Violence during the levels is predominantly mild and although blood is shown, opponents disappear or respawn on defeat. During the cut scenes however, the violence is more graphically detailed with characters standing over the bloodied and mutilated corpses of their victims and a scene where a little blind girl is stabbed in the back by her knife wielding murderous teddy bear, the tip of the bloodied knife clearly protruding through her chest. It is this scene which contributes to the higher rating due to the vulnerability of the victim.
It is worth noting that there is also a scene involving a woman wearing a short dress, drinking in a club with two men. While one man fondles her breast to which she does not appear to object, another is depicted dropping pills in her drink without her notice. The woman is then depicted being aided by the two men who are holding her up as she walks towards a darkened doorway, her thonged buttocks visible under her coat. While you do not see anything untoward actually happen to her, the suggestion of an sinister motive on the part of the men is pretty clear.