reality testing


Summary: The individual's objective evaluation of the external world and the ability to differentiate adequately between it and the internal world; considered to be a primary ego function.

Top Publications

  1. Nahum L, Ptak R, Leemann B, Schnider A. Disorientation, confabulation, and extinction capacity: clues on how the brain creates reality. Biol Psychiatry. 2009;65:966-72 pubmed publisher
    ..Rather than invoking high-level monitoring processes, the human brain seems to make use of an ancient biological faculty-extinction-to keep thought and behavior in phase with reality. ..
  2. Woolley J, Cox V. Development of beliefs about storybook reality. Dev Sci. 2007;10:681-93 pubmed
    ..In Experiment 2, 136 4- and 5-year-olds heard similar stories. Results replicated those from Experiment 1, and also indicated a growing awareness of the basic nature of realistic fiction. ..
  3. Schnider A. Spontaneous confabulation and the adaptation of thought to ongoing reality. Nat Rev Neurosci. 2003;4:662-71 pubmed
  4. Matute H, Vadillo M, Vegas S, Blanco F. Illusion of control in Internet users and college students. Cyberpsychol Behav. 2007;10:176-81 pubmed
    ..Understanding how robust and general this effect is, is a first step towards eradicating irrational and pseudoscientific thinking. ..
  5. Moore M, Fresco D. Depressive realism: a meta-analytic review. Clin Psychol Rev. 2012;32:496-509 pubmed publisher
    ..Methodological paradigm was also found to influence whether results consistent with depressive realism were found (d's ranged from -.09 to .14). ..
  6. McDannald M, Whitt J, Calhoon G, Piantadosi P, Karlsson R, O DONNELL P, et al. Impaired reality testing in an animal model of schizophrenia. Biol Psychiatry. 2011;70:1122-6 pubmed publisher
    ..and devastating brain disorder characterized by hallucinations and delusions, symptoms reflecting impaired reality testing. Although animal models have captured negative symptoms and cognitive deficits associated with schizophrenia, ..
  7. Boyer P. Further distinctions between magic, reality, religion, and fiction. Child Dev. 1997;68:1012-4; discussion 1027-30 pubmed
    ..3) We have no good description of children's handling of fiction. (4) Cultural systems of religious representations make particular demands on developmental processes. ..
  8. Woolley J. Thinking about fantasy: are children fundamentally different thinkers and believers from adults?. Child Dev. 1997;68:991-1011 pubmed
    ..Suggestions are offered as to how children and adults may differ in this domain, and an agenda for future research is offered. ..
  9. Brewin C. A theoretical framework for understanding recovered memory experiences. Nebr Symp Motiv. 2012;58:149-73 pubmed
    ..Memory appraisals may also influence the sense that an event has been forgotten for a long time. Recovered memories, although unusual, do not contradict what we know about how memory works. ..

More Information


  1. Langdon R, Bayne T. Delusion and confabulation: mistakes of perceiving, remembering and believing. Cogn Neuropsychiatry. 2010;15:319-45 pubmed publisher
    ..Underlying both spontaneous confabulations and other received delusions, we propose, is an inability to inhibit the prepotent tendency to upload and maintain experiential content (mnemonic or perceptual) into belief. ..
  2. Markey C, Markey P. A correlational and experimental examination of reality television viewing and interest in cosmetic surgery. Body Image. 2010;7:165-71 pubmed publisher
    ..Results indicated that participants who watched a television program about cosmetic surgery wanted to alter their own appearance using cosmetic surgery more than did participants who were not exposed to this program. ..
  3. Preda A. Do schizophrenia patients want to be involved in their treatment?. Am J Psychiatry. 2006;163:937; author reply 937 pubmed
  4. Reese H, McNally R, Wilhelm S. Reality monitoring in patients with body dysmorphic disorder. Behav Ther. 2011;42:387-98 pubmed publisher
    ..The results suggest that impairments in reality monitoring do not contribute to the development or maintenance of appearance-related beliefs in BDD. ..
  5. Surian L, Geraci A. Where will the triangle look for it? Attributing false beliefs to a geometric shape at 17 months. Br J Dev Psychol. 2012;30:30-44 pubmed publisher
    ..These findings provide support for theoretical accounts that emphasize continuity in the development of theory of mind core concepts and belief reasoning skills. ..
  6. Fowler J, Hilsenroth M, Groat M, Biel S, Biedermann C, Ackerman S. Risk factors for medically serious suicide attempts: evidence for a psychodynamic formulation of suicidal crisis. J Am Psychoanal Assoc. 2012;60:555-76 pubmed publisher
    ..attempts, including assessments of affect flooding, negative self-schema / fragmentation, and impaired reality testing, closely approximating Maltsberger's psycho-dynamic formulation of suicide crisis...
  7. Apperly I, Samson D, Chiavarino C, Humphreys G. Frontal and temporo-parietal lobe contributions to theory of mind: neuropsychological evidence from a false-belief task with reduced language and executive demands. J Cogn Neurosci. 2004;16:1773-84 pubmed
    ..We discuss the importance of gaining empirical evidence about the scope of ''theory of mind'' impairments, and the important role for neuropsychological studies in this project. ..
  8. Flannery K, Walles R. How does schema theory apply to real versus virtual memories?. Cyberpsychol Behav. 2003;6:151-9 pubmed
  9. Kosik K. Beyond phrenology, at last. Nat Rev Neurosci. 2003;4:234-9 pubmed
  10. Dodds T, Mohler B, Bülthoff H. Talk to the virtual hands: self-animated avatars improve communication in head-mounted display virtual environments. PLoS ONE. 2011;6:e25759 pubmed publisher
  11. Ziemer C, Plumert J, Cremer J, Kearney J. Estimating distance in real and virtual environments: Does order make a difference?. Atten Percept Psychophys. 2009;71:1095-106 pubmed publisher
    ..These subtle yet persistent order effects suggest that memory can play an important role in distance perception. ..
  12. Donnelly D. The function of suffering as portrayed in the Scarlet Letter and reflected in clinical work. J Am Psychoanal Assoc. 2012;60:1139-59 pubmed publisher
    ..Hawthorne, it is argued, intuitively grasped this function of suffering in his novel. ..
  13. Al Heeti K, Hamid A, Alghorani M. The Irrational Beliefs Inventory: psychometric properties and cross-cultural validation of its Arabic version. Psychol Rep. 2012;111:47-63 pubmed
  14. McDaniel M, Lyle K, Butler K, Dornburg C. Age-related deficits in reality monitoring of action memories. Psychol Aging. 2008;23:646-56 pubmed publisher
    ..However, sensory information derived from imagination appears to be more similar to that derived from performance for older adults than for younger adults. ..
  15. Leynes P, Cairns A, Crawford J. Event-related potentials indicate that reality monitoring differs from external source monitoring. Am J Psychol. 2005;118:497-524 pubmed
    ..Furthermore, there were no frontal old-new ERP differences during reality monitoring, suggesting that different decision processes are used in these types of source monitoring decisions. ..
  16. Judd P. Neurocognitive impairment as a moderator in the development of borderline personality disorder. Dev Psychopathol. 2005;17:1173-96 pubmed
    ..Areas for future research that might verify or refute this theory are suggested. ..
  17. Wang R. Between reality and imagination: when is spatial updating automatic?. Percept Psychophys. 2004;66:68-76 pubmed
    ..Automatic updating of the real objects required perceptual experience of these targets, either visually or by touch, and did not occur when the targets were described verbally. Implications for spatial cognition research are discussed. ..
  18. Fertuck E, Target M, Mergenthaler E, Clarkin J. The development of a computerized linguistic analysis instrument of the reflective functioning measure. J Am Psychoanal Assoc. 2004;52:473-5 pubmed
  19. Oka K. [The psychopathology of "as if" experiences]. Nervenarzt. 2007;78:780-6 pubmed
    ..As mentioned, reality and appearance get pathologically entangled in both obsessive and delusional patients. Some therapeutic proposals are offered from the standpoint of these "as if" patents. ..
  20. Hansen C, Torgalsbøen A, Røssberg J, Andreassen O, Bell M, Melle I. Object relations and reality testing in schizophrenia, bipolar disorders, and healthy controls: differences in profiles and clinical correlates. Compr Psychiatry. 2012;53:1200-7 pubmed publisher
    Deficits in object relations (OR) and reality testing (RT) functions are found in schizophrenia but have never been investigated in bipolar disorder...
  21. Schuld J, Slotta J, Schuld S, Kollmar O, Schilling M, Richter S. Popular belief meets surgical reality: impact of lunar phases, Friday the 13th and zodiac signs on emergency operations and intraoperative blood loss. World J Surg. 2011;35:1945-9 pubmed publisher
    ..Scientific analysis of our data does not support the belief that moon phases, zodiac signs, or Friday 13th influence surgical blood loss and emergency frequency. Our data indicate that such beliefs are myths far beyond reality. ..
  22. Brooks R. Un-thought out metaphysics in analytical psychology: a critique of Jung's epistemological basis for psychic reality. J Anal Psychol. 2011;56:492-513 pubmed publisher
    ..This model of understanding subjectivity is briefly contrasted with Heidegger's 'fundamental ontology' which focuses on a non-Cartesian 'understanding' of the 'presencing of being' in everyday social and historical contexts. ..
  23. Cormier A, Jourda B, Laros C, Walburg V, Callahan S. [Influence between early maladaptive schemas and depression]. Encephale. 2011;37:293-8 pubmed publisher
    ..Further research will be necessary to explore the role of depression as an activator or/and by reinforcing early maladaptive schemas. ..
  24. Carcamo C. [Perceived quality: illusion or perception]. Rev Calid Asist. 2011;26:184-7 pubmed publisher
  25. Waugaman R. "If you want to bring someone back to reality, you have to enter their world first". Psychiatry. 2005;68:236-42 pubmed
  26. Echterhoff G, Higgins E, Groll S. Audience-tuning effects on memory: the role of shared reality. J Pers Soc Psychol. 2005;89:257-76 pubmed
    ..Message and memory were more closely associated for high than for low trusters. Apparently, audience-tuning effects depend on the communicators' experience of a shared reality. ..
  27. Klein W, Lipkus I, Scholl S, McQueen A, Cerully J, Harris P. Self-affirmation moderates effects of unrealistic optimism and pessimism on reactions to tailored risk feedback. Psychol Health. 2010;25:1195-208 pubmed publisher
  28. Maher B. The relationship between delusions and hallucinations. Curr Psychiatry Rep. 2006;8:179-83 pubmed
    ..In this case, it would be reasonable to regard the hallucinations as exercising a causative role in the development of delusions. ..
  29. Weaver K, Garcia S, Schwarz N, Miller D. Inferring the popularity of an opinion from its familiarity: a repetitive voice can sound like a chorus. J Pers Soc Psychol. 2007;92:821-33 pubmed
    ..Implications for social consensus estimation and social influence are discussed. ..
  30. Principe G, Tinguely A, Dobkowski N. Mixing memories: the effects of rumors that conflict with children's experiences. J Exp Child Psychol. 2007;98:1-19 pubmed
    ..Developmental changes in children's understanding of conflicting mental representations were linked to their ability to resist being misled by the conflicting rumor. ..
  31. O Brien P, Johns L. A graded exposure intervention for distressing visual hallucinations in schizophrenia. Behav Cogn Psychother. 2013;41:495-9 pubmed publisher
    ..Through exposure to the hallucinatory content, the client re-appraised her VH as non-threatening, and her fear of them reduced. This reduction in anxiety led to a decrease in the occurrence of the VH. ..
  32. Besnard J, RICHARD P, Banville F, Nolin P, Aubin G, Le Gall D, et al. Virtual reality and neuropsychological assessment: The reliability of a virtual kitchen to assess daily-life activities in victims of traumatic brain injury. Appl Neuropsychol Adult. 2016;23:223-35 pubmed publisher
    ..Moreover, regression analyses demonstrated that performance on NI-VCT matched real-task performance. Our results support the idea that the virtual kitchen is a valid tool for IADL assessment in patients who have sustained a TBI. ..
  33. Schneider J. Experiences in K and -K. Int J Psychoanal. 2005;86:826-39 pubmed
    ..Her need not to know reached a point where she psychically obliterated the analyst through the use of negative hallucination. ..
  34. Tutter A. Metamorphosis and the aesthetics of loss: I. Mourning Daphne--the Apollo and Daphne paintings of Nicolas Poussin. Int J Psychoanal. 2011;92:427-49 pubmed publisher
    ..The poetic and aesthetic reworking of the regressive, magical experience of metamorphosis restores it to the symbolic world of metaphor: for reparation, remembrance, and return. ..
  35. Döhnel K, Schuwerk T, Meinhardt J, Sodian B, Hajak G, Sommer M. Functional activity of the right temporo-parietal junction and of the medial prefrontal cortex associated with true and false belief reasoning. Neuroimage. 2012;60:1652-61 pubmed publisher
    ..False over true belief reasoning induced activation in the posterior MPFC (pMPFC), supporting its role in the decoupling mechanisms, which is defined as processing a mental state independently of the state of reality. ..
  36. Guttentag R, Ferrell J. Reality compared with its alternatives: age differences in judgments of regret and relief. Dev Psychol. 2004;40:764-75 pubmed
    ..Experiment 3 focused on the understanding of relief. In contrast to the findings from Experiment I, the 7-year-olds in Experiment 3 made their judgments solely on the basis of what actually occurred. ..
  37. Beck T, Mitmansgruber H, Kumnig M, Schüßler G. [Depressives have the better view - the influence of mood on the recognition of emotional expression]. Z Psychosom Med Psychother. 2013;59:247-53 pubmed
    ..In four out of six tests the depressive persons achieved significantly better results. We suggest that these results can be interpreted as further evidence for the concept of depressive emotional realism. ..
  38. Moritz S, Woodward T, Jelinek L, Klinge R. Memory and metamemory in schizophrenia: a liberal acceptance account of psychosis. Psychol Med. 2008;38:825-32 pubmed publisher
    ..These data assert that LA is a core mechanism contributing to both enhanced acceptance of weakly supported response alternatives and metamemory deficits, and this may be linked to the emergence of positive symptomatology. ..
  39. Vaden V, Woolley J. Does God make it real? Children's belief in religious stories from the Judeo-Christian tradition. Child Dev. 2011;82:1120-35 pubmed publisher
    ..Story familiarity and family religiosity also affected children's responses. The authors conclude that God's involvement in a story influences children's belief in the reality of the characters and events in that story. ..
  40. Hydén L, Antelius E. Communicative disability and stories: Towards an embodied conception of narratives. Health (London). 2011;15:588-603 pubmed publisher
  41. Woodward T, Menon M. Considerations for analysis of source monitoring data when investigating hallucinations in schizophrenia research. Eur Arch Psychiatry Clin Neurosci. 2011;261:157-64 pubmed publisher
    ..We instead recommend analysis of covariance (ANCOVA), or difference score methodology, as an appropriate method for partialling external-source guessing rates (external-source false positives) out of externalization bias rates. ..
  42. Green C, Freeman D, Kuipers E, Bebbington P, Fowler D, Dunn G, et al. Paranoid explanations of experience: a novel experimental study. Behav Cogn Psychother. 2011;39:21-34 pubmed publisher
    ..In line with current theories, the findings suggest that emotional processes contribute to paranoid interpretations of events, although, as a novel study with a modest sample, it requires replication. ..
  43. Cooper S. An elusive aspect of the analyst's relationship to transference. Psychoanal Q. 2010;79:349-80 pubmed
    ..To clinically illustrate his points, the author summarizes the case of a patient whose transference fantasies and attributions engendered quite contrasting reactions by two different analysts. ..
  44. Koydemir S, Demir A. Shyness and cognitions: an examination of Turkish university students. J Psychol. 2008;142:633-44 pubmed publisher
    ..The authors discuss the findings in terms of relevant literature and cultural issues. ..
  45. Cox R, Barnier A. Hypnotic illusions and clinical delusions: a hypnotic paradigm for investigating delusions of misidentification. Int J Clin Exp Hypn. 2009;57:1-32 pubmed publisher
    ..These findings highlight the instrumental value of hypnosis to the investigation and understanding of delusions and autobiographical memory. ..
  46. Schrank B, Stanghellini G, Slade M. Hope in psychiatry: a review of the literature. Acta Psychiatr Scand. 2008;118:421-33 pubmed publisher
    ..Many conceptual frameworks for hope have been proposed, but empirical evidence on its predictive power in mental health is lacking. ..
  47. Arrigo B, Bullock J. The psychological effects of solitary confinement on prisoners in supermax units: reviewing what we know and recommending what should change. Int J Offender Ther Comp Criminol. 2008;52:622-40 pubmed
    ..The connections between internment and mental illness-as well as isolation and race, gender, and class-are explored. A set of recommendations for the reform of secure housing is presented. ..
  48. Achim A, Weiss A. No evidence for a differential deficit of reality monitoring in schizophrenia: a meta-analysis of the associative memory literature. Cogn Neuropsychiatry. 2008;13:369-84 pubmed publisher
    ..In addition, memory tests that do not include new items appear to maximise this effect, perhaps by removing a potential response outlet for subjects who lack confidence in the accuracy of their memory performance. ..
  49. Birnbaum G, Svitelman N, Bar Shalom A, Porat O. The thin line between reality and imagination: attachment orientations and the effects of relationship threats on sexual fantasies. Pers Soc Psychol Bull. 2008;34:1185-99 pubmed publisher
    ..Emotional threat was also most likely to induce negative views of others in more avoidant women. Implications for understanding the underlying functions of sexual fantasies within the context of romantic relationships are discussed. ..
  50. Freeman P. Perception should approximate reality. Optometry. 2005;76:345-6 pubmed
  51. Besiroglu L, Uguz F, Ozbebit O, Guler O, Cilli A, Askin R. Longitudinal assessment of symptom and subtype categories in obsessive-compulsive disorder. Depress Anxiety. 2007;24:461-6 pubmed
  52. El Haj M, Fasotti L, Allain P. Source monitoring in Alzheimer's disease. Brain Cogn. 2012;80:185-91 pubmed publisher
    ..Our results emphasize the role of inhibitory processes in AD patients' source monitoring decline. The close relation between source and inhibitory decline in AD is interpreted in terms of a common neural base for both concepts. ..
  53. Bunce L, Harris M. "He hasn't got the real toolkit!" Young children's reasoning about real/not-real status. Dev Psychol. 2013;49:1494-504 pubmed publisher
    ..Together, these results support the hypothesis that understanding reality status on the basis of authenticity develops before ontological status. The development of reasoning about real/not-real status is discussed. ..