Reality testing refers to which of the following?

• A. The ability to identify external voices as separate from self
• B. Assessing whether voices know the patient’s thoughts
• C. A type of cenesthetic hallucination
• D. A mood symptom criterion

Answer: (B)

Reality testing is the ability to distinguish what is real from what is a product of one’s own mind. In psychosis, it involves recognizing that perceptual experiences like voices are external and separate from one’s own thoughts. Identifying external voices as separate from self demonstrates intact reality testing. The idea that voices know the patient’s thoughts isn’t what reality testing assesses; that notion would imply a delusion about mind-reading, not the capacity to judge reality. Cenesthetic hallucinations are bodily sensations labeled as real, which is a different phenomenon, and mood symptom criteria relate to affective symptoms rather than the ability to discern reality.