This has been a really noticeable change since the patch. For some classes, it's not really an issue, but if you rely on your companion for tanking/damage soaking it can be big trouble.
Other than the possible increase in spike damage, I think that threat generation seems to be less reliable; even with Khem in threat-generation mode, my Lightning sorc seems to attrack a lot more grief than she used to, and I can't seem to shake that threat even if I'm not attacking. If I am getting hit by two silver enemies at once, the damage can quickly overwhelm my newly downgraded shield and healing abilities.