Realiteitsbesef

Realiteitsbesef is a term used in Dutch to denote the capacity to perceive, interpret, and respond to the external world as it is, distinguishing what is real from what is imagined or believed. In clinical psychology and psychiatry, the concept is closely linked to insight and reality testing: the ability of a person to recognise the presence of symptoms, understand their implications, and align beliefs and behaviors with external evidence. A higher level of realiteitsbesef supports treatment engagement and adaptive functioning, while impaired realiteitsbesef can be observed in conditions such as psychotic disorders, delirium, and some neurodegenerative diseases.

Realiteitsbesef comprises cognitive judgments about facts and events, as well as more affective and social judgments about norms and situational appropriateness. It develops through childhood and adolescence and can be influenced by cognitive development, education, language, and cultural context. In clinical and elder-care settings, the term is sometimes discussed in relation to reality orientation—awareness of time, place, and person—which can fluctuate with disease progression.

Assessment of realiteitsbesef is typically performed by clinicians through interviews and observation, and, when relevant, the use of standardized scales for insight or reality testing. Interpretations of realiteitsbesef are context-dependent and culturally shaped; what constitutes an appropriate sense of reality may vary across different settings and populations.