The album does not contain the actors' performances as of the film, plus as such is not careful a true soundtrack album. Byrne affirmed in an interview that the decision not to let go these unique renditions (including performances by John Goodman and Pops Staples) is a major regret. While an original cast recording for this movie was by no means free, several of the film performances did appear on single releases of several songs from the album. Later, lead singer Byrne released the album Sounds as of True Stories containing incidental music from the soundtrack. (The video is in fact an extended series lifted directly from the film itself).

On monitor, the additional songs are performed by the movie actors. In the novel American Psycho, this Chatting Heads album is the one that Patrick Bateman plays throughout the start of the story.