This game contains scenes of realistic violence towards fantasy characters. Some of the deaths in the game, primarily of the monsters, can be realistically violent. For example, one monster has its hand cut off, blood and bone is shown coming from the wound as the hand twitches on the floor, another enemy explodes leaving bloodied entrails behind. Some of the player’s deaths are also realistic with bulb boy’s head being crushed and blood shown coming out from his eyes. The game also features pictures/sounds likely to be horrifying with some of the sections evoking strong feelings of dread and tension as well as gruesome images and creature designs that may cause revulsion.