Background: Delay discounting is the process of making choices that provide small immediate rewards versus choosing to wait for a greater more meaningful reward. Measured by two constructs, delay discounting measures the gain or loss of value on an outcome when delay is present, and delay aversion, measures the emotional response when a delay is present. Emerging evidence shows delay discounting is associated with poor self-care behavior, glycemic control, and quality of life. There is limited data on the impact of delay discounting on psychological health (depression, anxiety, perceived stress) and social support.

Methods: This study used data from 365 adults with T2DM to evaluate relationships between delay discounting and psychological health and social support. Delay discounting was measured with the validated QDQ scale with 2 subscales for delay discounting and delay aversion. Depression was measured by the PHQ-9, anxiety by the GAD-8, perceived stress by the PSS-4, and social support by the DUSOC. Adjusted linear regression was used to assess the relationship between delay discounting and delay aversion on psychological health (depression, anxiety, perceived stress) and social support controlling for relevant covariates.

Results: Mean age of the sample was 61.8 years, 54.5% were African American, 41.8% were White, and 3.7% were Hispanic/Other. After adjusting for sociodemographic factors, delay aversion was significantly associated with depression (B=.35; p<0.001) , anxiety (B=.52; p<0.001) , stress (B=.22; p<0.001) , and lower family support (B=-.62; p<0.05) . Delay discounting was significantly associated with depression (B=.32; p<0.001) , anxiety (B=.46; p<0.001) , and stress (B=.26; p<0.001) .

Conclusion: Both constructs of delay discounting (delay discounting and aversion) are significantly associated with poor psychological health and poor social support. Future studies need to examine mechanisms and pathways for potential interventions.


J.A.Campbell: None. L.E.Egede: None.


National Institute of Diabetes and Digestive Kidney Disease (K24DK093699, R01DK118038, R01DK120861, PI: Egede) National Institute for Minority Health and Health Disparities (R01MD013826, PI: Egede/Walker) .

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at