Addiction	The protagonist - and possibly other characters - may get addicted to one or more substances.	2008 / 2015	16 games
Aging	Characters, especially the protagonist, age over time and possibly die from it (eventually).	1988 / 2016	45 games
Allergies	Simulates allergies to a degree.	1996 / 2015	2 games
Ambient temperature	Player interacts with environmental heat and/or cold.	2002 / 2018	39 games
Bleeding	Protagonist and other characters may get severe wounds that bleed profusely, eventually leading to the character's death if not taken care of.	1994 / 2018	48 games
Consistent damage	Any damage dealt or received is constant with no arbitrary fluctuation.	1985 / 2016	17 games
Dark space	Outer space is realistically depicted as dark/black place instead of the usual colorful juice spill.	1977 / 2018	187 games
Defense breaking	Defenses can be broken, disrupted, or otherwise temporarily or permanently negated. A shield flung aside, struck so hard the person staggers and can't parry for a sec, etc.	2000 / 2018	42 games
Destructible items	Items that the player can pick up and use, place in their inventory and so forth can be destroyed while lying about.	1991 / 2015	39 games
Environmental contact	Tools, weapons, etc. can touch the environment instead of acting as if they were simply 2D printouts on your HUD or passing through everything as if they were air.	2008 / 2017	19 games
Fall impact	Falling down a significant height causes the character to recoil from the impact, roll across the floor, or otherwise react to the impact force.	1990 / 2018	160 games
Fatigue	Characters suffer from extended periods exertion or staying awake, ranging from simple fatigue to more drastic ailments. Usually fixed by a good night's rest.	1982 / 2018	60 games
Friendly Fire	Player can attack their own side purposefully or by accident or be attacked themself in similar manner.	1979 / 2018	221 games
Full body awareness	First person games where when you look down you see your body (legs, pelvis, torso, etc.) instead of nothing (just hands/arms are not enough). Not including cases limited to scripted sequences, cinematics, or others where player control is limited.	1984 / 2018	114 games
Imperfect healing	Any immediate healing the player can use can not accomplish perfect results.	1992 / 2018	9 games
Imperfect recovery	Player can't ever recover fully from received wounds, transformations, and such.	2006 / 2013	6 games
Injuries	Getting wounded has much broader effects beyond simple loss of health points.	1988 / 2018	97 games
Unprotected inventory	Items in your inventory can be damaged or destroyed.	1994 / 2015	7 games
Item durability	Items wear down with use, rust and otherwise degrade with time or from being subjected to the elements.	1985 / 2018	143 games
Malfunctioning	Tools, vehicles, and whatever else have a possibility to malfunction under certain conditions, though usually only when they become too worn down.	1992 / 2018	44 games
Miscommunication	It is normal for communication to be perfect in fiction unless it is for plot, thus this signifies such troubles occur either on their own or as part of the plot.	1992 / 2014	13 games
No crosshair	There's no targeting crosshair on the HUD.	1996 / 2016	32 games
NPC friendly fire	NPCs - especially those opposing the protagonist - can harm their allies, accidentally or intentionally.	1996 / 2017	58 games
Overheating	Devices overheat and the player must deal with them either by waiting for them to cool down or forcibly cooling them somehow.	1984 / 2018	68 games
Pain	Getting hit, falling significant heights, being electrocuted, etc. cause the subjected character (especially in case of the protagonist) to reel in pain or otherwise temporarily becoming incapacitated.	1994 / 2015	53 games
Realistic damage		1985 / 2015	52 games
Recoil	Simulates recoil to some degree, throwing aim off target rather than usual bullet dispersion increasing for a moment or simply nothing at all.	1997 / 2017	59 games
Ammo reload: Realistic	Upon reloading a weapon, the previous clip/mag is discarded or stored back as partial clip/mag instead of filling the current clip/mag with the number of missing bullets.	1986 / 2014	18 games
Resting	Player character can or must rest occasionally, usually to combat fatigue or for other restorative purposes.	1984 / 2018	163 games
Rotting	Organic substances, especially those used for food, eventually rot and spoil.	1985 / 2018	52 games
Scarring	Getting injured creates permanent scarring or similar markers of the injury.	1994 / 2016	6 games
Silent void	No sound is transmitted across the vacuum of space.	2008 / 2013	7 games
Stamina	Simulates character's ability to continuously perform strenuous physical activity such as running, carrying heavy objects and so on, draining the character's stamina and eventually preventing farther work-out before resting.	1993 / 2018	209 games
Static health	Player character's maximum health never increases permanently (short-lived boosts are allowed).		0 game
Stray fire	Missed shots can actually hit something.	1994 / 2015	22 games
Unrestricted violence	Player is free to hurt and kill [i]anyone[/i], from random pedestrians to puppies.	1987 / 2018	103 games