Our son was exposed to persistent bullying in a school he attended in his early primary school years (age 4 and 5 ), at age 6 he expressed an acute anxiety regarding a voice in his head that told him he was a bad person.....he was seen by a clinical psychologist for assessment; the psychologist decided he was perfectly normal, healthy and bright...our son was very social,highly sensitive, verbally expressive, and affectionate. We removed him from that awful school; later we find out that the school principal had record of children that were removed due to bullying, and this same principal later told us she believed " that bullying is part of life and you might as well get use to it", to top this off this same principal felt our child was the cause of being bullied! So you can imagine how our child was stressed and how he convinced himself over the years in his mind that he was a bad person and that is why he was bullied and marginalized by his peers; the change of school helped but did not nothing obviously to rewire his brain regarding how he would cope with stress later in life, his self perception , and his anxietyand need to be approved. In his teens every time he was stressed his negative self perception would re-emerge, eventually he stressed himself to the point of psychosis....paranoia schizophrenia. Today we believe that those early year experiences traumatized him, and we did not understand the full extent of that trauma although we worried about his former expereience and impact. But his self assurance masked his inner pain, and he was so out-going and positve, successful at his endeavors we were fooled. We thought a change of school and love/care at home would remedy the experience he had......obviously it was not enough as his trauma surfaced later in his teens wit increase of acadmeic , peer stress etc.. which we mistook as teen angst. It did not help that our son in his teens refused any form of extensive therapy, but by then he was already in advanced stages of his mental illness. So orphanages may be one cause of early childhood traumatic experiences but even trauma caused by persistent bullying are definitely another cause! It does not have to be rape, physical abuse, as verbal abuse and psychological alienation is enough ...to re-wire the brain. By the way the trauma did nothing to stop his cognitive development, he was bright at school, social, won awards in drama, art and debating but on the onset of his acute mental illness in his teens (breakdown) his cognition became undermined......the rest is history of paranoia-schizophrenia with all the positive and negative symptoms.