Rape, murder, starvation, religious zealotry turned deadly and drug abuse are a few of the occurrences that give rise to dark manifestations and incarnations.

The damage system is extremely deadly and gritty: A well-placed bullet or a single stab wound can be enough to kill or severely injure a human character.

Beyond this, each player can use the EKG strip to keep track of his or her character's adrenaline levels, changed stats, and Fight or Flight reaction.

The myth of the game is filtered through ancient religions and belief systems focusing on banished malevolent creatures which want to re-enter our world.

Here our world overlaps with nightmarish dimensions that in most cases are the result of a terrible crime, sin or other similarly horrific occurrence.

Driven to the brink of insanity by the shifts in reality the character has to solve puzzles and find answers in order to survive.

Instead the antagonists are very human: in Thriller style, players concentrate on profiling and hunting brutal and sadistic serial offenders.

There are rumors that speak of entire mob crews turning up ripped to shreds, with signs of shooting in every direction without hitting a thing.

Large, unethical, and greedy corporations and clandestine agencies conduct their unlawful experiments in their hidden laboratories.

Depraved sexual crimes sometimes give rise to different creatures that are manifestations of the pain, death and degradation of the victim.

As one of the many Noctum universe creatures the Flesh Dolls stalk our world with a twisted sense of vengeance and a depraved need.

If given the opportunity they attack plastic surgeons, torturing them to death through sadistic medical procedures as they blame them for their condition.

This gives their soul a physical form and as perverted creatures and they return to the world of the living, looking pale and broken.

They have a distorted sense of things and exact their revenge on parents and children alike who have a good life, which the Forsaken never had when still living.

Their small size and childish looks are deceptive as they’re extremely resilient to damage and have an array of abilities which makes them much more dangerous than any human.

Possessions, entities capable of body jumping, and curses which can take over a person and twist a location into a deadly maze are other dangers which the characters can encounter.

There are also aspects which are seen in The Thing, Resident Evil, and similar games and movies where an entity or pathogen mutates, changes or replaces individuals, causing violent outbreaks.