Hey guys, just a heads up, this is still a fine card.
I have a hard time spending XP on purely defensive cards, but in terms of sheer horror tank value you can get in a single action Elder Sign Amulet is undisputed champion.
Many powerful heals require 2+ actions, First Aid for example which gives Bulletproof stiff competition takes 5 actions to get full use out of (and is limited). Elder Sign Amulet is 1 action for a whopping 4 more sanity to work with, there is no other card in the game that nets you so much sanity in so little time.
The action efficiency is important, lots of characters scramble for actions. In solo, actions are your most precious resource. If you're trying to multitask clues and combat in a team, you definitely don't have actions to spare! In a team where you're the key performer in a particular role (the only killer, the only cluer). Elder Sign Amulet is a go-to card for the characters who have sanity trouble but no actions to spare.
Obviously the exact same is true for Bulletproof Vest and health.
Officer Pawterson costs 2 less resources and prevents 2 less pain, I don't see either card as being better, being free makes the card better in certain decks, worse in other decks.
Key of Ys is nice for horror tanking, but Key of Ys is less a card you use for tanking than it being the side-effect of using Key of Ys for massive buffs. Heck, grab Elder Sign Amulet and use it to cover your Key of Ys.
The only card that completely overwhelms the Elder Sign Amulet is Deny Existence, where preventing any trigger of 2 horror effectively nets you as much tanking as the Amulet would but for 0 actions and no cost while also being there if you have trouble with other stuff.