John Astin

Santa Clara University | SCU · Department of Counseling Psychology

Over the past several decades, there has been an exponential growth in psychological theory and research to develop techniques by which individuals can gain a positive sense of control in their lives. One such model is Control Therapy (Shapiro & Astin, 1998; Shapiro, Astin, Shapiro, Soucar, & Santerre, 2010; D. H. Shapiro, Soucar, S. L. Shapiro, &...

Objective: The objective of this study was to determine whether a mindfulness program, created for the workplace, was both practical and efficacious in decreasing employee stress while enhancing resiliency and well-being. Methods: Participants (89) recruited from The Dow Chemical Company were selected and randomly assigned to an online mindfulne...

Informed consent is the cornerstone of human research subject protection. Many subjects sign consent documents without understanding the study purpose, procedures, risks, benefits, and their rights. Proof of comprehension is not required and rarely obtained. Understanding might improve by using an interactive system with multiple options for hearin...

The purpose of this paper was to examine the longitudinal effects of psychological sense of control and control-related coping strategies on breast cancer outcomes. Utilizing the California Cancer Registry, follow-up data on cancer recurrence and all-cause mortality were obtained for 54 of 58 women originally diagnosed with breast cancer in 1992 to...

Although the quest for active control and mastery can be seen as a central thread that ties together important aspects of human experience, we are frequently confronted with the reality that much of what is encountered in life lies outside our active instrumental control. Control must involve finding healthy and life-affirming ways to exercise pers...

Both psychological and neurobiological findings lend support to the long-standing clinical observation that negative affect is involved in the development and maintenance of alcohol dependence, and difficulty coping with negative affect is a common precipitant of relapse after treatment. Although many current approaches to relapse prevention emphas...

Control Therapy is an integrated approach to psychotherapy and health care that combines theory, research, and practice. Its theory, test construction, and interventions have been developed and empirically tested over a 25-year period involving research and clinical work with thousands of individuals in more than a dozen countries.

All psychotherapeutic systems have a vision of psychological health rooted in and stemming from their view of human nature. The goal of therapy is to develop interventions that, based on each orientation's personality theory, remove obstacles and barriers and develop awareness, insights, skills, and abilities that enhance a person's psychological h...

Psychology has had a long and stormy relationship with the term self-control and related concepts of choice, willpower, self-regulation, human agency, and personal autonomy. Although the concept raises difficult questions about the nature of self, free will, and determinism, the importance of self-control cannot be ignored. Research has shown that...

John Astin, PhD, is a health psychologist at the California Pacific Medical Center Research Institute in San Francisco. He studies psychological, attitudinal, and sociocultural barriers to the integration of mind-body factors in medicine and is especially interested in the role of contemplative practices, particularly meditation, in improving menta...

Stress and negative mood during pregnancy increase risk for poor childbirth outcomes and postnatal mood problems and may interfere with mother-infant attachment and child development. However, relatively little research has focused on the efficacy of psychosocial interventions to reduce stress and negative mood during pregnancy. In this study, we d...

To examine residents' and medical students' attitudes toward the incorporation of psychosocial factors in diagnosis and treatment and to identify barriers to the integration of evidence-based, mind-body methods. A random sample of third- and fourth-year medical students and residents was drawn from the Masterfiles of the American Medical Associatio...

Context There is growing interest in the integration of meditation in higher education. Purpose Here, we review evidence bearing on the utility of meditation to facilitate the achievement of traditional educational goals and to enhance education of the “whole person.” Research Design We examine how meditation practices may help foster important c...

This article describes recent theoretical developments and empirical findings regarding the role of negative affect (NA) and emotion regulation in nicotine dependence and smoking cessation. It begins with a review of affect-based models of addiction that address conditioning, affect motivational, and neurobiological mechanisms and then describes th...

Headache is one of the most common and enigmatic problems encountered by family physicians. Headache is not a singular entity, and different pathologic mechanisms are involved in distinct types of headache. Most types of headache involve dysfunction of peripheral or central nociceptive mechanisms. Mind-body therapies such as biofeedback, cognitive...

In the current issue of Arthritis Care & Research, the study by Pradhan and colleagues (1) suggests that training in the skill of mindfulness (what they and others have defined as "moment-to-moment, non-judgmental awareness" (2)) may benefit patients with rheumatoid arthritis (RA). While the investigators failed to find significant changes in RA di...

Mind-body medicine (MBM) approaches to many health problems have been well documented in the literature, including through multiple meta-analyses. Efficacy has been well demonstrated in conditions such as headache, irritable bowel syndrome, anxiety, fibromyalgia, hypertension, low back pain, depression, cancer symptoms, and postmyocardial infarctio...

Examine physicians' attitudes toward the incorporation of psychosocial factors in diagnosis and treatment and identify barriers to the integration of evidence-based mind-body methods. Random sample of primary care physicians and physicians from selected non-primary specialties was drawn. A total of 1058 physicians completed a 12-page survey. The re...

Recently, the psychological construct mindfulness has received a great deal of attention. The majority of research has focused on clinical studies to evaluate the efficacy of mindfulness-based interventions. This line of research has led to promising data suggesting mindfulness-based interventions are effective for treatment of both psychological a...

The purpose of this study was to examine patterns and predictors of complementary and alternative medicine (CAM) among breast cancer patients. A review of the existing survey literature on CAM use for breast cancer was conducted with a series of eight focus groups (N = 67) to further examine the perspectives of breast cancer patients on CAM. The ra...

While data are conflicting, studies have appeared in the literature suggesting that mental intentions sent from a distance (eg, intercessory prayer, spiritual healing) can possibly influence clinical outcomes in patients suffering from an array of medical conditions. The purpose of this study was to examine the potential efficacy of distant healing...

This study of medical students, residents, and physicians examined their responses to focus group questions in an effort to understand barriers to discussing psychosocial issues and using mind-body interventions to address health issues. Four focus groups were conducted: two with medical students and residents, one with primary care doctors, and on...

Our objective was to develop a pilot measure of subjective outcomes of complementary and alternative medicine (CAM). Current options for assessing subjective outcomes in CAM are either too burdensome or fail to represent diverse outcomes. A single measure specifying common, patient-reported outcomes of CAM would be of value. We conducted a three-ph...

The literature is replete with evidence that the stress inherent in health care negatively impacts health care professionals, leading to increased depression, decreased job satisfaction, and psychological distress. In an attempt to address this, the current study examined the effects of a short-term stress management program, mindfulness-based stre...

Presented in this paper is a review of some of the evidence linking psychosocial factors to a variety of health outcomes. Drawing upon the work of the philosopher Ken Wilber, we begin with a consideration of some of the historic roots of the mind-body split. As will be seen, Wilber argues that in the premodern era, "mind" and "body" were essentiall...

This paper reviews the evidence for mind-body therapies (eg, relaxation, meditation, imagery, cognitive-behavioral therapy) in the treatment of pain-related medical conditions and suggests directions for future research in these areas. Based on evidence from randomized controlled trials and in many cases, systematic reviews of the literature, the f...

To test the short and longterm benefits of an 8 week mind-body intervention that combined training in mindfulness meditation with Qigong movement therapy for individuals with fibromyalgia syndrome (FM). A total of 128 individuals with FM were randomly assigned to the mind-body training program or an education support group that served as the contro...

Although emerging evidence during the past several decades suggests that psychosocial factors can directly influence both physiologic function and health outcomes, medicine had failed to move beyond the biomedical model, in part because of lack of exposure to the evidence base supporting the biopsychosocial model. The literature was reviewed to exa...

Studies in the United States, Europe, and elsewhere continue to document the growing interest in and use of complementary/alternative (CAM) therapies by the general public. Some of this research has suggested that CAM use is higher among middle-aged, “Baby Boomers” [6,7] and therefore less frequently used by both younger and older populations [3]....

To carry out a systematic review of the literature examining the effectiveness of spinal manipulation for the treatment of headache disorders, computerized literature searches were carried out in Medline, Embase, Amed and CISCOM. Studies were included only if they were randomized trials of (any type of) spinal manipulation for (any type of) headach...

To carry out a systematic review of the literature examining the efficacy of psychological interventions (e.g., relaxation, biofeedback, cognitive-behavioral therapy) in the treatment of rheumatoid arthritis (RA). Studies that met the following criteria were included: random assignment, wait-list or usual care control condition; publication in peer...

In this article we suggest that despite decades of compelling research in suchfields as behavioral medicine and mind-body medicine, a more integral, less fragmented approach is still needed. We argue that one of the obstacles to realizing a more holistic-oriented medicine (ie, biopsychosociocultural) has been the lack of a comprehensive conceptual...

To assess the status of managed care and insurance coverage of complementary and alternative medicine (CAM) and the integration of such services into managed care. A literature review and information search were conducted to determine which new insurers had special policies for CAM from 1999 to 2000. Telephone interviews were conducted with a sampl...

Previous research indicates wide use of complementary and alternative medicine (CAM). While understanding this trend is certainly important, an equally meaningful although largely unexamined research question is: why do the majority of patients and individuals fail to avail themselves of such therapies? Understanding these factors may be particular...

To conduct a systematic review of the available data on the efficacy of any form of "distant healing" (prayer, mental healing, Therapeutic Touch, or spiritual healing) as treatment for any medical condition. Studies were identified by an electronic search of the MEDLINE, PsychLIT, EMBASE, CISCOM, and Cochrane Library databases from their inception...

PURPOSE: To conduct a systematic review of the available data on the efficacy of any form of "distant healing" (prayer, mental healing, Therapeutic Touch, or spiritual healing) as treatment for any medical condition. DATA SOURCES: Studies were identified by an electronic search of the MEDLINE, PsychLIT, EMBASE, CISCOM, and Cochrane Library database...

Large scale surveys in the United States and abroad suggest that 35-60% of adults have used some form of complementary/alternative medicine (CAM). However, no studies to date have focused on predictors and patterns of CAM use among elderly persons. The population surveyed were Californians enrolled in a Medicare risk product that offers coverage fo...

To assess the status of managed care and insurance coverage of complementary and alternative medicine (CAM) and the integration of such services into conventional medicine. A literature review and information search was conducted to determine which insurers had special policies for CAM. Telephone interviews were conducted with a definitive sample o...

Research suggests that one of the principal reasons patients are attracted to alternative medicine is that they find many of these therapies more congruent with their philosophical orientation toward health. Many mind-body approaches, which are some of the most frequently used classifications of complementary and alternative therapies, grow out of...

The relationship of modes of control and desire for control to psychosocial adjustment in women with breast cancer was examined. Fifty-eight women with stage I or stage II breast cancer were surveyed shortly after their diagnosis and again 4 and 8 months later. The authors hypothesized that a control profile in which individuals use a positive yiel...

Studies suggest that between 30% and 50% of the adult population in industrialized nations use some form of complementary and/or alternative medicine (CAM) to prevent or treat a variety of health-related problems. A comprehensive literature search identified 25 surveys conducted between 1982 and 1995 that examined the practices and beliefs of conve...

Research both in the United States and abroad suggests that significant numbers of people are involved with various forms of alternative medicine. However, the reasons for such use are, at present, poorly understood. To investigate possible predictors of alternative health care use. Three primary hypotheses were tested. People seek out these altern...

Context.— Research both in the United States and abroad suggests that significant numbers of people are involved with various forms of alternative medicine. However, the reasons for such use are, at present, poorly understood.Objective.— To investigate possible predictors of alternative health care use.Methods.— Three primary hypotheses were tes...

This study examined the effects of an 8-week stress reduction program based on training in mindfulness meditation. Previous research efforts suggesting this program may be beneficial in terms of reducing stress-related symptomatology and helping patients cope with chronic pain have been limited by a lack of adequate comparison control group. Twenty...

This article begins by examining psychology's contributions to understanding the positive consequences of control for individual mental and physical health. Person-environment control mismatches and the negative personal, interpersonal, and societal consequences of seeking and having control are then discussed. As corrections to mismatches and nega...

This article begins by citing apparently conflicting sets of literature regarding the association between control and cardiovascular risk. Each set of findings is based on a unidimensional understanding of control. To gain more precise information, a multidimensional control inventory, the Shapiro Control Inventory (SCI), was given to twenty indivi...

This book is both an exploration of the role of control of health and disordered cognitive, behavioral, and affective functioning and a practical guide to integrating control-based techniques into virtually any practice. Weaving theory, research, and clinical insight into a coherent framework, the authors identify the personal, interpersonal, and c...

Thesis (Ph. D., Health Psychology)--University of California, Irvine, 1997. Includes bibliographical references (leaves 84-88). Photocopy.