Unreal? A Behavioral, Physiological, and Computational Model of the Sense of Reality

Our awareness of dreams, hallucinations, and illusions reflects an intriguing human capacity to recognize potentially false perceptions, known as the Sense of Reality (SoR). Though central to mental health, the study of SoR has been hindered by the subjective nature of hallucinatory experiences. Here we employed a novel virtual reality paradigm simulating virtual hallucinations, mirroring the phenomenology of clinical hallucinations. Combining psychophysics, physiological recordings, and computational modeling in one exploratory (n = 31) and one preregistered experiment (n = 32), we found that SoR varied with virtual hallucination magnitude and domain. SoR judgments were associated with distinct motor, pupillary, and cardiac responses, allowing classification of virtual hallucination exposure. We present a computational model in which SoR judgments arise from comparing current sensory input to an internal model of the world. Our results shed light on the age-old question how do we know what is real?