Silent Hill Downpour [BLUS30565]

Low FPS seems like the cause, your Preferred SPU threads is too high. Try 2 and 1. Also don't disable anisotropic filtering. If you do disable it basically forces the game to disable any filtering even if the game has some by default.

Tried it with 1 and 2 with anisotropic on automatic, I have the save fps in the scene, I guess there's no way to increase the fps on my current pc