It is based on Jack Ketchum's 1989 novel of the same name,[1] which was inspired by the real-life murder of Sylvia Likens, to whom the movie is dedicated.

Ruth freely allows her sons' young friends, including David, to her house, where she entertains them and offers them beer and cigarettes.

Meg reports the abuse to a local police officer named Lyle Jennings, but law enforcement does not criminally charge Ruth.

As punishment, Ruth and her sons bind Meg in the basement and torment her, strip her, and then leave her overnight, hanging by the arms from the rafters.

With Ruth's approval, the neighborhood children visit the Chandler residence to tie, beat, burn and cut Meg for fun.

While they are distracted speaking to the officer, David loosens Meg's bindings and tells her to escape that night, even offering to leave money for her in the woods.

Ruth then carves a sexually explicit message into Meg's abdomen with a heated bobby pin and burns her clitoris with a blowtorch.

David attempts to leave and get help, but the boys tie him up and kick him in the groin before turning their attention back to Meg.

Ruth's two remaining sons arrive in the basement, and Willie attempts to cut David’s throat with a knife before Officer Jennings intervenes and arrests the Chandler boys.