784 Conditions for Further Study
iors are noted by the individual  and/or others, suggesting a change in mental state (i.e., the
symptoms are of sufficient severi ty or frequency to warrant clin ical attention) (Criterion A).
Attenuated delusions (Criterion  A1) may have suspiciousness /persecutory ideational con-
tent, including persecutory ideas of reference. The individual may have a guarded, distrust-
ful attitude. When the delusions are moderate in severity, the individual views others as
untrustworthy and may be hyperv igilant or sense ill will in others. When the delusions are
severe but still within the attenuated range, the individual entertains  loosely organized be-
liefs about danger or hostile in tention, but the delusions do no t have the fixed nature that is
necessary for the diagnosis of a psychotic diso rder. Guarded behavior in the interview can
interfere with the ability to gath er information. Rea lity testing and perspective can be elic-
ited with nonconfirming evidence, but the prop ensity for viewing the world as hostile and
dangerous remains strong. Attenuated delusions may have grandiose content presenting as
an unrealistic sense of superior capacity. Wh en the delusions are moderate, the individual
harbors notions of being gifted, influential, or special. When the delusions are severe, the in-
dividual has beliefs of superiority that often alienate friends and worry relatives. Thoughts
of being special may lead to unrealistic plans and investments, yet skepticism about these at-
titudes can be elicited with persis tent questioning and confrontation.
Attenuated hallucinations (Criterion A2) include alterations in sensory perceptions,
usually auditory and/or visual. When the hallucinations are moderate, the sounds and