When id Software released first-person shooter “Doom” via MS-DOS (Microsoft Disk Operating System) in 1993, it caused a wave of controversy, leading many psychologists and researchers to wonder if the satanic-themed horror game and graphic depiction of gore would negatively influence its young audience. Twenty-one years later, young players yawn at what they believe to be the tame nature and primitive graphics of “Doom” -- especially compared with modern video game series such as “Gears of War” and “God of War,”  just two of many franchises that often graphically depict violence and sexuality.

doom-punch Screenshot from 1993's "Doom." Photo: Courtesy/id Software

During the past two decades, video game hardware and software have become more advanced, allowing for more realistic depictions of violent and sexual content. Tuesday’s launch of action-adventure game “Grand Theft Auto V” on the eighth-generation Xbox One and PlayStation 4 caught the attention of anti-violence advocates and the Internet by depicting a first-person viewpoint of a player having sex with a prostitute and then knocking her unconscious once she exits the vehicle. You can view the video, which has already garnered more than 200,000 views, here.

gta A prostitute in 'GTA 5.' Photo: Courtesy/Rockstar Games

Anti-violence critics often target the GTA franchise for its depiction of sex and violence, and the series has been the poster child for violent video games since the launch of the original “GTA” title in 1997. Except for the first game, all “Grand Theft Auto” installments were developed by New York City-based Rockstar Games, a multinational studio owned by distributor Take-Two Interactive. Though the titles in the series aren’t the only playable games that contain controversial amounts of violence or sexual content, the “GTA” series is considered a repeat offender.

And players love it. Last year’s September launch of the title on the Xbox 360 and PlayStation 3 went on to sell more than 34 million copies.

Tuesday’s release of “GTA V” for the Xbox One and PS4 has a few updates and new features, but it’s essentially the same game that launched just a year ago for the Xbox 360 and PS3. What sets the eighth-generation version (and upcoming PC version) apart is the ability to play the game in first-person mode, instead of the standard third-person or top-down viewpoint that “GTA” games generally offer. This makes the entire gameplay experience (sex with prostitutes, visiting strip clubs, running over pedestrians) all the more real.

hooker First-person view of a prostitute in eighth-generation version of 'GTA 5.' Players can engage in sexual intercourse with her and then murder her. Photo: Courtesy/Rockstar Games

"This is a criminal setting. It’s a gritty underworld. It is art. And I embrace that art, and it’s beautiful art, but it is gritty,” Strauss Zelnick, CEO of Take-Two Interactive told Bloomberg on Tuesday. "Let's not make no bones about the environment in which we operate. And we stand shoulder to shoulder with other major picture releases and major television shows that explore a similar universe."

A number of researchers, however, believe that some impressionable players may not always be able to distinguish the difference between fantasy and reality. Over the past decade, dozens of studies have debated the presence of sexualized, violent content in video games, and some claim it can negatively affect players.

“The research in this area is very clear that playing violent video games leads to increased real-world aggression,” Jean Twenge, Ph. D, professor of psychology at San Diego State University and author of “Generation Me” told International Business Times. “This is based on both correlational (real-world) and experimental (controlled lab) studies.”

“GTA V” isn’t the first video game to depict sexualized violence from a first-person viewpoint. First-person shooters have been around since the early 1970s, originating with 1973’s “Maze War.” There are dozens of first-person shooter games (e.g., the “Call of Duty” franchise) in which players are able to shoot in-game targets using firearms. So, why are some people so upset over “GTA V’s” first-person mode?  

Maze_war "Maze War," one of the original first-person shooters. The nature of the genre has evolved dramatically. Photo: Courtesy/Wikipedia

“The interactive nature of ‘GTA V’ gameplay involving sexual activity with a prostitute that takes the player through the actions of driving down the street, picking up the prostitute, driving down the street while glancing over at her lace-clad legs, and then engaging in various sex acts has the potential to prime this behavior in a player's mind,” Jacqueline Helfgott, Ph.D., and professor of criminal justice at Seattle University told IBTimes. Helfgott has examined the relationship between video games and violence and suggests that violent video games can be a risk factor for a subset of individuals predisposed to violent behavior.

“Video games alone don’t cause people to become violent, but we need to have a more complex understanding of how games affect violence-prone individuals immersed in hypermasculine subcultures,” Helfgott explained. She also suggests that “the interactive nature of first-person video game play has the potential to exacerbate violent fantasy in ways that may be much more impactful than less interactive media forms.”

Helfgott suggests that playing “GTA V” repeatedly can lead to the reinforcement of violent fantasies in the minds of certain players.

“Games such as ‘GTA’ allow for repeated game play where the user can experience the virtual activity over and over and over,” Helfgott said. “For individuals who are already prone to sexually violent fantasy, this offers a safe haven to ‘practice’ the activity in ways that feed fantasy and preexisting cognitive scripts.”

So, for some players, the experience of having sex with a prostitute and murdering her in a video game can potentially be a trigger that leads to real-world behavior; others can separate the game from reality.

“Men who view certain types of pornography are more likely to endorse the myth that women enjoy rape,” Twenge added. “So given all of the research, yes, it seems possible that playing a video game featuring sex with and killing of prostitutes could have an effect on attitudes toward women.”

“GTA 5” on the Xbox 360 and PlayStation 3 is currently the sixth best-selling video game of all time. If seventh-generation sales are any indication, millions of new fans could be introduced to the series over the upcoming year. That’s a lot of new fans experiencing violence and sexual content from a first-person perspective.

Earlier this year, CEO Zelnick spoke of Take-Two Interactive’s goal to further “GTA V’s” presence as a global phenomenon.  

“Thirty-four million copies have been sold, and yet the truth is not everyone has bought it,” Zelnick told MCV during video game fair Gamescom in Germany in August. “One way to look at it is that 34 million copies have been sold, but there’s 7 billion people on Earth. So we have over 6.9 billion people left to address.”