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Beck's cognitive model of depression suggests that negative cognitions can maintain depression. Thus reducing the frequency of negative cognitions should reduce depression. Consistent with this proposition, in low endogenous patients with primary major depressive disorder, distraction produced fewer depressing thoughts than the control procedure, with corresponding differences in self-report and psychomotor measures.

The effects on depressive thinking and depressed mood of a brief, standardized distraction procedure were examined. In low endogenous patients (scoring 3 or less on the Newcastle Diagnosis Scale (NDS)), distraction significantly reduced the frequency of depressing thoughts. Consistent with Beck's cognitive model of depression, these patients were significantly less depressed after distraction than after a control procedure. In high endogenous patients (scoring 4 or more on the NDS), distraction produced less marked reductions in frequency of depressing thoughts, and no significant change in depressed mood. It is suggested that the relationship between negative thinking and depressed mood differs in the two patient groups.