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Case 1:20-cr-00330-PAE Document663_ Filed 06/15/22 Page 76 of 77 Porensic-Psychiatric Report Ghislaine Maxwell FORMULATION Ms. Maxwell ts a 59-year-old Caucasian woman, who 1s being evaluated at the request of her attorney in order to assess her current mental state and risk of flight. Ms. Maxwell has consistent described, and complained formally of, being subject to unfair and inconsistent treatment by correction officers and ongoing sleep deprivation throughout her incarceration. Research indicates that the experience of unfairness, disrespect, and a lack of safety significantly contributes to psychological distress in incarcerated individuals. Furthermore, recent research on the effects of sleep deprivation on cognitive functioning states that “sleep deprivation resulted in a loss of cognitive flexibility through feedback blunting...sleep deprivation causes a fundamental problem with dynamic attentional control.”* Furthermore, one study showed that: Relative to baseline, sleep deprivation was associated with lower scores on Total EO (decreased global emotional intelligence), Intrapersonal functioning (reduced self-regard, assertiveness, sense of independence, and self-actualization), Interpersonal functioning (reduced empathy toward others and quality of interpersonal relationships), Stress Management skills (reduced impulse control and difficulty with delay of gratification), and Behavioral Coping (reduced positive thinking and action orientation). Esoteric Thinking (greater reliance on formal superstitions and magical thinking processes) was increased? 2 American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing 3 Liebling, A., Durie, L., Stiles, A., & Tait, S. (2013). Revisiting prison suicide: The role of fairness and distress. In The offects of imprisonment (pp. 229-251). Willan. * Honn, K. A., Hinson, J. M., Whitney, P., & Van Dongen, H. P. A. (2019). Cognitive flexibility: a distinct element of performance impairment due to sleep deprivation. Accident Analysis ¢ Prevention, 126, 191-197. 5 Killeore, W. D., Kahn-Greene, E. T., Lipizzi, E. L., Newman, R. A., Kamimori, G. H., & Balkin, T. J. (2008). Sleep deprivation reduces perceived emotional intelligence and constructive thinking skills. Séep medicine, 25), 517-526. Page 7 of 8 DOJ-OGR-00010522