Long-term symptom management is an important consideration for many individuals with serious mental illness to maintain recovery over time,... Show moreLong-term symptom management is an important consideration for many individuals with serious mental illness to maintain recovery over time, prevent relapse and rehospitalization, and decrease symptom severity. Psychotropic medications can be an important aspect of treatment planning; however, many barriers exist that can impact medication adherence and treatment efficacy. Research suggests that internalized stigma and neurocognition may impact medication adherence, but research has yet to investigate the relationship between these three constructs in tandem. In this study, medication adherence was measured via medication possession ratio calculated from pharmacy records (objective) and self-reported medication use (subjective). Selection of neurocognitive domains and assessment measures was informed by MATRICS and ISBD-BANC consensus batteries. The primary expectations were that verbal memory and executive functioning would be related to medication adherence behaviors and that these domains would moderate the relationship between internalized stigma and medication adherence. A consistent association was seen between measures of self-reported medication use over time, suggesting participants were generally consistent in their reported use. While analyses testing the primary hypotheses were nonsignificant, in the context of limitations of statistical power, trends emerged that may be worthy of further investigation. Future research should continue to explore the potentially multifaceted relationships between factors contributing to adherence. A more comprehensive understanding these relationships has implications for clinicians and consumers in addressing treatment barriers and disengagement by developing more nuanced and targeted interventions. Show less