Extended Abstract
1. Introduction
The ability to regulate excitements is an important growth task to maintain the inner balance of individuals, adaptive communication, and promoting mental health [1]. Some conceptualizations about the excitement regulation emphasize on control of emotional experiences, in particular, pretending to control negative emotions, and also the reduction of emotional excitement [2]. On the contrary, others emphasize the functional nature of excitement on excitement regulation and mention that the emotional regulation is not synonymous with emotional control.  Therefore, it necessarily does not include immediate reduction of negative emotions. Research has been conducted on  the importance of excitement in paving the path, continuity, resistance in treatment, quality of therapeutic relationship, and the type of selective interventions. 
The present study attempted to identify emotional regulation problems and emotional distress in order to provide the basis for the use of appropriate therapies and techniques to increase the effectiveness of therapeutic interventions, prevent recurrence of disorder, resistance in treatment, and failure in the therapeutic relationship. Therefore, this study is trying to diagnose cognitive, metacognitive and meta-excitement components related to emotional distress.
2. Method
This study is a descriptive correlation study, and the statistical population is comprised of all Iranian medical students studying in 2014-15 academic year. In this research, multi-stage cluster sampling was used in a way that four colleges of Medical, Nursing, Midwifery, and Rehabilitation and Health  were randomly selected among the faculties of Iran University of Medical Sciences. In every college, several classes have been randomly selected proportional to their students in each of the educational levels of that faculty.  Then questionnaires were distributed randomly among these students. Among the participants, 223 people (57.5%) were male and 165(42.5%) were female.  Their mean age was 22.57 years, and the minimum age of the participants was 18 years and maximum age was 32 years. In regression analysis, for each predictor variable, there must be 10 subjects [19]. 
According to this article, the sample size should be at least 370, but considering the size of society and falling rates, 400 people participated in the research. The variables studied have been listed as follows: 1. Emotional distress; 2. Emotional schemes; 3. Initial incompatibility schemas; 4. Metacognition; 5. Attention awareness; and 6. Commitment and acceptance. Results were analyzed using SPSS software version 22 and Pearson's two-variable correlation statistical strategies and step-by-step linear regression analysis.
3. Results
Table 1 shows the demographic characteristics of the participants in the study. Can variables such as emotional schemas, initial incompatibility scheme, metacognition, commitment and acceptance and attention awareness predict student emotional distress? To answer this question, a step-by-step linear regression method was used, and the two scales of intrinsic and extrinsic inefficient strategies were independently evaluated. The dimensions of emotional schemas, initial incompatibility schema, acceptance and action, metacognition, and attention awareness were entered into the regression model in a step-by-step manner to predict the amount of intrinsic inefficient emotion regulation strategies. In the first step, acceptance and action entered the regression equation because of the highest correlation with highly intrinsic inefficient excitement regulation strategies. Next, the variables were split and analyzed, to make the maximum increase in the amount of the coefficient of determination (R2).  Entry of variables continued to the point where the amount of significance of the model reached 95% and the error level reached 5%.
Significance of F statistic (F=06.33) showed that regression of these variables (acceptance and action, emotional self-awareness, attention awareness, acceptance of feelings, social isolation/alienation, trying to be logical, vulnerability to the intensity of intrinsic excitement regulation strategies) was significant (P=0.0001).
There is a significant relationship between acceptance and action, emotional self-awareness, attention awareness, acceptance of feelings, social isolation/alienation, trying to be logical, vulnerability, and the intensity of intrinsic excitement regulation (R=0.649). In total, they accounted for 42.1% of the amount of intrinsic excitement regulation strategies (R2=421). That way, the more was the extent of acceptance and action, emotional self-awareness, attention awareness, accepting fewer emotions, the higher was the level of social isolation/alienation, trying to be logical, vulnerability, and amount of intrinsic inefficient strategies.
4. Discussion
The results showed that there is a significant relationship between acceptance and action, emotional self-awareness, attention awareness, acceptance of feelings, social isolation/alienation, trying to be logical, vulnerability, and the intensity of intrinsic excitement regulation strategies (R=0.649). In total, they accounted for 42.1% of the amount of intrinsic excitement regulation strategies (R2=421).  These results are in line with Schubler's view [37] that experience- and pattern-based avoidance in the person who does not want to be in contact with physical senses, excitements, thoughts or behavioral inclinations led to the use of internal and external inefficient methods. These results are also consistent with the model of Kuyken et al. [38], which mentioned that people have acceptance without judgment regarding their affairs. This refers to the awareness of perceptions, cognition schemas, emotions or body feelings, without judging or evaluating them being good or bad, true or false, healthy or unhealthy and important or insignificant. In this regard, Roemera [39] showed that the lower the level of awareness, the higher the amount of excitement problems. Also, Deplus [40] showed that attention awareness group interventions enhanced the ability to adjust the excitement in teenagers. Tang [41] presented a research where attention awareness as a mediating agent can increase self-control for excitement regulation.
The results showed that there is a significant relationship between higher values, mistrust/mistreatment, attention awareness, agreement, and acceptance of emotions with the severity of extrinsic excitement regulation strategies (R=0.522). In total, it accounted for 27.2% of the amount of extrinsic excitement regulation strategies (R2=272).  Due to the higher amount of higher values, attention awareness and acceptance of fewer emotions, mistrust/ill-treatment and agreement, the level of extrinsic excitement regulation strategies was also higher. In a study by Laura [42], it was shown that there was a significant relationship between awareness and reducing distress. 
Acknowledgments
This research was extracted from the MSc. thesis of the first author, in the Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran. Tehran Institute of Psychiatry has financially supported the present paper.
Conflict of Interest
The authors declared no conflicts of interest.