During a psychotic episode, a person may have difficulty determining what is:

During a psychotic episode, individuals experience significant disruptions in their perception of reality. This may include hallucinations, delusions, or disorganized thinking, leading them to struggle with differentiating what is real and what is not real. This inability to discern reality can impact their thoughts, emotions, and behaviors, often resulting in experiences that do not align with external reality.

While concepts such as good and bad, true and false, or safe and unsafe can also be affected during a psychotic episode, the fundamental challenge lies in the perception of reality itself. The person may genuinely believe in the reality of their hallucinations or delusions, which can cause confusion and distress. Therefore, the correct answer highlights the core issue that arises during such episodes, focusing specifically on the difficulty in distinguishing real experiences from altered or imagined ones.