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The Everyday Memory Questionnaire - Revised:

Development of a 13-item scale

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The Everyday Memory Questionnaire - revised:
Development of a 13-item scale
Jane Royle a; Nadina B. Lincoln a
a
Sheffield Teaching Hospitals NHS Trust, Sheffield, University of Nottingham,
Nottingham, UK

First Published on: 26 April 2007

To cite this Article: Royle, Jane and Lincoln, Nadina B. (2007) 'The Everyday
Memory Questionnaire - revised: Development of a 13-item scale', Disability &
Rehabilitation, 30:2, 114 - 121
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 Disability and Rehabilitation, 2008; 30(2): 114 – 121
Downloaded By: [Lincoln, Nadina B.] At: 20:38 19 January 2008

RESEARCH PAPER

The Everyday Memory Questionnaire – revised: Development

of a 13-item scale

JANE ROYLE & NADINA B. LINCOLN

Sheffield Teaching Hospitals NHS Trust, Sheffield, University of Nottingham, Nottingham, UK

Accepted January 2007

Abstract
Purpose. The Everyday Memory Questionnaire (EMQ) was developed as a subjective measure of memory failure in
everyday life [1]. Previous studies have investigated the factor structure of the EMQ in both healthy participants and people
with multiple sclerosis (MS). The aim of the present study was to confirm the factor structure of the EMQ, to determine the
internal consistency and criterion validity of the scale and to develop a shortened version.
Method. A retrospective design, including participants from a study on MS patients and their carers and a study on stroke
patients. Psychometric properties of the EMQ-28 were explored, and the measure was further revised from comparative
analyses between the clinical and non-clinical groups.
Results. Reliability and factor analysis of the EMQ-28 identified two main factors, general memory and attentional function,
showing some concordance with previous research. Further analysis reduced the questionnaire to a 13-item measure (EMQ-
R), with two main factors (Retrieval and Attentional tracking), strong internal reliability, and good discriminatory properties
between clinical and control groups.
Conclusions. The 28-item questionnaire consistently differentiated between two broad systems of memory and attention,
with some differentiation of visual and verbal, or language systems. Results showed some consistency with previous findings.
The revised, 13-item questionnaire is a valid and reliable tool that has good face validity for use with neurological patients.
Further exploration of the revised EMQ is recommended to provide information regarding its psychometric and clinical
properties.

Keywords: Memory, assessment, cognition

Introduction
Reliable measurement of the functional impact and
report of memory problems continues to present a
dilemma to the practitioner. Recent developments in
the practice of neuropsychology have led to a shift
from a diagnostic to ecological and rehabilitative
focus [2]. Traditional neuropsychological tests have
consistently been found to have poor ecological
validity, which is defined as the relationship between
performance on neuropsychological tests and beha-
viour in everyday settings [3]. Memory question-
naires, therefore, are proposed as a potentially useful
adjunct to traditional tests to improve such ecological
validity.
Ecologically-based questionnaires to identify
memory problems have some reliability [4,5]
but varying validity [2,6,7]. The poor association
between memory tests and performance may result
from anomalies between everyday tasks and abilities
assessed by memory tests. Validity is higher when
memory questionnaires are compared to more
ecologically-based tests [8], and correlations between
questionnaires and test results have been higher
where questionnaires were completed by significant
others [1,3,9].
Herrman [10] reviewed 14 memory question-
naires, proposing that self-report measures do not
measure memory performance per se, but are
measures of metamemory, or beliefs about memory
performance. He concluded that there is valid utility
for memory questionnaires in the assessment of first
hand observations of one’s own performance versus
second-hand report from others; an individual’s
susceptibility to cognitive errors under stress; and

Correspondence: Jane Royle, Sheffield Teaching Hospitals NHS Trust, Sheffield, and University of Nottingham, UK. E-mail: Jane.Royle@sth.nhs.uk
ISSN 0963-8288 print/ISSN 1464-5165 online ª 2008 Informa UK Ltd.
DOI: 10.1080/09638280701223876

Downloaded By: [Lincoln, Nadina B.] At: 20:38 19 January 2008
as an assessment of cognitive function for people
with psychological and neurological disorders.
A valid and reliable memory questionnaire has
several uses for people with psychological, neurolo-
gical and physical health problems including: mea-
surement of outcome or process, an ecological tool
to assess everyday memory as an adjunct to standard
clinical tests, comparing metamemory and memory
beliefs for individuals with memory problems, asses-
sing insight and awareness, particularly if used with
both client and family member, and as a heuristic
tool to compare different types of memory com-
plaint. In the clinical setting they also provide an
opening to explore cognitive difficulties in a non-
threatening manner and an aid to engage someone in
a rehabilitation or therapeutic process, by asking for
the client’s personal views and perceptions.
The Everyday Memory Questionnaire (EMQ) was
initially developed for use with survivors of head
injury [1] and has subsequently been further refined
and developed with both non-clinical and clinical
samples. The original questionnaire consisted of 35
items, which has since been altered to a 28-item
questionnaire [11] to increase the measure’s validity
and facilitate self-administration. The 28-item scale
was developed with 22 items representing valid
memory difficulties, and six items representing floor,
or bogus items, representing atypical memory
difficulties as a measure of response validity. The
response format has also been altered over time,
from relative frequencies (‘sometimes’) to absolute
values (e.g., ‘about once a week’), with a 9-point
scoring system simplified to a five-point scale [12]
although there are no reported analyses of the impact
on reliability and validity.
Clinical samples explored using the EMQ include:
Survivors of head injury [1,13,14,15]; the elderly [7,
16]; people with Alzheimer’s disease [17]; survivors
of stroke [12,18,19]; multiple sclerosis [20,21,22]
and epilepsy [14].
Three studies have explored the factor structure of
the EMQ [17,22,23]. Cornish [23] administered the
28-item scale with the 9-point scoring system to a
sample of 277 undergraduates. Five factors ex-
plained 49% of the variance, which were proposed
to reflect underlying memory processes. Prior to this
study, Richardson and Chan [22] had explored the
factor structure of the original 35-item EMQ, using a
postal questionnaire with 115 MS patients. The
authors modified the measure, by including a
‘nuisance’ rating, and included patients’ self-reports
and the ratings by relatives or carers in their analysis,
which somewhat confounds results. They also found
a five-factor structure, explaining 62% of variance.
More recently, Eflikides et al. [17] explored the
factor structure of the 28-item EMQ with a modified
4-point rating scale as part of a larger study exploring
The Everyday Memory Questionnaire – revised 115
relationships between the EMQ, Wechsler Memory
Scale (WMS) and the Rivermead Behavioural
Memory Test (RBMT). They included 233 non-
clinical individuals (Greek population) and found a
seven-factor structure, explaining 62% of variance.
They postulated that the EMQ measured metamem-
ory, an awareness of episodic memory problems, and
correlated with more concrete performance mea-
sures within the RBMT.
Although Cornish [23] and Richardson and Chan
[22] both identified a five-factor structure, there were
key differences between them. Richardson and Chan
identified their factors as: Receptive communication;
Route-finding; Absent-mindedness; Face recogni-
tion; and Expressive communication. Cornish’s
factors were interpreted as: Retrieval; Task monitor-
ing; Conversational monitoring; Spatial memory;
and Memory for activities. Cornish proposed that
there were similarities between ‘Conversational
monitoring’ and ‘Expressive communication’;
‘Spatial memory’ and ‘Route-finding’; and ‘Task
monitoring’ and ‘Absent-mindedness’, but that the
‘Receptive communication’ and ‘Face recognition’
factors were not replicated in his study. There are
clear links between ‘Conversational monitoring’ and
‘Expressive communication’, with four of five items
in Richardson and Chan’s study overlapping with
Cornish; and links between ‘Spatial memory’ and
‘Route finding’, with two of four items in Richardson
and Chan’s study overlapping with Cornish. It is
unclear where the proposed links between ‘Task
monitoring’ and ‘Absentmindedness’ occur, how-
ever, given that ‘Absentmindedness’ consists of a
combination of factors 1, 2, 4 and 5 in the Cornish
study, with only one item overlapping with Cornish’s
‘Task monitoring’, and a far stronger link with factor
1 ‘Retrieval’.
In comparison, Eflikides et al. [17] defined the
seven factors identified as: Problems in prospective/
general memory; Difficulties in learning and repeti-
tion of responses; Forgetting changes in daily
routines; Visuo-spatial; Semantic memory; Episodic
memory and for faces; and Visual reconstruction
memory. There are clear links between
‘Visuo-spatial’ and the ‘Spatial’ Factor in Cornish’s
[23] study, and ‘Route-finding’ in Richardson and
Chan’s [22] study. There are also links between
‘Forgetting changes in daily routine’ and the
‘Memory for activities’ factor in Cornish’s study.
Otherwise, there are wide-ranging overlaps between
and across the three different studies.
These three studies indicate difficulties in clearly
defining the underlying factor structure of the EMQ,
other than a strong ‘Spatial’ factor, which is con-
sistent across both non-clinical and an MS popula-
tion. Findings are complicated by the different
samples, methodology and type of questionnaires
 116 J. Royle & N. B. Lincoln
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used. We have identified no studies that compare MS group. The stroke patients were recruited from
the validity of the EMQ across different groups of the register of stroke admissions to the City,
clinical and non-clinical participants. The EMQ has University and General hospitals in Nottingham for
also been altered over time, simplifying its scoring a treatment trial. All had evidence of memory
system, with no data on the psychometric impact. problems as assessed on the Rivermead Behavioural
Cornish [23] suggested extending the items in the Memory Test. Participant characteristics are shown
EMQ to improve its psychometric properties and in Table I. Ethical approval was granted by Notting-
diagnostic utility. In clinical practice, however, the ham Local Research Ethics Committee.
28-item questionnaire is quite lengthy, with anecdotal
evidence that some items can be difficult to interpret,
Procedure
and feel repetitive. Although there is obvious merit in
extending the questionnaire to improve its psycho- The revised version of the Everyday Memory
metric and diagnostic properties, the use of the EMQ Questionnaire [24] was administered to all partici-
as a clinical tool would suggest a need to reduce the pants. Those in the healthy control group and stroke
items, to improve its face validity and ease of use, but sample were sent the questionnaire by post. Those in
maintain an element of differentiation between the MS sample were asked to complete the ques-
different everyday memory failures. tionnaire as part of a broader battery of outcome
The aims of this study were: measures, carried out by interview 4 months after
recruitment to the study by an independent assessor,
. To determine the internal consistency and blind to group allocation.
factor structure of the 5 response category The EMQ consisted of 28 items, each describing
version of the EMQ in healthy participants; everyday activities, which may involve memory
. To determine the construct validity by com- failure. A 5-point scoring was used with a scale of:
paring patients with memory problems with 0 (once or less in the last month); 1 (more than once
healthy participants; a month but less than once a week); 2 (about once a
. To develop a shortened version of the ques- week); 3 (more than once a week but less than once a
tionnaire for clinical use and to determine its day); and 4 (once or more in a day) [20].
sensitivity to differences between patients with
memory problems and healthy participants;
Statistical analyses
. To determine the internal consistency and
factor structure of the revised version of the All data were analysed using SPSS version 11 for
EMQ in clinical participants (people with Windows statistical package. Reliability analyses
memory problems following MS and stroke) (using Cronbach’s alpha) and factor analyses (using
and healthy participants. a principal components analysis and either a direct
oblimin or varimax rotation, depending on results)
were carried out on the non-clinical sample initially.
Method Items were removed in a stepwise fashion according
to the following criteria:
Participants
Data were drawn from two sources for three groups: . Corrected item-total correlations less than 0.3
A sample of MS patients (n ¼ 160) from a study in reliability analyses;
evaluating cognitive assessment and intervention
[20]; a healthy control sample, (n ¼ 98) comprising
Table I. Descriptive statistics for three groups.
relatives of the MS patients from Lincoln et al. [20];
and a sample of stroke patients (n ¼ 90) from a drug Healthy MS Stroke
treatment trial with memory-impaired stroke patients control n ¼ 98 n ¼ 160 n ¼ 90
(unpublished).
Gender
Participants with clinically definite, clinically Male 32% 30% 35%
probable or laboratory supported MS were recruited Female 68% 70% 65%
from a multiple sclerosis management clinic at Age
University Hospital, Nottingham. Although all were Mean 43 43 68
screened for cognitive profile, there were no exclu- SD 15 11 10
sion or inclusion criteria based on cognitive perfor- Range 14 – 76 17 – 71 41 – 88
mance. Participants in this study were randomly Mean total EMQ (25 item)
allocated to receive either a cognitive assessment or a Mean 0.63 0.93 1.27
SD 0.6 0.81 0.7
cognitive assessment and rehabilitation. The healthy Range 0 – 73 0 – 89 2 – 85
control sample was recruited from relatives of the
 The Everyday Memory Questionnaire – revised 117
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. Items that poorly differentiated the three
samples (healthy controls, MS and Stroke),
defined as not significant or significant only at
the 5% level in one-way analyses of variance
with Bonferroni post hoc test of multiple
comparisons;
. Items with consistent low scores across the
three samples, defined as (a) having item
means lower than the total scale mean for all
3 groups, and (b) less than 20% of each group
scoring 3 – 4 for the item.
Reliability and factor analysis of the non-clinical
sample were then repeated for the revised scale,
using Cronbach’s alpha and principal components
factor analysis with direct oblimin or varimax
rotation, as appropriate [23,25,26], estimating num-
ber of factors to be retained as those with Eigenvalues
over 1.
Comparisons across the three samples were
carried out, using one-way analyses of variance, with
the non-parametric Welch statistic where variances
were not homogenous and the Bonferroni post hoc
test. The mean total for the 13-item scale and each
factor were compared.
Results
Reliability and Factor analyses, using healthy
control sample
Participants’ total scores on the questionnaire are
shown in Table I. Cronbach’s alpha for the scale was
high (0.91) indicating strong internal reliability. On
checking the individual items, three were found to
have low corrected item-total correlations: item 11
(Failing to recognize, by sight, close relatives or
friends that you meet frequently) (r ¼ 0.13); item 19
(Forgetting important details about yourself, e.g.,
your birthdate or where you live) (r ¼ 0.01); and item
25 (Getting lost or turning in the wrong direction on
a journey, on a walk, or in a building where you have
often been before) (r ¼ 0.18). These items were
removed and the analyses repeated resulting in a
Cronbach’s alpha of 0.92, with all items showing a
corrected item-total correlation of at least 0.3,
indicating strong internal reliability.
A factor analysis of the remaining 25 items was
carried out for the healthy controls (n ¼ 98). A
principal components analysis using a varimax
rotation produced a 5-factor solution, which ex-
plained 61% of the variance. Results are shown in
Table II.
Comparisons across three groups
Overall scale totals and all remaining 25 items were
compared across the three groups using one-way
analyses of variance (total scores are shown in Table
I). Levene’s test for homogeneity of variance was
violated for all the items, therefore the more
conservative Welch test for significance was used,
and the Bonferroni post hoc test, to allow for
multiple comparisons. There were significant differ-
ences between the three groups for total EMQ score
(p 5 0.001) indicating that the scale is sensitive to
differences in memory between the groups. Bonfer-
roni post hoc analysis indicated that 5 items did not
differentiate between the 3 groups (1,7,10,21,26).
Low occurrence was taken into account by
identifying low scoring items across the 3 groups.
Low scoring was defined as (a) having item means
lower than the total scale mean for all 3 groups, and
(b) less than 20% of each group scoring 3 – 4 for the
item. Nine items were identified as low scoring using
these criteria (2,3,4,12,21,22,23,26,27). Both of
these sets of items were removed, leaving a 13-item
scale (see Appendix 1).
Participants’ total scores on the questionnaire,
summed over all 13 items, ranged from 0 – 41, with a
mean total of 9.75 (SD 8.6) (n ¼ 98). Cronbach’s
alpha for the scale was high (0.89), and all items

Table II. Loadings from initial factor analysis, healthy-control sample.

Factor 1 Factor 2 Factor 3 Factor 4 Factor 5

Item Loading Item Loading Item Loading Item Loading Item Loading

1 0.46 9 0.48 2 0.65 10 0.73 23 0.79

4 0.53 17 0.43 3 0.71 12 0.77 24 0.54
5 0.67 22 0.47 20 0.48 16 0.50
6 0.73 26 0.72 21 0.48
7 0.77 27 0.85
8 0.81 28 0.58
13 0.63
14 0.77
15 0.73
18 0.58
 118 J. Royle & N. B. Lincoln
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showed a corrected item-total correlation of at least
0.3, indicating strong internal reliability.
A principal components analysis estimating factors
by a scree plot with Eigenvalues over 1, using an
oblimin rotation suggested 3 factors explaining 62%
of the variance. Correlations among the 3 factors
were low to moderate, ranging from 0.20 – 0.48.
Table III shows the final factor pattern matrix,
together with means and communalities for indivi-
dual items. All factors have at least two items with
loadings of 0.5 or greater. Based on the items with
the heaviest loadings, the following interpretations
are offered for two of the three factors:
Factor 1: Retrieval. Similar to Cornish’s ‘retrieval’, items
in this factor concern failing to recall recent events
(5,6,8,15) retrieving words from memory (13) and
prospective memory (14,18). Indications are that these
memories are stored and accessed with prompts, but
retrieval without prompts is unreliable.
Factor 2: Attentional tracking. All four items in this factor
(16,17,20,28, and associated links with 18 and 9)
concern losing track in conversation or when reading,
suggesting an attentional or working memory problem.
Items in factor 3 share little in common and there
is no clear interpretation of the processes involved in
both.
Comparisons across 3 groups: 13-item scale
A one-way analysis of variance was carried out
comparing the whole 13-item scale, and the three
factors. Factor scores were calculated by totalling
the items in each factor, weighting them equally.
As variances were not homogeneous, the more
conservative Welch statistic was used. Bonferroni
post hoc tests were used for multiple comparisons
between groups. Results are shown in Table IV.
Results show highly significant differences be-
tween groups for the revised scale, and for each
factor, with stroke patients scoring the highest
overall. Bonferroni tests also showed significant
differences between groups for all combinations
except between MS and stroke patients for Factor
2, and between healthy controls and MS patients for
Factor 3. Generally, Factor 1 represents the highest
scoring items and Factor 3 the lowest. MS patients
scored highest for Factor 1 (retrieval) and Factor 2
(attentional tracking). Stroke patients scored highly
for all three.
Pearson Product Moment correlations were cal-
culated between the original 28-item and the revised
13-item scales across all 3 groups. The two versions
were very highly significantly correlated, for the
whole sample r ¼ 0.97, p 5 0.001; and each group
(healthy control r ¼ 0.97; p 5 0.001; MS r ¼ 0.98;
p 5 0.001; stroke r ¼ 0.94; p 5 0.001).
Discussion
The main aims of this study were to determine the
psychometric properties of the 28-item EMQ (five
response category version) for healthy participants
and participants with memory problems. These
analyses were then drawn upon to revise the ques-
tionnaire, resulting in a 13-item questionnaire with
potential to be used as a valid and reliable measure of
individuals’ beliefs about memory performance
in everyday life. The psychometric properties of the
28-item questionnaire were explored using the
healthy control group (n ¼ 98). Initial reliability

Table III. Mean scores and factor loadings in the three-factor solution (direct oblimin rotation).

Scores

Orig. No. Factor and abridged item Mean SD Communalities

Factor 1: Retrieval
5 Having to check whether you have done something 1.34 1.2 0.59
6 Forgetting when it was that something happened 1.04 1.2 0.66
8 Forgetting that you were told something yesterday 0.96 1.1 0.71
13 Finding that a word is ‘on the tip of your tongue’ 1.36 1.2 0.61
14 Completely forgetting to do things you said you would 0.67 1.0 0.75
15 Forgetting important details of what you did 0.48 1.0 0.68
18 Forgetting to tell somebody something important 0.70 0.9 0.62
Factor 2: Attentional Tracking
16 When talking to someone, forgetting what you just said 0.90 1.1 0.61
17 When reading a paper, being unable to follow the story 0.47 0.7 0.43
20 Getting the details mixed up 0.40 0.7 0.54
28 Repeating to someone what you have just told them 0.60 1.0 0.64
Factor 3:
9 Starting to read something you have read before 0.39 0.7 0.58
24 Forgetting where things are normally kept 0.44 0.9 0.70

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Table IV. Comparison of three groups on the 13-item scale and
three factors.
Healthy
control MS Stroke
Mean SD Mean SD Mean
Revised scale*** 0.75 0.66 1.11 0.95 1.51
Factor 1*** 0.94 0.87 1.31 1.1 1.82
Factor 2*** 0.59 0.65 1.011 1.0 1.281
Factor 3*** 0.411 0.64 0.611 0.91 1.02
Note: ***p 5 0.001: 1post hoc tests not significant.
analyses indicated internal reliability that was im-
proved by removal of three items (11,19,25). Initial
factor analyses on the remaining 25-item scale
yielded results that differed somewhat from previous
findings [17,22,23], although there was some con-
sistency with Cornish’s [23] study with a ‘General
memory’ factor (incorporating a combination of
Cornish’s ‘Retrieval’ and ‘Memory for activities’);
and a ‘Visual attention’ factor (incorporating a com-
bination of Cornish’s ‘Task monitor’ and ‘Spatial
memory’).
It may be that differences in sample, recruitment
and methodologies could explain differences in
factor structures identified. However, if everyday
memory abilities involve different cognitive domains,
consistency would be expected regardless of the
sample studied. These results indicate that the
questionnaire used with a non-clinical population
does fairly reliably and consistently differentiate
between two broad systems of memory and atten-
tion, with some differentiation of visual versus verbal,
or language systems.
The main aim of this study was to develop a
reliable and valid clinical tool. A 13-item scale was
developed. Reliability analyses indicated strong
internal reliability with good correlations between
each item and the item total. Further factor analyses
of the revised scale carried out using the healthy
control group indicated a three-factor solution. The
first, and strongest, factor ‘Retrieval’ showed marked
similarities with the original ‘General memory’ factor
for the full scale, and Cornish’s [23] ‘Retrieval’ factor
(items 6,8,13,14,15). All of these items involve a
distinct memory failure, suggesting a failure of a
retrieval system (i.e., failing to recall without
prompt). The second factor ‘Attentional tracking’
included four items all involving attention, mostly
verbal, with one visual item (item 17). This factor has
some concordance with the original ‘Visual atten-
tion’ factor (items 17 and 28) and Cornish’s
‘Conversational monitor’ (items 20 and 28). The
third factor showed the strongest overlap with
Eflikides et al.’s [17] ‘Visual reconstruction’ (items
9 and 24) but no similarities were found with
The Everyday Memory Questionnaire – revised 119
Richardson and Chan’s [22] study, despite including
a similar clinical group. It is not clear what the
common elements to this factor are but it could be
retained pending further clarification.
As with the original questionnaire, the factor
SD
analysis of the revised scale broadly differentiated
0.86 between memory and attentional systems. A com-
0.98 parison of means across the three groups (clinical
0.97
and healthy control) showed that the 13-item scale
1.02
differentiated between the groups, with the stroke
group scoring highest overall, for the total score and
factor totals. Analyses indicate that ‘Retrieval’ and
‘Attentional tracking’ factors best differentiated
between both clinical and the healthy control group.
Further evidence of the validity of the revised scale
was confirmed by the strong relationships between
the original and revised versions, suggesting that the
revised 13-item questionnaire could provide a valid
and reliable tool for clinical use as a measure of
individual’s attitudes and beliefs about memory
difficulties, with some differentiation between
memory and attentional problems.
It is important to take into account methodological
limitations when considering these results. A retro-
spective analysis was used, including data from two
previous studies. The healthy control sample was
drawn from relatives of patients in the MS study, and
therefore presented a reasonable match for the MS
patients, but it would have been preferable to have an
additional well-matched control sample for the
stroke group. We have little demographic informa-
tion, and there were differences in sample sizes and
significant age differences between the stroke and the
other two groups. The stroke sample was signifi-
cantly older than the healthy control or MS groups.
However, age alone would not be expected to affect
the factor structure of the scale. Formal memory
assessment would have further informed results,
providing information on the nature of any memory
impairment, as the healthy control group, in parti-
cular, may have had previously unrecognised
memory difficulties.
In addition, there were differences in the method
of administering the EMQ. It was sent out as postal
questionnaires to stroke patients, whereas it was
administered by a researcher who was known to MS
patients and their families. However it would be
expected that the items would retain their relation-
ships with each other even though the levels of
impairment may differ.
This analysis has yielded a revised, shortened
version of the EMQ, with sound psychometric
properties. The questionnaire provides a potentially
useful clinical tool, to explore subjective report and
beliefs about memory and attentional difficulties with
a range of clients. It is short and therefore more likely
to be used in clinical practice than the original
 120 J. Royle & N. B. Lincoln
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version. It may also provide a useful aid to engage-
ment in therapy or rehabilitation, as a systematic
method of gathering subjective perceptions and
beliefs about difficulties.
Further research is needed to directly compare
report using the EMQ-R to formal assessment of
memory and attention, using both traditional and
more ecologically valid assessment tools, such as
the RBMT [27] or the Test of Everyday Attention
[28]. Finally, further concurrent validity is needed,
comparing results from the EMQ-R with similar
questionnaires, such as the Cognitive Failures
Questionnaire [9] and the Cognitive Difficulties
Scale [29], which both measure similar constructs.
In addition an assessment of test-retest reliability is
essential if the EMQ-R is used as a measure of
change, for example following rehabilitation The
reliability of the full EMQ has been found to be good
(r ¼ 0.85) [17] but further studies are needed.
References
1. Sunderland A, Harris JE, Baddeley AD. Do laboratory
tests predict everyday memory? A neuropsychological study.
J Verbal Learning Verbal Behav 1983;22:727 – 738.
2. Chaytor N, Schmitter-Edgecombe M. The ecological validity
of neuropsychological tests: A review of the literature on
everyday cognitive skills. Neuropsychol Rev 2003;13:181 –
197.
3. Higginson CI, Arnett PA, Voss WD. The ecological validity of
clinical tests of memory and attention in multiple sclerosis.
Arch Clin Neuropsychol 2000;15:185 – 204.
4. Hickox A, Sunderland A. Questionnaire and checklist
approaches to assessment of everyday memory problems. In:
Crawford JR, Parker DM. editors. A Handbook of Neurop-
sychological Assessment. Mahwah, NJ: Lawrence Erlbaum
Associates; 1992. pp 103 – 114.
5. Ruisel I. Memory rating. Studia Psychologica 1991;33:71 –
77.
6. Larrabee GJ, Crook TH. The ecological validity of memory
testing procedures: Developments in the assessment of every-
day memory. In: Sbordone RJ, Long CJ, editors. Ecological
validity of neuropsychological testing. Delray-Beach FL: GR
Press/St Lucie Press; 1996. pp 225 – 242.
7. Sunderland A, Watts K, Baddeley AD, Harris JE. Subjective
memory assessment and test performance in elderly adults.
J Gerontol 1986;41:376 – 384.
8. Schlechter TM, Herrman DJ, Sronach P, Rubenfeld L,
Zenker S. Metamemory Questionnaires. Paper presented at
the American Educational Research Meeting, New York;
1982.
9. Broadbent DE, Cooper PF, Fitzgerald P, Parkes KR. The
cognitive failures questionnaire (CFQ) and its correlates. Br J
Clin Psychol 1982;21:1 – 16.
10. Herrman DJ. Know thy memory: The use of questionnaires
to assess and study memory. Psychological Bull 1982;92:
434 – 452.
11. Sunderland A, Harris JE, Gleave J. Memory failures in
everyday life following severe head injury. J Clin Neuropsy-
chol 1984;6:125 – 141.
12. Tinson DJ, Lincoln NB. Subjective memory impairment after
stroke. Int Disabil Stud 1987;9:6 – 9.
13. Boake C, Freeland JC, Ringholz GM, Nance ML, Edwards
KE. Awareness of memory loss after severe closed head injury.
Brain Inj 1995;9:273 – 283.
14. Goldstein LH, Polkey CE. Everyday memory after unilateral
temporal lobectomy or amygdalo-hippocampectomy. Cortex
1992;28:189 – 201.
15. Quemada JI, Cespedes JMM, Ezkerra J, Ballesteros J, Ibarra
N, Urruticoechea I. Outcome of memory rehabilitation in
traumatic brain injury assessed by neuropsychological
tests and questionnaires. J Head Trauma Rehabil 2003;18:
532 – 540.
16. Seltzer B, Vasterling JJ, Hale MA, Khurana R. Unawareness
of memory deficit in Alzheimer’s disease: Relation to mood
and other disease variables. Neuropsychiatry, Neuropsychol
Behav Neurol 1995;8:176 – 181.
17. Eflikides A, Yiultsi E, Kangellidou T, Kounti F, Dina F,
Tsolaki M. Wechsler Memory Scale, Rivermead Behavioural
Memory Test and Everyday Memory Questionnaire in healthy
adults and Alzheimer’s patients. Eur J Psychological Assess
2002;18:63 – 77.
18. Stewart FM, Sunderland A, Sluman SM. The nature and
prevalence of memory disorder late after stroke. Br J Clin
Psychol 1996;35:369 – 379.
19. Towle D, Edmans J, Lincoln NB. Use of computer presented
games with memory impaired stroke patients. Clin Rehabil
1988;2:303 – 308.
20. Lincoln NB, Dent A, Harding J, Weyman N, Nicholl C,
Blumhardt LD, Playford ED. Evaluation of cognitive assess-
ment and cognitive intervention for people with multiple
sclerosis. J Neurol, Neurosurg Psychiatry 2002;72:93 – 99.
21. Richardson JTE. Memory impairment in multiple sclerosis:
Reports of patients and relatives. Br J Clin Psychol 1996;35:
205 – 219.
22. Richardson JTE, Chan RCB. The constituent structure of
subjective memory questionnaires: Evidence from multiple
sclerosis. Memory 1995;3:187 – 200.
23. Cornish IM. Factor structure of the everyday memory ques-
tionnaire. Br J Psychol 2000;91:427 – 438.
24. Sunderland A, Harris JE, Baddeley AD. Assessing everyday
memory after severe head injury. In: Harris JE, Morris PE,
editors. Everyday memory, actions, and absentmindedness.
London: Academic Press; 1984. pp 193 – 212.
25. Kline P. The handbook of psychological testing. London:
Routledge; 1993.
26. Kline P. An easy guide to factor analysis. London: Routledge;
1994.
27. Wilson BA, Cockburn J, Baddeley AD. The Rivermead
Behavioural Memory Tests. Bury St Edmunds, UK: Thames
Valley Test Company; 1984.
28. Robertson IH, Ward T, Ridgeway V, Nimmo-Smith I. The
test of everyday attention. Bury St Edmunds, UK: Thames
Valley Test Company; 1994.
29. McNair D, Kahn R. The cognitive difficulties scale. In: Crook
T, Ferris S, Bartus R, editors. Assessment in geriatric
psychopharmacology. New Canaan, CT: Mark Powley and
Associates; 1983. pp 137 – 143.
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Appendix 1
Everyday Memory Questionnaire – Revised
Instructions
Below are listed some examples of things that happen to people in everyday life. Some of them may happen
frequently and some may happen very rarely. We should like to know how often on average you think each one
has happened to you over the past month. Write the appropriate letter in the box beside the item.

A. Once or less in the last month.

B. More than once a month but less than once a week.
C. About once a week.
D. More that once a week or less than once a day.
E. Once or more in a day.

1. Having to check whether you have done something that you should have done.
2. Forgetting when it was that something happened; for example, whether it was
yesterday or last week.
3. Forgetting that you were told something yesterday or a few days ago, and maybe
having to be reminded about it.
4. Starting to read something (a book or an article in a newspaper, or a magazine)
without realizing you have already read it before.
5. Finding that a word is ‘on the tip of your tongue’. You know what it is but cannot
quite find it.
6. Completely forgetting to do things you said you would do, and things you planned
to do.
7. Forgetting important details of what you did or what happened to you the day
before.
8. When talking to someone, forgetting what you have just said. Maybe saying
‘what was I talking about?’
9. When reading a newspaper or magazine, being unable to follow the thread of a story;
losing track of what it is about.
10. Forgetting to tell somebody something important, perhaps forgetting to pass on a
message or remind someone of something.
11. Getting the details of what someone was told you mixed up and confused.
12. Forgetting where things are normally kept or looking for them in the wrong
place.
13. Repeating to someone what you have just told them or asking someone the same
question twice.

Please check that you have put a letter in EVERY box. THANK YOU.

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