This proposed Science of Behavior Change (SOBC) study will translate research on delay discounting to the prevention of Type 2 diabetes (T2D) in persons with prediabetes. A cross-sectional design will be used to test if delay discounting (DD) is a target related to behavioral and medical adherence in persons with prediabetes. Specifically, researchers will examine whether measures of DD, region of interest (ROI) neural activation during DD, and other executive functions are predictive of behavioral and medical adherence among prediabetics.


Leonard H. Epstein, PhD

Principal Investigator

University at Buffalo School of Medicine and Biomedical Sciences

Division of Behavioral Medicine

Buffalo, NY

Dr. Epstein is SUNY Distinguished Professor in the Departments of Pediatrics and Community Health and Health Behavior at the University of Buffalo, and the Chief of the Division of Behavioral Medicine. Dr. Epstein’s research interests focus on health behavior change and determinants of eating, physical activity and drug self-administration.  Dr. Epstein is an internationally recognized authority in the fields of childhood overweight, physical activity, weight control and family intervention. For the past 25 years, Dr. Epstein has conducted research relevant to the prevention and treatment of childhood obesity, including mechanisms that regulate intake and energy expenditure in children. He is a fellow in numerous scientific organizations including the American Association for the Advancement of Science (AAAS), and has been the President of the division of Health Psychology, APA, and recipient of the American Psychological Association Award for Outstanding Contributions to Health Psychology.  Dr. Epstein chaired the Behavioral Medicine Study Section, NIH, and served on the Advisory Board for Center for Scientific Research, NIH.  Dr. Epstein has published over 400 scientific papers and three books.

Warren K. Bickel, PhD

Principal Investigator

Virginia Tech Carillion Research Institute

Psychology Department

Roanoke, VA

Dr. Bickel is an accomplished scholar and researcher in addiction and health behavior research. He received his Ph.D. in developmental and child psychology from the University of Kansas and completed post-doctoral training at Johns Hopkins University School of Medicine.  He has led research programs at the Albert Einstein College of Medicine, the University of Vermont, and the University of Arkansas for Medical Sciences. He currently leads NIH-funded research programs at the Virginia Tech Carilion Research Institute.  He is the recipient of numerous awards and honors including the 2016 Nathan B. Eddy Award for outstanding research. Dr. Bickel has co-edited five books and published over 350 papers and chapters.  His work is frequently cited and receives national and international recognition.

Susan Czajkowski, PhD


Lead Project Scientist

Will Aklin, PhD


Project Scientist

Luke Stoeckel, PhD


Program Official

1. Snider, S. E., Mellis, A. M., Poe, L. M., Kocher, M. A., Turner, J. K., & Bickel, W. K. (2019). Reinforcer pathology: Narrative of hurricane-associated loss increases delay discounting, demand, and consumption of highly palatable snacks in the obese. Psychology of addictive behaviors: journal of the Society of Psychologists in Addictive Behaviors.

2. Deshpande, H. U., Mellis, A. M., Lisinski, J. M., Stein, J. S., Koffarnus, M. N., Paluch, R., ... & Bickel, W. K. (2019). Reinforcer pathology: Common neural substrates for delay discounting and snack purchasing in prediabetics. Brain and cognition, 132, 80-88.

3. Epstein, L. H., Paluch, R. A., Stein, J. S., Mellis, A. M., Quattrin, T., Mastrandrea, L. D., ... & Bickel, W. K. (2019). Role of delay discounting in predicting change in HBA1c for individuals with prediabetes. Journal of behavioral medicine, 1-9.

4. Bickel, W. K., Athamneh, L. N., Basso, J. C., Mellis, A. M., DeHart, W. B., Craft, W. H., & Pope, D. (2019). Excessive discounting of delayed reinforcers as a trans-disease process. Current opinion in psychology.

5. Snider, S. E., DeHart, W. B., Epstein, L. H., & Bickel, W. K. (2019). Does delay discounting predict maladaptive health and financial behaviors in smokers?. Health Psychology, 38(1), 21.

6. Epstein, L. H., Stein, J. S., Paluch, R. A., MacKillop, J., & Bickel, W. K. (2018). Binary components of food reinforcement: Amplitude and persistence. Appetite, 120, 67-74.

7. Mellis, A. M., Athamneh, L. N., Stein, J. S., Sze, Y. Y., Epstein, L. H., & Bickel, W. K. (2018). Less is more: Negative income shock increases immediate preference in cross commodity discounting and food demand. Appetite, 129, 155-161.

8. Epstein, L. H., Paluch, R. A., Carr, K. A., Temple, J. L., Bickel, W. K., & MacKillop, J. (2018). Reinforcing value and hypothetical behavioral economic demand for food and their relation to BMI. Eating behaviors, 29, 120-127.

9. Epstein, L. H., & Anzman-Frasca, S. (2017). The promise of early childhood self-regulation for obesity prevention. Pediatrics, 139(5), e20170389.

10. Bickel, W. K., Stein, J. S., Moody, L. N., Snider, S. E., Mellis, A. M., & Quisenberry, A. J. (2017). Toward Narrative Theory: Interventions for Reinforcer Pathology in Health Behavior. In Impulsivity (pp. 227-267). Springer International Publishing.

11. Bickel, W. K., Mellis, A. M., Snider, S. E., Athamneh, L. N., Stein, J. S., & Pope, D. A. (2017). 21st century neurobehavioral theories of decision making in addiction: Review and evaluation. Pharmacology Biochemistry and Behavior.

12. Sze, Y. Y., Stein, J. S., Bickel, W. K., Paluch, R. A., & Epstein, L. H. (2017). Bleak Present, Bright Future: Online Episodic Future Thinking, Scarcity, Delay Discounting, and Food Demand. Clinical Psychological Science, 2167702617696511.

13. Stein, J. S., Sze, Y. Y., Athamneh, L., Koffarnus, M. N., Epstein, L. H., & Bickel, W. K. (2017). Think fast: rapid assessment of the effects of episodic future thinking on delay discounting in overweight/obese participants. Journal of Behavioral Medicine, 1-7.

14. Sze, Y. Y., Slaven, E. M., Bickel, W. K., & Epstein, L. H. (2017). Delay discounting and utility for money or weight loss. Obesity science & practice, 3(1), 69-74.

15. Bickel, W. K., Moody, L., & Higgins, S. T. (2016). Some current dimensions of the behavioral economics of health-related behavior change. Preventive medicine, 92, 16-23.

16. Bickel, W. K., Mellis, A. M., Snider, S. E., Moody, L., Stein, J. S., & Quisenberry, A. J. (2016). Novel Therapeutics for Addiction: Behavioral Economic and Neuroeconomic Approaches. Current treatment options in psychiatry, 3(3), 277-292.