Disturbing. But probably very close to reality in the way that she portrays the public's view of a serial killer, the media's obsession with news that isn't really news and how it affects people. I actually found the sub-plot about the media and public spectacle about Gretchen more intriguing than the Gretchen/Archie plot, it made me sick to my stomach in how close it really came to how things are. Mind you, the whole book was a bit demented and sick (of course) and a few places made me gag just a little bit while reading with the extreme and grotesque imagery.
If you've read the first 2 books in the series, read this one. If you haven't read the first 2, read them before reading this (it wouldn't make any sense without them)...but know that none of the books are for the faint of heart - if you don't like "gross" you will have a hard time with these books.