A serial killer who rapes and tortures his victims is a major player in the story, and he mentions how his father sexually abused him as a child. He later rapes and murders another character's wife and young daughter and tries to claim that the child made sexual advances. Another character implies a sexual attraction to young girls. Allusions to the movie Psycho and insinuations of incestuous mother-son relationships are included throughout, though nothing of the sort is directly discussed or depicted.