Ben makes excuses for Mia's abusive behavior towards him throughout the course of the game. But he stands up for himself in Ending 4, when the relationship ends.
Both Inco and Olivia have low-contact parents. Olivia's mother is never mentioned, and her father works abroad. Inco's parents are frequently mentioned but are almost never home, implying a neglectful household.
In ending one, Vinny makes a macaroni art piece for Olivia as an apology for upsetting her. In response he gets cussed out and has it torn up in front of him. He is clearly upset by this.
The beloved teacher and mentor, Mr.Iadakan, dies of bone cancer about two thirds of the way through the game in all endings. He is a major character up until that point appearing at least once every school day.
Olivia's wrist is injured from doing extra school work for her bully. Inco is mentioned to sometimes get scratches on his wrists and hands from Olivia grabbing too hard.
There is a cross in the Payne's family house, a "Raptor Jesus" is frequently used in place of "Jesus Christ". Christmas is celebrated by the main cast.
At the end of ending one, Olivia is despicted in a hospital bed assumedly in a coma or otherwise critical condition after a backwards fall down the stairs.
Ableism is a key theme the game tackles. Olivia, a wheelchair user, faces different forms of it: benevolent, hostile, institutional and internalised ableism.
One of the main characters is a bully who uses ableist slurs towards Olivia.