, ▁be ▁an ▁adult . ▁ ▁F athers ▁and ▁other ▁male ▁care g ivers ▁have ▁been ▁the ▁perpet rat ors ▁in ▁only ▁seven ▁percent ▁of ▁the ▁cases ▁studied . ▁ ▁When ▁they ▁are ▁not ▁act ively ▁involved ▁in ▁the ▁ab use , ▁the ▁f athers ▁or ▁male ▁guard ians ▁of ▁F DI A ▁vict ims ▁are ▁often ▁described ▁as ▁being ▁distant , ▁em otion ally ▁dis eng aged , ▁and ▁power less . ▁These ▁men ▁play ▁a ▁pass ive ▁role ▁in ▁F DI A ▁by ▁being ▁frequently ▁absent ▁from ▁the ▁home ▁and ▁rarely ▁visit ing ▁the ▁hospital ized ▁child . ▁Usually , ▁they ▁veh ement ly ▁den y ▁the ▁possibility ▁of ▁ab use , ▁even ▁in ▁the ▁face ▁of ▁over wh el ming ▁evidence ▁or ▁their ▁child ' s ▁ple as ▁for ▁help . ▁ ▁Over all , ▁male ▁and ▁female ▁children ▁are ▁equally ▁likely ▁to ▁be ▁the ▁victim ▁of ▁F DI A . ▁In ▁the ▁few ▁cases ▁where ▁the ▁father ▁is ▁the ▁perpet r ator , ▁however , ▁the ▁victim ▁is ▁three ▁times ▁more ▁likely ▁to ▁be ▁male . ▁ ▁Society ▁and ▁culture ▁ ▁Term in ology ▁The ▁term ▁" M unch aus en ▁synd rome ▁by ▁proxy ", ▁in ▁the ▁United ▁States , ▁has ▁never ▁officially ▁been ▁included ▁as ▁a ▁discrete ▁mental ▁dis order ▁by ▁the ▁American ▁Psych iat ric ▁Association , ▁which ▁publish es ▁the ▁Di agnostic ▁and ▁Statist ical ▁Man ual ▁of ▁M ental ▁Dis orders ▁( DS M ), ▁now ▁in ▁its ▁fifth ▁edition . ▁Although ▁the ▁D