Not shown but in medical notes thay can be found in a secret room near the end of the game, the notes described a doctor noticing bruises on a child for long periods of time inflicted by his mother
A character may be menaced by the antagonist in a closet. If she survives, the other characters tell her it was just a dummy and chalk up her claims of a real person being in there with her to stress-induced hallucinations.
A child is held captive as collateral and later killed. Further child victims are implied. The game's main antagonist is said to have been abused as a child.
In the first few shots of the game there is a dead rat that has been run over by a trolley
There are dead animals found pinned to walls and dead pigs in a freezer
No real snakes in world. But there's a realistic drawing of a cobra on a poster advertising "snake oil". You see it very briefly at the beginning of the game right before the couple enters the hotel. Then you see the same poster again when Erin is in a dusty corridor. You can interact with it and look at it more carefully.
In the prologue depending on your choices a character can be drowned
If you want to avoid this scene when playing as marie in the bathtub choose to investigate instead of relaxing
The main antagonist makes animatronics out of his victims. Some corpses are put up on display. These look disturbing with several mechanical parts separating parts that shouldn't be separated. One corpse's jaw is taken apart and with a mechanic it can move up an down from the rest of the face.
The player can find a severed hand. In a document there's a mention of an ear being cut off. This is graphically shown.
Near the end of the game, somebody's hand is cut off by an axe. There's an explicit close-up of the amputation.
At the end of the prologue, a character ends up trapped in a gas chamber.
Later, two characters may end up in a trap where they will gradually run out of air. The death by asphyxiation in this scene can be avoided by choosing 'Attack' instead of 'Take' as Erin in the closet or by choosing to kill the character on the left when the choice presents itself. (Don't worry; they will be saved.)
Multiple characters are tortured and there's lore found about past tortures. The entire game is based off a real life serial killer who had a murder hotel where he trapped and tortured his victims.
Notes and keepsakes from previous victims can be found around the hotel. Some were parents who brought their children with them. No parents are killed onscreen.
Implied. The antagonist destroys all of his victims' belongings in an industrial shredder, and a doll can be found among the yet-to-be-destroyed possessions of his previous victims.
Early on in the game when a character pushes through a tight rocky passage, he gets jumpscared by a mannequin on the other side of the passage.
Mannequins are used multiple times to induce a jumpscare, some accompanied by audio and/or a scared reaction by the characters.
When the player examines the preserved crow, the animatronic inside triggers together with a loud noise.
Mannequins are used on many occasions and can be found on almost any location in the game. Besides standard mannequins, there are also animatronics. Some of which have real human parts/bodies. These are the most disturbing mannequins in the game.
(POSSIBLE SPOILERS)
When playing as Erin in the Silver Ash Institute scene an animatronic dressed as a patient vomits, however it is not graphic and can be avoided by not touching it.
There is a rare scene that involves a character spitting on another character.
SPOILER: If Jamie knocks Du'Met off the roof in Chase and Kate and Erin are dead, Jamie spits on Du'Met.
There is a recreation of a clinic in the hotel but notes and documents reveal it was not a mental institution, but for scamming people with health conditions.
Kate has anxiety and carries a book about it with her.
Mark is afraid of heights and has an anxious reaction when he has to cross a bridge over a great drop.
There was a married gay couple in the hotel a few weeks before the protagonists; one of their preserved bodies can be found. Two of the protagonists are also LGBT and can die.