This paper uses data from four studies (N = 150, 150, 154 and 79) to examine the associations between hypochondriacal concerns (HCs) and stress appraisals (primary and secondary). A search activity account of HCs suggests that increased levels of HCs should be associated with positive appraisals of a stressful situation (i.e., increased levels of perceived challenge and perceived control). However, the results indicated that in terms of primary appraisals, increased perceptions of threat and not challenge were consistently associated with increased levels of HCs. Further, the results indicated that the association between threat and HCs is mediated by somatosensory amplification. Consistent with the search activity account it is shown that increased levels of perceived control (secondary appraisals) are associated with increased levels of HCs. The association for perceived control remains once variance due to somatosensory amplification is partialled and generalizes to a sample of patients with a sexually transmitted infection. The results are interpreted in relation to the transactional model of the stress process.