Potential effects of sibling abuse include difficulty separating pleasure from pain and fear from desire in a sexual relationship, depression, eating disorders, substance abuse, low self-esteem, and suicide, re-victimization in adulthood, prostitution in later life, difficulty in developing and sustaining intimate relationships, trouble negotiating boundaries, sexual issues, and interdependency in relationships, shame, fear, humiliation, anger, and guilt, severe psychiatric disorders such as dissociative coping and complex post traumatic stress disorder, wide variety of health and mental health issues, significant problems with affect regulation, impulse control, somatization, sense of self, cognitive distortions, and problems with socialization, and higher risk of pregnancy than father-daughter incest.