This strikes me with the feeling of a Alfred Hitchcock movie. It gives the feeling of horror, but not by blatantly showing it. Being in black and white is what really pulls this off. The position of the doll's head makes this even more creepy. She is staring at nothing, with a slight grin- she never knew what was coming. >-)
The high key and noise work well for this shot. It adds to the tension you have created. The lighting is another well used element. It is like someone opened a door letting the light in, and this carnage is what they found.
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