In some ways, horror stories have changed little since Poe was writing. After all, Poe was the master of horror. Today’s horror replicates his ideas. The main differences are that while Poe was mostly psychological, while definitely being gory, modern horror movies and stories are often just gory.
Poe wrote “The Tell-tale Heart” to include a minimum of violence. Most of the suspense occurs in our horrifyingly following the narrator as he explains how he killed the old man.
You should have seen how wisely I proceeded—with what caution—with what foresight—with what dissimulation I went to work! I was never kinder to the old man than during the whole week before I killed him. (p. 4)
Most modern horror stories are just a lot of blood and violence, hacking body parts and so on. There is suspense, but it is not on an intellectual level. The suspense is not cerebral, but more primitive.
All horror stories have suspense and violence, but the best ones also include a psychological component.