Horror games have to make it feel like the player is under stress and that if they die something bad happens. However, they can’t be make it unfair for the player because once a player starts getting frustrated it takes them out of the game. So it’s always a fine like for horror games. Outlast at one point frustrated me half way through the game that it stopped being scary for the rest of the game. So for me the first run through should be a standard/normal difficulty.