C., Del Re, A. C., Wampold, B. E., \u0026amp; Horvath, A. O. (2018). The alliance in adult psychotherapy: A meta-analytic synthesis. \u003cem\u003ePsychotherapy\u003c/em\u003e, \u003cem\u003e55\u003c/em\u003e(4), 316\u0026ndash;340. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1037/pst0000130\u003c/span\u003e\u003cspan address=\"10.1037/pst0000130\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFl\u0026uuml;ckiger, C., Mahlke, F., John, G., Daus, P., \u0026amp; Zinbarg, R. E. (2024). How strongly are trait positive and negative affectivity associated with anxiety symptoms? A multilevel meta-analysis. \u003cem\u003eJournal of Anxiety Disorders\u003c/em\u003e, 102956. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.janxdis.2024.102956\u003c/span\u003e\u003cspan address=\"10.1016/j.janxdis.2024.102956\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFl\u0026uuml;ckiger, C., Rubel, J., Del Re, A. C., Horvath, A. O., Wampold, B. E., Crits-Christoph, P., Atzil-Slonim, D., Compare, A., Falkenstr\u0026ouml;m, F., Ekeblad, A., \u0026amp; Barber, J. P. (2020). The reciprocal relationship between alliance and early treatment symptoms: A two-stage individual participant data meta-analysis. \u003cem\u003eJournal of Consulting and Clinical Psychology\u003c/em\u003e, \u003cem\u003e88\u003c/em\u003e(9), 829\u0026ndash;843. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1037/ccp0000594\u003c/span\u003e\u003cspan address=\"10.1037/ccp0000594\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHenniger, N. E., \u0026amp; Harris, C. R. (2015). Envy across adulthood: The what and the who. \u003cem\u003eBasic and Applied Social Psychology\u003c/em\u003e, \u003cem\u003e37\u003c/em\u003e(6), 303\u0026ndash;318. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/01973533.2015.1088440\u003c/span\u003e\u003cspan address=\"10.1080/01973533.2015.1088440\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHoogland, C. E., Thielke, S., \u0026amp; Smith, R. H. (2017). Envy as an evolving episode. In \u003cem\u003eEnvy at work and in organizations: Research, theory, and applications\u003c/em\u003e (pp. 111\u0026ndash;142). Emerald Group Publishing. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1108/S1746-979120170000007005\u003c/span\u003e\u003cspan address=\"10.1108/S1746-979120170000007005\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHopwood, C. J., Pincus, A. L., \u0026amp; Wright, A. G. C. (2021). Six assumptions of contemporary integrative interpersonal theory of personality and psychopathology. \u003cem\u003eCurrent Opinion in Psychology\u003c/em\u003e, \u003cem\u003e41\u003c/em\u003e, 65\u0026ndash;70. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.copsyc.2021.03.007\u003c/span\u003e\u003cspan address=\"10.1016/j.copsyc.2021.03.007\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIzdebska, A., \u0026amp; Pastwa-Wojciechowska, B. (2013). Organizacja osobowości i jej pomiar \u0026ndash; polska adaptacja kwestionariusza IPO Kernberga i wsp\u0026oacute;łpracownik\u0026oacute;w. \u003cem\u003eCzas Psychologiczny\u003c/em\u003e, \u003cem\u003e19\u003c/em\u003e, 17\u0026ndash;34.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKernberg, O. F. (2019 Winter;47(4):353\u0026ndash;372). Psychotic Personality Structure. Psychodyn Psychiatry. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1521/pdps.2019.47.4.353\u003c/span\u003e\u003cspan address=\"10.1521/pdps.2019.47.4.353\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 31913791.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKernberg, O. F., \u0026amp; Michels, R. (2009). Borderline personality disorder. \u003cem\u003eAmerican Journal of Psychiatry\u003c/em\u003e, \u003cem\u003e166\u003c/em\u003e(5), 505\u0026ndash;508.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLange, J., Weidman, A. C., \u0026amp; Crusius, J. (2018). The painful duality of envy: Evidence for an integrative theory and a meta-analysis on the relation of envy and schadenfreude. \u003cem\u003eJournal of Personality and Social Psychology\u003c/em\u003e, \u003cem\u003e114\u003c/em\u003e(4), 572\u0026ndash;598. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1037/pspi0000118\u003c/span\u003e\u003cspan address=\"10.1037/pspi0000118\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLeichsenring, F., Abbass, A., Heim, N., Keefe, J. R., Kisely, S., Luyten, P., \u0026amp; Steinert, C. (2023). The status of psychodynamic psychotherapy as an empirically supported treatment for common mental disorders\u0026ndash;an umbrella review based on updated criteria. \u003cem\u003eWorld Psychiatry\u003c/em\u003e, \u003cem\u003e22\u003c/em\u003e(2), 286\u0026ndash;304. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1002/wps.21104\u003c/span\u003e\u003cspan address=\"10.1002/wps.21104\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLeichsenring, F., Heim, N., Leweke, F., Spitzer, C., Steinert, C., \u0026amp; Kernberg, O. F. (2023). Borderline personality disorder: A review. \u003cem\u003eJournal Of The American Medical Association\u003c/em\u003e, \u003cem\u003e329\u003c/em\u003e(8), 670\u0026ndash;679. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1001/jama.2023.0589\u003c/span\u003e\u003cspan address=\"10.1001/jama.2023.0589\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLorentzen, S., \u0026amp; H\u0026oslash;glend, P. A. (2008). Moderators of the effects of treatment length in long-term psychodynamic group psychotherapy. \u003cem\u003ePsychotherapy and Psychosomatics\u003c/em\u003e, \u003cem\u003e77\u003c/em\u003e(5), 321\u0026ndash;322. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1159/000147946\u003c/span\u003e\u003cspan address=\"10.1159/000147946\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMarmarosh, C. L. (2021). Ruptures and repairs in group psychotherapy: From theory to practice. \u003cem\u003eInternational Journal of Group Psychotherapy\u003c/em\u003e, \u003cem\u003e71\u003c/em\u003e(2), 205\u0026ndash;223. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/00207284.2020.1855893\u003c/span\u003e\u003cspan address=\"10.1080/00207284.2020.1855893\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMcGuire-Snieckus, R., McCabe, R., Catty, J., Hansson, L., \u0026amp; Priebe, S. (2007). A new scale to assess the therapeutic relationship in community mental health care: STAR. \u003cem\u003ePsychological Medicine\u003c/em\u003e, \u003cem\u003e37\u003c/em\u003e(1), 85\u0026ndash;95. Epub 2006 Nov 9. PMID: 17094819.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMiceli, M., \u0026amp; Castelfranchi, C. (2007). The envious mind. \u003cem\u003eCognition and Emotion\u003c/em\u003e, \u003cem\u003e21\u003c/em\u003e(3), 449\u0026ndash;479. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/02699930600814735\u003c/span\u003e\u003cspan address=\"10.1080/02699930600814735\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMielimąka, M., Rutkowski, K., Cyranka, K., Sobański, J. A., M\u0026uuml;ldner-Nieckowski, Ł., Dembińska, E., Smiatek-Mazgaj, B., \u0026amp; Klasa, K. (2015). Effectiveness of intensive group psychotherapy in treatment of neurotic and personality disorders. \u003cem\u003ePsychiatria Polska\u003c/em\u003e, \u003cem\u003e49\u003c/em\u003e(1), 29\u0026ndash;48. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.12740/PP/26093\u003c/span\u003e\u003cspan address=\"10.12740/PP/26093\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMuran, J. C., \u0026amp; Eubanks, C. F. (2020). \u003cem\u003eTherapist performance under pressure: Negotiating emotion, difference, and rupture\u003c/em\u003e. American Psychological Association. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1037/0000182-000\u003c/span\u003e\u003cspan address=\"10.1037/0000182-000\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOgrodniczuk, J. S., Piper, W. E., Joyce, A. S., Weideman, R., McCallum, M., Azim, H. F., \u0026amp; Rosie, J. S. (2003). Differentiating symptoms of complicated grief and depression among psychiatric outpatients. Can J Psychiatry. ;48(2):87\u0026ndash;93. doi: 10.1177/070674370304800204. PMID: 12655905.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePrusiński, T. (2023). Personality disorder type only sometimes matters: An exploration of patients\u0026rsquo; personality disorder as a source of variance in early therapeutic alliance. \u003cem\u003eClinical Psychology \u0026amp; Psychotherapy\u003c/em\u003e, \u003cem\u003e30\u003c/em\u003e(3). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003eArticle 2943. https://doi.org/10.1002/cpp.2943\u003c/span\u003e\u003cspan address=\"Article 2943. 10.1002/cpp.2943\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRosendahl, J., Alldredge, C. T., Burlingame, G. M., \u0026amp; Strauss, B. (2021). Recent developments in group psychotherapy research. \u003cem\u003eAmerican Journal of Psychotherapy\u003c/em\u003e, \u003cem\u003e74\u003c/em\u003e(2), 52\u0026ndash;59. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1176/appi.psychotherapy.20200031\u003c/span\u003e\u003cspan address=\"10.1176/appi.psychotherapy.20200031\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eScherer, K. R., \u0026amp; Moors, A. (2019). The emotion process: Event appraisal and component differentiation. \u003cem\u003eAnnual Review of Psychology\u003c/em\u003e, \u003cem\u003e70\u003c/em\u003e(1), 719\u0026ndash;745. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1146/annurev-psych-122216-011854\u003c/span\u003e\u003cspan address=\"10.1146/annurev-psych-122216-011854\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSmith, R. H. (2004). Envy and its transmutations. In L. Z. Tiedens, \u0026amp; C. W. Leach (Eds.), \u003cem\u003eThe social life of emotions\u003c/em\u003e (pp. 43\u0026ndash;63). Cambridge University Press. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1017/CBO9780511819568.004\u003c/span\u003e\u003cspan address=\"10.1017/CBO9780511819568.004\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSmith, R. H., \u0026amp; Kim, S. H. (2007). Comprehending envy. \u003cem\u003ePsychological Bulletin\u003c/em\u003e, \u003cem\u003e133\u003c/em\u003e(1), 46\u0026ndash;64. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1037/0033-2909.133.1.46\u003c/span\u003e\u003cspan address=\"10.1037/0033-2909.133.1.46\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSobański, J. A., Klasa, K., Rutkowski, K., Dembińska, E., \u0026amp; Muldner-Nieckowski, Ł. (2013). Symptom profile of patients who dropped out of complex psychotherapy at a day hospital for neurotic disorders: A retrospective analysis. \u003cem\u003ePsychiatria i Psychoterapia\u003c/em\u003e, \u003cem\u003e9\u003c/em\u003e(4), 14\u0026ndash;38.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSosnowska, M., Prot, K., Murawiec, S., Kos-Maszaro, I., Kamela, D., Lech, K., Czerwińska, M., Grudowska, B., Skiba, J., Augustyn, A., Krzysztoszek, B., \u0026amp; Twardowska, H. (2012). Trudności emocjonalne terapeut\u0026oacute;w i szybsze rozpoczynanie leczenia w ramach opieki środowiskowej \u0026mdash; por\u0026oacute;wnanie leczenia środowiskowego z leczeniem ambulatoryjnym. \u003cem\u003ePsychoterapia\u003c/em\u003e, \u003cem\u003e3\u003c/em\u003e(162), 55\u0026ndash;63.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKlasa, K., Sobański, J. A., Konop, M., Dembińska, E., Mielimąka, M., Citkowska-Kisielewska, A., Jęda, P., Pelc, M., \u0026amp; Rutkowski, K. (2022). Complaints of dyspnea and their associations with personality traits in patients referred to psychotherapy in a day hospital. \u003cem\u003eJournal Of Psychosomatic Research\u003c/em\u003e, \u003cem\u003e157\u003c/em\u003e, 110786. Epub 2022 Mar 18. PMID: 35364372.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWright, A. G. C., Hopwood, C. J., \u0026amp; Pincus, A. L. (2021). The interpersonal situation: Contemporary perspectives on interpersonal theory and assessment. \u003cem\u003eCurrent Opinion in Psychology\u003c/em\u003e, \u003cem\u003e41\u003c/em\u003e, 106\u0026ndash;111. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.copsyc.2021.04.004\u003c/span\u003e\u003cspan address=\"10.1016/j.copsyc.2021.04.004\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYalom, I. D., \u0026amp; Leszcz, M. (2020). \u003cem\u003eThe theory and practice of group psychotherapy.\u003c/em\u003e Hachette UK.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZilcha-Mano, S., \u0026amp; Muran, J. C. (2024). Thinking transtheoretically about alliance and rupture: Implications for practice and training. \u003cem\u003eClinical Psychology in Europe\u003c/em\u003e, \u003cem\u003e6\u003c/em\u003e. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.32872/cpe.12439\u003c/span\u003e\u003cspan address=\"10.32872/cpe.12439\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Special Issue), Article e12439.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"journal-of-contemporary-psychotherapy","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"jocp","sideBox":"Learn more about [Journal of Contemporary Psychotherapy](http://link.springer.com/journal/10879)","snPcode":"10879","submissionUrl":"https://submission.springernature.com/new-submission/10879/3?","title":"Journal of Contemporary Psychotherapy","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"group psychotherapy, envy, personality organisation, leader–member relationship, psychodynamic therapy","lastPublishedDoi":"10.21203/rs.3.rs-9332763/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9332763/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjectives\u003c/h2\u003e \u003cp\u003eThe study focuses on envy as a complex interpersonal affect. It examines variability in patients\u0026rsquo; levels of personality organisation, envy, and the therapist-patient relationship in psychodynamic group process.\u003c/p\u003e\u003ch2\u003eDesign\u003c/h2\u003e \u003cp\u003e: Conducted between 2022 and 2024, the study included a sample of 164 patients treated in 3 half-opened therapeutic groups, the majority of whom were diagnosed with personality or anxiety disorders.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThe following instruments were used: the Inventory of Personality Organisation (IPO-PL), the Neurotic Personality Questionnaire (NPQ), and the Scale to Assess Therapeutic Relationship (STAR).\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eLinear mixed-effects analyses (LMM) were conducted. Regarding personality organisation there were no statistically significant differences across the three therapeutic groups. In all therapy groups the leader\u0026ndash;member therapeutic relationship strengthened, and envy levels declined significantly, with modest differences in change trajectories between groups.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThe findings suggest parallel and partially independent change processes, which is of considerable clinical relevance.\u003c/p\u003e","manuscriptTitle":"Parallel Change Processes in Envy and the Patient–Therapist Relationship During Psychodynamic Group Psychotherapy","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-16 13:59:12","doi":"10.21203/rs.3.rs-9332763/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"240216437659000870594739376953102140395","date":"2026-05-15T18:35:08+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-08T13:56:22+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-08T04:22:20+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-08T04:21:50+00:00","index":"","fulltext":""},{"type":"submitted","content":"Journal of Contemporary Psychotherapy","date":"2026-04-06T10:12:06+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"journal-of-contemporary-psychotherapy","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"jocp","sideBox":"Learn more about [Journal of Contemporary Psychotherapy](http://link.springer.com/journal/10879)","snPcode":"10879","submissionUrl":"https://submission.springernature.com/new-submission/10879/3?","title":"Journal of Contemporary Psychotherapy","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"044e0dad-23fa-4170-b369-43e141203810","owner":[],"postedDate":"April 16th, 2026","published":true,"recentEditorialEvents":[{"type":"reviewerAgreed","content":"240216437659000870594739376953102140395","date":"2026-05-15T18:35:08+00:00","index":21,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-16T13:59:12+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-16 13:59:12","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9332763","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9332763","identity":"rs-9332763","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}