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The origins of the survival horror game can be traced back to earlier horror fiction. Archetypes have been linked to the books of H. P. Lovecraft, which include investigative narratives, or journeys through the depths. Comparisons have been made between Lovecraft's Great Old Ones and the bosses encountered are seen in many survival horror games. The themes of survival have also been traced to the slasher film subgenre, where the protagonist endures a confrontation with the ultimate antagonist.[5] Another major influence on the genre is Japanese horror, including classical Noh theatre, the books of Edogawa Rampo,[19] and Japanese cinema.[20] The survival horror genre largely draws from both Western (mainly American) and Asian (mainly Japanese) traditions,[20] with the Western approach to horror generally favoring action-oriented visceral horror while the Japanese approach tends to favour psychological horror.[11]

In 1989, Electronic Arts published Project Firestart, developed by Dynamix. Unlike other early games in the genre, it featured a science fiction setting inspired by the film Alien, but had gameplay that closely resembled later survival horror games in many ways. Travis Fahs considers it the first to achieve "the kind of fully formed vision of survival horror as we know it today," citing its balance of action and adventure, limited ammunition, weak weaponry, vulnerable main character, a feeling of isolation, storytelling through journals, graphic violence, and use of dynamically triggered music - all of which are characteristic elements of later games in the survival horror genre. Despite this, it is not likely a direct influence on later games in the genre and the similarities are largely an example of parallel thinking.[10]

However, the game often considered the first true survival horror, due to having the most influence on Resident Evil, was the 1989 release Sweet Home, for the Nintendo Entertainment System.[34] It was created by Tokuro Fujiwara, who would later go on to create Resident Evil.[35] Sweet Home's gameplay focused on solving a variety of puzzles using items stored in a limited inventory,[36] while battling or escaping from horrifying creatures, which could lead to permanent death for any of the characters, thus creating tension and an emphasis on survival.[36] It was also the first attempt at creating a frightening storyline within a game, mainly told through scattered diary entries left behind fifty years before the events of the game.[37] Developed by Capcom, the game would become the main inspiration behind their later release of Resident Evil.[34][36] Its horrific imagery prevented its release in the Western world, though its influence was felt through Resident Evil, which was originally intended to be a remake of the game.[38] Some consider Sweet Home to be the first true survival horror game.[39]