Children of affluence are generally presumed to be at low risk. However, recent studies have suggested problems in several domains--notably, substance use, anxiety, and depression--and 2 sets of potential causes: pressures to achieve and isolation from parents. Recognizing the limited awareness of these issues, the objectives in this paper are to collate evidence on the nature of problems among the wealthy and their likely causes. The first half of the paper is focused on disturbances among affluent children and the second half is focused on characteristics of their families and neighborhoods. Widespread negative sentiments toward the rich are then discussed, and the paper concludes with suggestions for future work with families at the upper end of the socioeconomic spectrum.