Although generally true to the tone and story of James's work, the film is set in the 1920s—in contrast to the original 1840s setting—and accentuates sexual elements that some theorists have identified in the novella.

Ann tells how she was hired by an aristocrat (Mark Umbers) to care for the orphans Miles (Josef Lindsay) and Flora (Eva Sayer).

A particular disagreement concerned the film's horrific elements; some critics considered it to be genuinely scary, while others suggested that the horror was not fully effective.

[6] This allowed the introduction of the Freudian psychiatrist interviewing the main character;[6] this framing device is not used by James, but both the novella and the film share a first-person narrator.

[11] The television critic Matthew Baylis observed that the film creates unease and horror through distortions of reality, and that The Turn of the Screw is not a "screaming-banshees-and-horrible-corpses style of ghost story".

[5] The film utilises subtle horror, including details such as a broken doll on a window ledge, and the fact that viewers never discover certain elements of the story (for example, it is never revealed why the character Miles has been suspended from his boarding school).

[14] The Turn of the Screw starred Michelle Dockery as Ann, Sue Johnston as Mrs Sarah Grose, Dan Stevens as Dr Fisher, Mark Umbers as the Master, Nicola Walker as Carla, Edward MacLiam as Peter Quint and Katie Lightfoot as Emily Jessel.

[25] The film's story is told in a series of flashbacks interspersed with discussions between Ann (Dockery), a patient in a sanatorium, and Dr Fisher (Stevens), a skeptical and atheistic psychiatrist.

In flashbacks, Ann is hired by a wealthy and sophisticated aristocrat (Umbers) to act as a governess for his orphaned nephew and niece who live at Bly.

Ann believes the figures to be the ghosts of Quint and Jessel, seeking to continue their passionate and violent sexual encounters through Miles and Flora.

She then begins to suspect that Miles and Flora, having been groomed by and involved in the activities of Quint and Jessel, may be deliberately seeking to bring the pair back.

She finds them by the lake, but they are playing roughly; when Miles pushes Flora's head under the water, Ann sees the pair as Quint and Jessel.

Ann is found some time later by the police, clutching Miles's dead body, but she refuses to speak of what happened until meeting Dr Fisher.

[5] The Times's David Chater, although he did not consider the film "terrifying" or "suppurate[d] in evil", found it "never less than absorbing", suspecting this would be particularly so for viewers unfamiliar with the story.

[30] The Turn of the Screw was chosen as "pick of the day" in The Sunday Times, despite the reviewer, Victoria Segal, expressing her view that the film was "far from perfect".

[30] Paul Whitelaw, writing in The Scotsman, commended Welch and Fywell for sustaining a horrific atmosphere, and noted that the soundtrack added to the horror.

[6] In a review for The Leader-Post, Andy Cooper praised the "creepy atmosphere" and tension, but said that the film "[fell] short in the chills department" and "could have done with a few jolts of terror to breathe more life into it".

[11] Gerard Gilbert, writing both for The Independent and The Arts Desk, felt that Ann's relationship to the Master was "unnecessarily sexed up",[32] and that this element added nothing to the story, and, in fact, detracted from it.

[34] In his review of the American DVD release for the Deseret Morning News, Chris Hicks said that he could not see why the changes had been made, and that the literalisation of the sex and violence detracted from the film.

[30] Sutcliffe was critical of the reframing of the story as a stereotypical account of how "a cocky young man of science has his certainties upturned", and said the film took "the terrifying indeterminacies of the original", turning them "into a slightly shabby ghost-train ride".

[35] Whittaker felt that the film failed to appropriately present the novella's ambiguity and implicit themes, saying that the adaptation "feels oddly obligated to fill in all those blanks, and it's really the script's fault".

[30] Sutcliffe expressed a similar view; for example, he noted that "when the governess sees Quint on the tower for the first time so do we, and the thing that really haunts us as we read the story—uncertainty—vanishes to be replaced by a much duller kind of fretfulness, about when something is next going to pop out at us.

[32][34][35][37] Dowling also picked out the performances of Lindsay and Sayer as worthy of note,[35] while Whitelaw praised MacLiam, who was able "to personify pure evil with scarcely a line of dialogue".

[10] Segal, by contrast, felt MacLiam was badly cast, which resulted in "one of the story's primary dark forces [looking] more like a member of Elbow than the very essence of evil".

Sborgi argues that the film is explicitly made psychological through particular narrative and visual choices; for example, Miles appears at the train station in a ghost-like way through a cloud of steam.

[7] For the literary theorist Thomas S. Hischak, The Turn of the Screw is a weak adaptation of the novella, with poor performances that can be "ascribed to the trite, anachronistic dialogue and leaden direction".