If you just install the game without any tweaks then you'll get screwed up graphics. The menus work but then once you're in game the water does crazy things as does the person that's meant to sit in your car - he kinds stands on the roof but is 50 times the size and all sorts of crazy oil-type colors.
Solution: I updated it to the v1.100 patch, set the settings I wanted using the settings exe separate from the game's exe then added these lines to User.reg, inside the root of your bottle:
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