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Although childhood sexual abuse (CSA) has been linked to risk for delinquency, research is limited on the potential pathways from CSA to subsequent delinquent outcomes. A total of 160 youth with confirmed CSA histories were interviewed at the time of abuse discovery, when they were 8 to 15 years of age, and again 1 and 6 years later. The findings supported the proposed relations from stigmatization following the abuse (abuse-specific shame and self-blame attributions) and internalizing symptoms to subsequent delinquency through anger and affiliation with deviant peers. This longitudinal research suggests that clinical interventions for victims of CSA must be sensitive to these affective and cognitive processes and how they affect delinquent activity.