Overview
Next Fear occurs when one plays a subsequent round of Silent Hill. After finishing the game with any ending, and after the credits havr rolled, one has the option to save the completion to a file, which can later be loaded to begin Next Fear Mode. The process can be repeated to include however many rounds one will play on a single save slot. With each round, the difficulty will increase to Normal and then to Hard, where it will remain for all subsequent rounds. Playing through Next Fear allows a player access to an arsenal of hidden items and weapons, and even a hidden ending.

The Built-In Bullet Adjust Cheat
Each subsequent round in Next Fear provides the opportunity to adjust the amount of bullets obtained in each box. To access this, go into the "secret" screen of the options menu (use the shoulder buttons, L1/L2/etc).

On your second round through the game, you can get x2 ammo; on the third, x3 ammo, and so forth up to x9. (The PAL version may only go as high as to x6.)

Next Fear Items
The following are all that can be obtained by playing Next Fear. If the item has been awarded, it will show up behind the final statistics screen after one finishes the game.

Chainsaw Complete the game once with any ending to achieve the chainsaw. It is located in the broken window of the shop, Cut-Rite Chainsaws, just down the street from the Church. It requires gasoline to operate.
Rock Drill Complete the game once with any ending to achieve the chainsaw. It is located in the control tower of the bridge in the bottom room. It requires gasoline to operate.
Gasoline Can This is located inside the (tah-dah!) gas station in Old Silent Hill. Each can of gas can only be used on one of the weapons, either the chainsaw or rock drill. Complete the game once, the next round will have one can available; complete the game twice and there will be two cans available, one for each weapon.
Katana How exactly one achieves the katana has always been a mystery, but the general consensus is that you have to complete the game once with a Good (or Good+) ending, and once with a Bad (or Bad+) ending. Others say you must complete the game three times, regardless of the ending. It will then be located in the locked room of the house on Levin St., the door to which will be automatically open.
Channeling Stone This will be located on the counter in the convenience store after one completes the game with the Good+ ending. Check the "Endings" section of this site for details on how to use it.
Hyperblaster This will be in Harry's inventory from the start after completing the game with the UFO ending.

Statistics
One of the purposes for playing through Next Fear mode is to see how well you can perform in the game. After the credits, the game will display your game stats and give you x.x/10 star ranking based on them.

Stat	Explanation	Gold Requirement
Mode	The difficulty level	n/a
Game Clear	How many rounds through the game	5 or more
Saves	Number of times you saved your progress	2 or less
Continues	Number of times having continued	1 or less
Total time	Time elapsed from start to finish	1.5 hrs or less
Running Distance	-	n/a
Walking Distance	-	n/a
Items	Total number of items collected	150 or more (+all 6 extras)
Defeated enemy/ fighting	Includes all enemies finished off by kicking	combined 150+, but try to balance them
Defeated enemy/ shooting	-
Shooting Style	Your accuracy	Keep "No Aiming Shots" below 0.10, and balance "Short", "Medium" and "Long Range" percentages

10-star Rank
Especially for the sake of obtaining the Green and most powerful beam for the Hyperblaster, it is optimal to achieve a 10-star ranking. This is done by receiving "gold" in every statistic, along with refraining from using the special weapons on your quest. You must be fast, accurate, and thorough at the same time. I recommend reading AEDavie's FAQ for strategic details.