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Virtual reality (VR) has been broadly applied to gaming and entertainment domains, and with commercial VR now proliferating, it is imperative for researchers to determine if immersive VR gaming has stronger impact on minors compared to conventional flat-screen gaming, especially games that are emotion-evoking, in order to ensure that consumers are protected. The present study aimed to investigate the psychological and physiological effects of a VR horror game by comparing the responses of 120 participants aged between 15 and 20 years old, with half of them playing in VR and the other half playing with consoles. In addition, the study also explored fear-inducing elements identified by both VR and console gamers. Results showed that the horror game elicited similar emotional responses, sense of presence, and perceived level of horror in participants regardless of gaming equipment used and age group. VR gamers experienced a significantly higher increase in electrodermal activity and tidal volume when playing the horror game compared to console gamers, while no significant differences were observed between age groups. Interestingly, the sound effects were the most reported fear-inducing elements by the participants. These results suggest implications for the classification of content descriptors and age ratings.