The first thing you need to do is get out of town. But before you can get out of town, you have to go into the basement of that house. And it’s not a nice place. The design scheme is very Ikea-for-serial-killers: trash on the floor, mold on the walls, the lighting strictly flashlight-only.

To further set the mood, there’s an empty milk carton with a notice on the back about a kidnapped girl, but her face has been blotted out. All the way back, in the darkest corner, behind a locked door, you can hear a woman sobbing. But when you finally get the lock open, there’s nobody there. Then, there is. And it’s not a woman, it’s a mannequin. And it’s alive. And then you accidentally push the button that flips the flashlight off.

Like its predecessors, the plot of “Silent Hill: Downpour” is fairly opaque. Players take on the role of Murphy Pendleton, a convict who escapes when his prison bus crashes, marooning him in the game’s eponymous town. At the game’s outset, there’s not much to know about Murphy’s personal life — such as why he’s in the hoosegow. But right away, it’s clear that he’s not a nice guy, since his first player-controlled task is to shiv a fellow inmate in the prison’s shower.

Such is the Kafkaesque nature of survival-horror video gaming, a leisure activity where one takes on the role of a criminal and clobbers another criminal, all without knowing the nature of either character’s original transgression.

The game, the eighth installment in Konami’s long-running horror franchise that arrives this week on Xbox and PlayStation 3, is finely tweaked to confuse, disempower and frighten the wits out of any gamer possessed of enough courage to pop it in the console and pick up a controller. A week later, the Konami will also release “Silent Hill: HD Collection,” a tuned-up version of the series’ second and third installments.

If the video game world has an answer to the experimentation with convention found in art house cinema, it’s the survival-horror genre. Games such as “Resident Evil” and “Alone in the Dark,” which force single players to fend for themselves in zombie and ghoul-heavy 3-D spook-houses, are heavily stylized, decidedly non-kid-friendly and fun in only the most oblique sense of the word.

But when it comes to generating good scares, they frequently surpass their competitors in other media, cultivating a distinct feel-bad experience that rivals Stephen King’s weirdest imaginings.

Good horror fiction gets most of its entertainment value by finding clever ways to manipulate anxiety. In literature, good scares come when everyday objects and situations are linked to surreal and disquieting imagery. For instance, there’s the scene in Stephen King’s novel “It” where the supernatural villain whispers to the protagonist from the bathroom drain. The book can be shoved in the dresser or under the bed, but ultimately, you walk into the bathroom to find yourself wondering if there’s anybody on the other end of the pipes.

Likewise, horror films build tension and then release it with “boo!” moments, when the serial killer jumps out from behind the corner or the little girl’s head spins around backwards.

Over the years video games have evolved their own technique for generating shivers: Horror via resource management. There are a lot of monsters, but not a lot of weapons. A player’s on-screen incarnation is thoroughly mortal, even a little wimpy. In these games, victory hinges on knowing when to fight and when to run and how to conserve the minimal firepower for when it counts. They cultivate a sense of helplessness, an idea that runs contrary to the prevailing logic of video game design.

“Most video games are about fantasy fulfillment,” explains Brian Gomez, a longtime game designer who worked on survival horror titles that include “Clive Barker’s Jericho” and “Alone in the Dark” and consulted on the development of “Silent Hill: Downpour.” “It’s all about the steady progression of unlocking new powers or weapons and a character moving from a mundane state into superhuman state. But ‘Silent Hill’ has no progression. The hero isn’t significantly more powerful by the end of the game.”

That much is true. Murphy is no super-soldier. If he runs too much, he gets winded. After a few blows, he starts to limp.

In the early survival-horror titles of the mid-’90s, clumsy game design helped amplify the fear factor. When the monsters jumped out, it was hard to run away, because you’d tie your fingers in knots just trying to move in a straight line. “You’d be, like, I want to fight this thing, but I literally can’t,” recalls Tomm Hulett, a senior associate producer at Konami who oversees the “Silent Hill” titles, which kicked off in 1999. He says that on “Downpour,” designers looked for similar ways to inspire panic without breaking the gameplay. They came up with a hand-to-hand combat system, in which players can only carry what they can hold in their hands and weapons quickly wear out and break.

“We didn’t want it to look like he knew what he was doing, ever,” Gomez says. “We wanted to make you feel like he’s running for his life and grabs whatever is handy and swings it wildly as a weapon.”

As a result, “Downpour” can get unpleasant, which is why survival-horror games rarely do gangbusters, sales-wise. According to VGChartz, a Web site that estimates game sales, the most recent “Silent Hill” titles moved about a quarter to a half-million copies worldwide on their respective game systems. Compare that with “Skyrim,” a well-received role-playing game that features a more friendly, player-empowering set of physics and has sold 5.34 million copies for the PlayStation 3 alone.

“That’s why [survival-horror] games don’t do as well financially as big blockbuster games,” Gomez says. “People can play ‘Skyrim’ for 100 hours, but I can’t imagine playing in a ‘Silent Hill’ environment for 100 hours. It’s too stressful.”

The chase and fight scenes are just a small part of the creep factor. As in horror films, the real nail-biting moments come from anticipation. Who is crying behind that locked door? Did you really just see a grim-faced child ghost behind that fence? Why is that broken wheelchair on the roof?

Ghost and goblins have been video game fixtures since, well, 1985’s “Ghosts ’N Goblins,” but it’s only within the past decade that video game systems have advanced to the point to allow for a convincing case of the virtual creeps, complete with detailed art, eerie sound effects and fast-paced action (even if that action involves running away as fast as you can).

Because you’re projecting yourself into a convincing, virtual environment, the frightening moments become more visceral. “In a horror movie, the audience is always watching somebody make the wrong move,” says Daniel Licht, who composed the score to “Downpour” and has worked on the TV show “Dexter” and the movie “Hellraiser: Bloodline” (the one set in space). “In the video game, you want to entice people to go into places. You’re doing the opposite.”

In horror films a heavy dose of special effects can kill the mood, because computer-generated environments appear cold and unnatural next to flesh-and-blood humans. But they work well in video games, where there are no humans for comparison, allowing the player to become completely immersed in the pixelated scene.

And what the “Silent Hill” series lacks in plot, it makes up in setting and scene. Most of the games, like “Downpour,” take place in a Twilight Zone-worthy American town where characters slip back and forth between the real world and a monster-strewn nightmare dimension while trying to solve a mystery or, more simply, not die. The effects can feel horrifically authentic. At one point in “Downpour,” Murphy accidentally sets a fire on a gas stove, which rages out of control until the kitchen morphs into a nightmare hellscape borrowed from the set of a Marilyn Manson video.

But unreality has its disadvantages. When horror movies and books go under the analytic microscope, monsters frequently get linked to real-life anxieties. The bug-like creatures from the early-’90s sci-fi thriller “Alien 3” were dubbed a stand-in for the AIDS epidemic. The zombies in “Dawn of the Dead” symbolized the specter of late-’70s commercialism.

“Silent Hill” and its survival-horror brethren have only the most tenuous link to social commentary. In part it’s because their environments are mostly animated, but also because they’re designed by a hodgepodge of production houses that are often far removed from the here and now, at least in the United States.

Although its main creative overseers are American, “Downpour” was mostly ginned up by a design team based in the Czech Republic. “A lot of the terrain is based on the surroundings they grew up in,” says Devin Shatsky, the game’s American design director. “Like the Capuchin Crypt [in Brno, Czech Republic], which houses these monks that have been mummified and preserved. We’ve taken elements of their environment and emulated them in ‘Downpour’ with some of our levels.” Meanwhile, the storytelling style is reminiscent of slow-burning Japanese horror flicks. And as a 90-pound weakling, Murphy’s character reaches out to nerds across the globe.

But survival-horror video games like “Silent Hill: Downpour” might just be scary because they’re so thoroughly absorbing.

“You can always put the book down or close your eyes in a movie, but in a video game, the action is still going on on the screen, so you must stay engaged,” Gomez says. “When you watch a movie, you’re always thinking, ‘Hey! Don’t open that cupboard!’ In the game, you’re the guy who has to open the cupboard.”