Psychiatric evaluations conducted during the trial characterized Madsen as exhibiting traits of narcissism, psychopathy, and a lack of empathy. Experts testified that he displayed a tendency towards grandiosity, a need for admiration, and a disregard for the rights and feelings of others. These findings were instrumental in establishing a motive for the murder.

Throughout his life and ventures, Madsen was consistently described as intelligent, ambitious, and driven, but also as arrogant, controlling, and prone to conflict. This combination of traits likely contributed to both his entrepreneurial success and his ultimate downfall. His ability to inspire and lead was coupled with a lack of interpersonal skills and a tendency towards recklessness.