Reality monitoring across disorders of reality: Systematic and narrative reviews of dissociation and psychosis
Journal of Psychiatric Research January 19, 2026 Gwynnevere Suter, Ian Apperly, L. Zhang et al. 1 citation
Reality monitoring—the ability to remember whether information came from one's own mind or from the outside world—is often impaired in clinical conditions, but no prior review had compared this ability across dissociation and psychosis. A systematic review of four high-quality papers (482 participants) found a small but significant negative association between reality monitoring and dissociation, indicating slight impairment. A narrative review of psychosis showed that clinical psychosis is robustly linked to impaired reality monitoring and an externalizing bias (attributing internal information to an external source), while results for non-clinical psychotic-like experiences were mixed. Comparing the two fields suggests a shared cognitive basis, but no studies have examined clinical dissociation or source-attribution biases, leaving the comparison incomplete.