We reviewed and summarize the extant literature on associative/dissociative cognitive strategies used by athletes and others in circumstances necessitating periods of sustained attention. This review covers studies published since a prior publication by Masters and Ogles (1998), and, in keeping with their approach, offers a methodological critique of the literature. We conclude that the distinction between associative and dissociative strategies has outlived its usefulness since initially proposed in an earlier era of ground-breaking research by Morgan and Pollock (1977) that was influenced to some extent by psychodynamic thinking. In recent years there has been an evolutionary shift in concepts of sustained attention toward mindfulness—moment-by-moment attention—that has had a significant impact on conceptual models and clinical practice in diverse areas including stress management, psychotherapy, and athletic performance. We propose that future research on cognitive activity in sustained performance settings be embedded in a mindfulness-based conceptual model.