Although there is a wide range of psychological responses to childhood sexual abuse, problems with low self-esteem, depression, dissociation, lack of trust, and strong feelings of shame are very common. In fact, the diagnosis of complex PTSD was developed largely out of the study of sexual abuse survivors. Borderline personality disorder is also strongly linked to child sexual abuse. Not surprisingly, many sexual abuse survivors also have disturbances in their sexual functioning as adults. Some survivors become over-controlled sexually, with intense fear of and aversion to sexual contact. Others go to the opposite extreme and become sexually promiscuous, engaging in compulsive, driven, and often reckless sexual behavior. A 2008 study by Beth Brodsky and colleagues showed that the effects of child sexual abuse can reach across generations. Children of mothers who were sexually abused as children had an increased rate of suicidal tendencies compared to children of non-abused mothers.