Major differences from the book include the removal of two major characters. Sylvia, Audrina's younger sister who is born with an unnamed but significant neurological disorder and Billie, Arden's mother who is a double amputee and becomes involved with Audrina's father for a time before dying the exact same way Ellsbeth did. Another major change is that in the novel, Vera has brittle bone disease and breaks her bones so often and easily that one of her legs grows shorter than the other. This of course contributes to her broken leg at the end and the resulting fall.
The film was adapted from the novel written in 1982. It has been published in various languages around the world.