The dolls are fantastic. They're very intimidating, their method of attack is clever and causes a great deal of worry every time one is near, and I like their final design way more than any of the concept art. For me, the dolls are the 'awww shit it's one of THEM!' enemy for Downpour.
The dog in the police car
kind of jumped me a bit. A cheap scare I suppose (sort of like the cat moment from Alien in SH1) but effective nonetheless.
The music in the town really put me on edge too, not so much the dulcimer parts but the woodwinds, especially the deepened woodwind sounds, like something David Lynch would compose for Rabbits/Inland Empire. I also loved how that music had extra layers that would come in while fighting monsters - drums, bass etc. all added in when fighting. It's been a while since I've heard proper interactive music like that in a game, I remember it was common in the N64 days with the MIDI music.
Where we're from, the birds sing a pretty song, and there's always music in the air.