Different Endings
Three different player choices will directly impact how the game plays out The player can kill or spare the mother in the prison; blame or forgive the father at the confessional; or save or allow the character of Wheeler to die. The choice will also give the player different costumes for subsequent plays. For example, according to cheats.ign.com, if you spare the mother, blame the father and allow Wheeler to die, you get the "Bogeyman" mask and ending.
Weapons
To unlock the circular saw, you must complete the game at least one time. The saw is inside the Shepherd family's garage. To unlock the laser gun, you must also complete the game at least once, but you must spare the mother in the prison, blame the father at the confessional and give Wheeler a health drink. The laser can then be found on subsequent plays in Joshua's room.
Young Alex Costume
There is one hidden costume that can be accessed through a cheat code. To play as a younger version of Alex, go to the game's main menu and input "Up," "Up," "Down," "Down," "Left," "Right," "Left," "Right" and "Circle" on the directional pad of the controller.
All Items
After the scene where Travis attacks Elie with a chain saw, search the wall area by the iron fence for a key to Room 301. This is an underground area where you can recover all of your weapons, as well as find a med pack, health drink and extra ammo.
Extra Scene
Pick up any extra photographs and drawings. The photographs offer hints and tips, but collecting them also unlocks an extra scene that will play after the end credits.